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.
CONFIGURATION & CLAIMS OPERATIONS (CCO) DIRECTOR - CONFIGURATION & BUSINESS DELIVERY
Work Location: Office for your Day
As the Configuration & Claims Operations Director (CCO) - Technical & Business Delivery, you will be responsible to oversee and continuously improve the Technical Teams within the CCO Department including end-to-end lifecycle of a claim and configuration. Actively manage relationships with CCO's delegate and vendor relationships providing oversight and guidance to ensure maximum value, efficiency, and quality of services. You will evaluate and recommend new solutions and services to meet the frequently changing business, market, and regulatory needs of the organization. Provide oversight and business ownership responsibility of applicable portfolio and department projects, ensuring timely and effective delivery. Lead and improve department performance through analyzation, automation, measurement, scaling and improving processes in support of UCare and CCO's Strategic Plans.
• Accountable for the development, maintenance, and continual improvement of CCO work intake and workflow processes, including prioritization, issues and escalation, communication and determination of analytical rigor required.
• Accountable for the development and maintenance of the CCO process architecture, CCO policies, controls, and audits. Ensure that processes, policies, and procedures adhere to contractual and regulatory requirements and support efficiency of CCO operations.
• Responsible for business ownership and oversight of applicable portfolio and department projects, ensuring timely and accurate delivery, addressing roadblocks and issues, and resource needs.
• Build and maintain business vendor partnership and framework ensuring continuous improvement, best practices, accountability, and maximum value gained.
• Build and provide oversight of resource and workforce management framework, including but not limited to capacity and forecast planning to support project work.
• Responsible for oversight and delivery of solutions across the lifecycle of claims and configuration including established governance, control, and approval processes are followed.
• Accountable for the budget management and coordination of CCO technical business resources, projects, and contracts.
• Build, maintain, and provide oversight of roadmaps for CCO business systems, projects, contracts and other high-priority initiatives.
• Prioritize portfolio projects and roadmap technical work, projects, resources, and implement processes to transition work to run the business functions and planning.
• Develop and manage strategic partnerships with IT and business leaders to align processes and strategies to improve all areas of oversight responsibility.
• Develop, plan, and execute on department plans and actions that are integrated with other departments and support the corporate strategic plan and UCare prioritized projects and initiatives.
• Oversee development, planning, and execution of all training, development and mentorship of staff. Evaluate, develop, and execute on leader training and development.
• Select, train, develop and evaluate staff and leaders to ensure desired performance. Establish and communicate clear performance standards across all teams and functions, ensuring standardized staff monitoring and performance evaluation.
• Other projects and duties as assigned.
Bachelor's degree; Master's Degree preferred. Demonstrated work experience may be considered in lieu of a degree.
Seven years of experience with system development lifecycle. Three years' experience in Health Plan Operations. Vendor relationship management experience. Five years managerial/supervisory/leadership experience in a managed care organization or other health insurance environment.
Claims, Provider, and Member data experience. Business analysis, project management methodologies, and process improvement experience.
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: 07/13/2023