CCO Audit Lead

5 days left

Minneapolis, Minnesota
Apr 20, 2023
Jun 10, 2023
Employment Status
Full Time
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 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.


Work Location: Work from Home or Office for Your Day

Position Description

As the Configuration and Claims Operations (CCO) Audit Lead, you will be responsible to lead CCO's regulatory program, financial, and internal audit efforts in collaboration with business partners, key stakeholders, and external parties and under the direction of UCare's Audit Owner. Ensure requirements and solutions conform to departmental, corporate, industry and government standards as specified. Provide core project management functions through the lifecycle of each audit including, but not limited to, defining requirements, authoring project-related documents, managing communication, and assisting with implementation.

• Serve as Liaison and CCO Lead for internal compliance audits and external audits performed by UCare and Delegates.

• Responsible for responding to regulatory audits and compliance actions, working with CCO stakeholders to develop and monitor required corrective action plans.

• Serve as the CCO owner for all SOX and Model Audit Rule (MAR) controls, monitoring and reporting. Ensure controls are documented, audited, and reviewed annually. Develop new controls, as needed.

• Recommend procedure and process improvements to ensure regulatory requirements are met. Build and maintain robust audit material repository within department.

• Partner with Corporate Compliance, Government Relations, Legal, external agencies and regulatory bodies on audit risk related topics to ensure CCO and UCare remain in compliance.

• Identify and recommend opportunities for process improvement and risk control to CCO Leadership.

• Serve as an experienced and trusted advisor for audit & compliance matters within the CCO Department.

• Lead the execution of periodic team, process or department-level audits as required.

• Other projects and duties as assigned.


Bachelor's degree: demonstrated experience may be considered in lieu of degree.

Required Experience

5 years of experience in the healthcare industry. Demonstrated experience with Project Management methodologies. Prior Medicaid, Medicare, and/or Commercial regulatory experience. Experience with auditing and investigating company processes.

Preferred Experience

Master's Degree. CMS Program, Financial, and/or HEDIS Audit Experience. Familiar with Model Audit and SOX Controls.


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: 4/19/2023

Similar jobs

More searches like this

Similar jobs