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.
MANAGER OF COMPLEX CASE MANAGEMENT
Work Location: Office for your Day or Work from Home
As the Complex Case Management Manager, you will be responsible for overseeing the complex case management program. Lead and develop strategies and align activities with the medical management strategy. You will support the development of the care model in accordance with population needs, managing care management daily operations, developing and monitoring outcome program metrics, monitoring compliance with regulatory agencies, contractual obligations regarding care management duties, collaboration with community partners and ensuring quality care management programming.
• Evolve and lead the complex case management team. Support growth and development of team skill sets, ensure operational preparedness, regulatory compliance, and individual/program performance management.
• Oversee day-to-day operational support and leadership of the complex case management program and functions. Monitor progress and make necessary adjustments to ensure timely and effective care delivery.
• Collaborate with clinical services leaders, health services leaders, medical directors, Heath Promotion and other UCare departments to facilitate effective program operations and utilization and case management.
• Establish key external stakeholder relations with providers, community resources, county contacts, etc. to advance the reach of the programs.
• Oversee the development of organizational and system procedures and use of data to drive population needs, develop and monitor key metrics, to include social factors impacting health, to evaluate care management processes/interventions.
• Perform continuous and iterative PDSA regarding key metrics and policies/procedures. Adheres to DHS/NCQA/CMS standards to achieve the goals and business objectives of the programs.
• Lead and/or participate in work groups and committees as assigned.
• Participate in the selection and orientation of assigned staff to ensure appropriate screening, hiring, and effective selection of staff members.
• Provide training, supervision, and staff development to enhance the knowledge and skills of Complex Case Managers. Train staff on requirements for products and corresponding processes, establish regularly scheduled one-on-on meetings at a minimum frequency of monthly to review and evaluate staff performance, establish regularly scheduled team meetings, assist with problem solving. Coordinate new employee orientation and evaluate additional staff development needs.
• Represent UCare as an active member of complex case management related work groups, sub-committees, interactions with regulators, and special projects. Some travel may be required.
• Other projects and duties as assigned.
Bachelor's degree in nursing or related field. Master's degree preferred. Unrestricted and current Minnesota licensure in field of study (as appropriate).
Five years of experience in health care industry in both provider and managed care healthcare environments. Two years supervisory or other leadership roles.
Knowledge of payer and provider utilization and case management. NCQA experience, Community-based experience in Medicaid, Medicare and Commercial plans a plus. Certified Case Manager.
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: 10/27/2023