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.
CONFIGURATION & CLAIMS OPERATIONS BUSINESS ANALYST SENIOR
Work Location: Work from home or Office for Your Day
As the Configuration & Claims Operations (CCO) Business Analyst Senior, you will be responsible to identify, plan and execute process, product or functional analysis for the purpose of identifying root cause issues, mitigating risk and optimizing department performance. Serve as the department's single point of contact for cross functional projects, workgroups, and committees. Collect and analyze data and report findings and recommendations. Plan, elicit and document requirements; make recommendations for change in order to improve provider and/or member experience and enhance department efficiency. Serve as liaison between the Business Analysis team and other CCO teams and departments within UCare. Work alongside business and technical teams to triage and troubleshoot solutions pre- and post-implementation. Ensure requirements and solutions conform to departmental, corporate, industry and government standards as specified. you will work alongside the business to support business process changes and/or related configuration requirements to ensure the payer system processes and pays claims accurately.
• Collaborate with business and technical stakeholders to perform analysis, define business requirements, and implement innovative solutions that solve business problems and support CCO Department Plan.
• Serve as the CCO single point of contact for company-wide initiatives, workgroups, and committees.
• Conduct post-production analysis to ensure changes are operating as intended. Measure improvements.
• Collaborate with CCO Leadership to identify and implement repeatable and sustainable process improvement efforts involving enhancements to end-to-end CCO processes and supporting systems and vendors to increase department effectiveness and efficiency. Supporting systems and vendors include but are not limited to: Electronic Data Interface (EDI), Optum, Macess/EXP, O'Neil, Formworks, ChangeHealth, Amisys, and HealthRules.
• Gather, document, and translate business requirements to ensure seamless transition to IT development, vendor or CCO configuration teams.
• Maintain a comprehensive, sustainable business process and work collaboratively with teams to support CCO goals and objectives. Collaborate with PMO Business Analysts to ensure utilization of best practices and appropriate methods and tools. Participate in the UCare Business Analysis Community of Practice.
• Support the analysis needs of the HealthRules System Management Team. Analyze data and present findings and recommendations for approval.
• Ensure seamless cross-functional communication through the use of standard workflow tools such as ServiceNow and Macess/EXP.
• Coordinate key vendor and business analysis activities.
• Committee and/or work group representation as defined by manager.
• Other projects and duties as assigned.
Bachelor's degree in business preferred; demonstrated experience may be considered in lieu of degree.
Five years of business analysis experience. Proven facilitation skills. Strong analytical and critical thinking skills. Strong written and verbal communication skills.
Health Plan Operations experience, specifically related to Claims Processing; Experience with the HealthRules payer platform, Project Management, Microsoft Project, Visio, and/or SharePoint.
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: 4/5/2023