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 TRIAGE SPECIALIST
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.
As a Provider Triage Specialist, you will be responsible for supporting UCare's efforts in delivering an excellent provider experience. Escalate systemic issues, identify risks and determine barriers in addition to supporting key provider relationships through collaboration with operations staff within provider organizations. Document issues related to research, tasks and decisions while keeping impacted providers informed of process. Apply strong critical thinking, project management and claims payment skills to conduct root cause analysis when resolving systemic payment and service issues.
• Collaborate daily with internal staff and providers to effectively resolve systemic provider issues in a timely manner.
• Document, research and resolve provider systemic problems, including issues that impact more than one provider, key UCare providers and BPO Clients (Business Process Outsourcing), with a focus on CareSystems.
• Communicate, prioritize and monitor work needed from various areas within UCare to resolve systemic and DHS provider issues through the use of project management skills.
• Ensure providers impacted by an issue are routinely informed about the progress toward resolution, which may include participation in face-to-face meetings when applicable.
• Develop summaries, reports and other documentation regarding provider systemic issue resolution at UCare for a variety of audiences.
• Share provider experience within UCare to support efforts to improve our work with provider partners.
• Engage leadership regarding barriers to addressing systemic issues in a timely manner or for any other guidance in advancing systemic issue resolution.
• Identify and communicate trends in provider systemic issues to support process improvements, provider education and corporate compliance activities, as needed.
• Other projects and duties as assigned.
Bachelor's degree; demonstrated experience may be considered in lieu of a degree.
Three years of experience in health care billing and/or payment setting. Examples include health plan claims processing, provider assistance center, provider network management or account management.
Provider services experience. Knowledge of health care claims processing and systems with State Public Programs, Medicare and commercial health plan products. Project management and critical thinking experience. SharePoint and Microsoft software proficiency.
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: 1/18/2023