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.
MENTAL HEALTH & SUBSTANCE USE DISORDER SERVICES COMPLIANCE & REGULATORY SUPERVISOR
Work Location: Work from home. Must be within a commutable distance to attend in-person meetings as necessary.
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 the Mental Health & Substance Use Disorder Services (MH & SUDS) Compliance and Regulatory Supervisor, you will be responsible to oversee daily operations of the team and refer department issues to the MH & SUDS Oversight Senior Manager. Participate in hiring and direct supervision of staff. You will collaborate with the MH & SUDS Oversight Senior Manager to coordinate new employee orientation and evaluate staff development needs. Mentor, coach, and evaluate individual staff performance. You will participate in planning, implementation, and evaluation of compliance and regulatory activities to ensure quality services and compliance with contractual requirements. Participate in and/or lead audit activities across all products. In addition, you will also participate in delegate meetings related to audit and oversight activities.
• Oversee the development and performance of audit and regulatory activities across products including department reporting and project management. Serve as the main point of contact for the organization regarding any audit and/or regulatory questions, issues or requirements on behalf of MH & SUDS.
• Research and assist in interpreting NCQA, CMS, State and Commercial regulatory requirements. Keep current on all applicable regulatory requirements and industry trends and occurrences. Present compliance and regulatory related topics to other departments (e.g., policy and procedure requirements, Mental Health Parity) and train staff on compliance related matters as needed.
• Provide oversight, direction and leadership for Mental Health Parity compliance including keeping evaluation documents up to date and coordinating with stakeholders throughout the organization including the Compliance department and the Government Relations department.
• Participate in the development, training and supervision of the oversight team, including, but not limited to the development of audit materials, reporting and development of training process for new hires.
• Lead the creation and maintenance of tools for delivering department dashboards including analytical data and status reports to internal and external clients including working with other partners.
• Conduct regularly scheduled one-on-ones with staff at a minimum frequency of monthly, to review and evaluate appropriateness and to provide support for staff activities. Schedule regular team meetings and assist with problem solving complex issues that may arise.
• Participate in administrative meetings as assigned by the Oversight Senior Manager.
• Establish positive working relationships with management to provide input on risks and controls and ensure a sustained understanding of compliance and regulatory requirements while maintaining independence and objectivity.
• Utilize project management techniques to assess program risks, monitor and facilitate task completion, apply appropriate escalation to remove barriers, and ensure projects achieve desired compliance program objectives.
• Utilize data analytics to monitor and trend specific compliance and regulatory requirements for key areas. Work with various business units and systems to identify and develop effective data mining practices as a means to improve proactively monitoring operational compliance with key regulatory requirements.
• Other project and regulatory duties as assigned.
Mental Health Professional or RN with requisite experience. Current and unrestricted license in Minnesota required.
Three years' experience in a managed care organization, quality management program in a health care setting or other related experience. Experience working with and interpreting state and federally funded program benefits, including Medicare and Medicaid are required. Experience with health care-related regulatory compliance, auditing, or surveying.
Experience in project management, accreditation survey preparation process, data collection, report writing, and basic data analytic skills. Experience with application of NCQA Federal and state regulatory standards. Supervisory experience preferred.
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: 1/20/2023