Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 13 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
PROVIDER CONTRACT MANAGER
Work Location: Office for Your Day
The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.
This position is responsible to develop, implement and manage contracting activities for hospital, professional, vendor, care system and/or ancillary providers. Including; development and execution of negotiation strategies, expansion efforts, special initiatives and building and preserving strong provider relationships. This position requires reliable transportation for travel throughout the state.
• Lead and coordinate contract negotiations and contracting processes for provider partners, including contract completion. Develop documentation that allows contractual terms to be implemented in the system timely and accurately. Ensure contracts and payment terms are negotiated in accordance with established contract administration policies and procedures, including state, federal, and other regulatory requirements.
• Coordinate regularly scheduled meetings with contracted providers to provide timely communication, effective education and enhanced provider relationships. Effectively problem solve and triage issues, where appropriate.
• Assist in the development and maintenance of provider contracts to ensure adequate coverage for all products. Initiate and orchestrate provider recruitment, contracting, and related development efforts.
• Review standard reports and contracting models to monitor providers, negotiate rates and/or manage network performance.
• Participate on internal workgroups to address ongoing provider issues or operational changes.
• Other projects and duties as assigned.
Bachelor's degree in health care management, business or related field; demonstrated experience may be considered in lieu of degree.
Three years of contract negotiation and health care experience in an HMO, commercial health insurance, Medicare or Medicaid health delivery system, large physician practice or other health care provider setting. Knowledge of managed care operations.
Knowledge of local provider market.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 11/15/2022