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.
PROVIDER NETWORK PARTNERSHIPS MANAGER
Work Location: Office for Your Day
As the Provider Network Partnerships Manager, you will be responsible to lead and manage provider partnership contracts related to external delegated networks as well as networks contributing to UCare's business expansion. Reliable transportation for travel is required.
• Provide oversight of contracts for assigned delegates and providers. Ensure contract requirements are met and network access is available. Assess and revise contracts, workplans, materials and policies and procedures, as needed. Monitor all performance measures.
• Collaborate with Compliance and Government Relations to ensure State/Federal and Internal Reporting Requirements are met by assigned providers and delegates.
• Participate in audits and monitor corrective action plans, as needed.
• Partner with delegates to update annual benefit changes. Participate on annual benefits implementation workgroups, as needed. Identify, adjust or create contracting and operational processes needed to support introduction of new UCare products and/or implementation of new benefits for existing products. Monitor implementation and testing of benefit changes.
• Identify, recommend and implement opportunities to strategically partner with delegates or alternative solutions to meet member, product and regulatory needs.
• Collaborate with Business Development team to identify and assess contracting needs for business expansion opportunities outside Minnesota.
• Ensure provider contracts are secured for designated UCare growth/product expansions as assigned to meet network adequacy.
• Develop key provider partnerships within these assigned business opportunities, such as value-based contracts, to optimize financial and quality performance.
• Document and resolve issues identified by providers, delegates or internal stakeholders with engagement from other UCare departments, as needed.
• Coach, mentor and manage high-performing team to meet goals performance standards.
• Participate on assigned UCare committees and work groups to represent departmental interests.
• Support company and department strategic and operational efforts.
• Other projects and duties as assigned.
Bachelor's Degree in health care management or related field. Master's degree preferred.
Six years of Network Management/Provider relations. Demonstrated ability to successfully and strategically work in matrixed/cross-departmental environments. Demonstrated staff supervisory/management experience.
Previous involvement with Medicare, Medicaid, and commercial insurance products/programs, either from the provider or payer perspective. Experience developing reimbursement strategies and an understanding of the relationship of provider reimbursement to health care costs.
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: 5/31/2023