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.
COMPLIANCE SPECIALIST - REGULATORY
Work Location: Office for Your Day
This position is responsible to provide support to the Compliance Program by supporting the Regulatory Change Management (RCM) and Incident Management functions. This includes Compliance360 reporting, monitoring various compliance incident reporting mechanisms, and assigning and tracking incidents. Regulatory Change Management is the framework for supporting and monitoring the delivery of changes driven by new regulations. In this role, you will provide RCM program support, reporting, and prioritization based on risk and escalation, as needed.
• Monitor compliance incidents reported through a variety of sources, including the Compliance Hotline, compliance email box and other methods for reporting compliance. This includes Fraud, Waste and Abuse (FWA) concerns. Gather pertinent information, including reaching out to reporter if needed, and document the information in the appropriate tracking system. Exercise initiative and sound judgment in responding to reported compliance incidents, including FWA leads, promptly in accordance with established policies and procedures, and if unable or unqualified to assist, promptly refer the incident to the appropriate Compliance or Special Investigations Unit (SIU) staff for handling.
• Assign reported compliance incidents to appropriate staff for investigation. Assist the Compliance Associate Director, Audit Director and SIU in following up on investigations and assuring appropriate documentation is maintained.
• Support Regulatory Change Management (RCM) Council activities by attending meetings and preparing meeting materials, presenting on monitoring activity as needed, taking meeting minutes, assisting with the agenda, maintaining Council documents, artifacts, and reporting.
• Create and maintain effective reports and dashboards to reflect current status of open implementations and assignment of business owners. This includes the maintenance of tools and shared resource sites.
• Assist the Compliance Associate Director in creating and maintaining a variety of compliance-related reports for various compliance governing bodies including the Compliance Oversight Committee, Regulatory Change Management Council, and the Council and Compliance Committee of the Board. When reports require data from other departments (e.g., the Compliance Monitoring Dashboard), ensure data is received timely, following up with departments as necessary.
• Maintain Compliance Program policies and procedures on designated SharePoint site related to Regulatory Change Management, Incident Management, and additional Compliance Program policies, as needed.
• Support the Regulatory Change Management function by tracking assignments and activity, activity completion, and monitoring. Maintain documentation and artifacts on various Compliance Program tools and resources including Compliance360, SharePoint and Microsoft Teams sites. Provide consultation to business owners and liaisons as needed to assist with the development of implementation plans including associated compliance reporting and monitoring elements, maintain a current status of action plan progress, conduct risk assessments against progress, validate implementation completion and escalate when necessary.
• Work collaboratively with business leaders and liaisons as appropriate to ensure guidance and reporting needs are met. Provide consultation on non-compliant assessment results and escalate those at risk.
• Review and provide support, issue identification, trending and recommendations on interventions on various Compliance monitoring projects.
• Build and leverage cross-functional relationships, influence and support a culture of compliance and ethics.
• Other projects and duties as assigned.
A Bachelor's degree: equivalent experience may be considered in lieu of degree.
Three years' experience working in a compliance role supporting a compliance program, regulations implementation and/or compliance assessments. Proficient PC skills required in Microsoft Office (Excel, Power Point. Teams and SharePoint).
Experience in health insurance and/or health care. Experience with Compliance360.
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: 12/13/2022