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 14 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.
CLINICAL CARE SYSTEM LIAISON - MEDICARE
Work Location: Work from Home or Office for Your Day
As the Clinical Care System Liaison - Medicare, you will be responsible to create and conduct care system product trainings related to Medicare Advantage for internal staff, external customers, counties, delegates, community groups and stakeholders. You will be responsible for developing strong partnerships and serving as a key contact for delegated entities, counties, and community groups regarding UCare products and case management processes including changes in process and regulatory expectations. In addition, the position is also responsible for developing and facilitating pilots and initiatives based on data about the needs of the population.
• Serve as the primary contact for UCare Medicare case management delegates. Be the primary point of contact for clinical and regulatory questions and concerns as they relate to UCare products. Lead delegate and at-risk relationships, including oversight, answering questions, facilitating meetings, participate in and present training materials and prepare communications.
• Develop outcome measures for delegates that reflect accountabilities for improved care management standards. Facilitate outcome-oriented data focused discussions regarding outcome measures that shift accountability to the delegate to support improved audit and financial results.
• Serve as support to PMAP team to assist with delegate relationships, including but not limited to, oversight, answering questions, facilitating meetings, participate in and present training materials, and preparing communications.
• Create and disseminate delegate communications regarding case management responsibilities, outcome deliverables and changes. Serve as the lead contact for outreach activities to case management delegates. Develop, coordinate and serve as the main point of contact for all case management projects and innovative initiatives with counties and community stakeholders.
• Represent Clinical Services (CLS) in internal and external vendor, clinical partnerships and care system work groups or initiatives. Represent outcome measures by bringing data to the meetings to interpret and discuss trends.
• Participate in UCare Medicare/PMAP delegate and internal staff auditing. Including, but not limited to, presentation of audit results to internal and external partners, establishing audit timelines and protocols, as well as communication plan. Utilize audit findings to identify knowledge gaps with delegates/case managers and assist with closing identified knowledge gaps.
• Develop and maintain materials for vendors and delegates. This includes training material, such as requirements grids, work instructions, product information, case management manuals, newsletters, and other resources. Develop and maintain materials for the program to support regulatory requirements, including but not limited to, the previously mentioned vendor and delegate material, policies and procedures, care plans, and health risk assessments.
• Maintain a strong working knowledge of case management functions, requirements, and regulations. Provide subject matter expertise in case management responsibilities, processes, and resources.
• Develop, coordinate, and facilitate case management-related projects, including but not limited to; implementing new regulations, leading program evaluations and clinical innovations that support the population. Prepare and implement project plans, statements or work, and be able to interpret, prepare and speak to results of the projects.
• Collaborate with teams across the organization. Provide back-up support within the Oversight area of CLS, build positive working relationship with delegated entities and maintain those relationships with finesse and graciousness.
• Prepare monthly reports on activities and identify opportunities to increase efficiencies, productivity, and quality of work. Present findings and recommendations to CLS Leadership for approval. Be knowledgeable about the demographics that our delegate agencies work with and be prepared to support them with demographic specific resources, including social determinants of health.
• Must have reliable transportation as travel throughout the state of Minnesota is required. In-person trainings and meetings required.
• Other projects and duties as assigned.
Bachelor's degree in nursing preferred. Current unrestricted nursing license in Minnesota.
At least five years of case management or care coordination experience with at least two years of experience in training and/or regulatory background. Strong health plan, managed care, health services, or other related experience. Unrestricted driver's license due to training, travel requirements.
Experience working within a NCQA accredited product or program.
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: 5/18/2023