Location
Rothschild, WI, United States
Posted on
Aug 31, 2021
Profile
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare contract.u0026nbsp; The primary purpose of this leadership role is to provide coaching to team members on production of work, quality of their reviews and education delivery to providers.u0026nbsp; This role contributes to WPS by ensuring that our Medical Review strategy is implemented in accordance with Centers for Medicare u0026amp; Medicaid Services (CMS) guidelines to achieve award fee validation and contract reviewal.u0026nbsp; u003cstrongu003eThis is a hybrid role that will work from home and in the office.u0026nbsp; You will report to one of our WPS offices approximately 4 to 8 times a month.u003c/strongu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eMonitor team and individual quality and quantity metricsu003c/liu003enu003cliu003eCoach and train team membersu003c/liu003enu003cliu003eEnsure proper workload distribution and timely completionu003c/liu003enu003cliu003eEnsure provider education is delivered professionally and timelyu003c/liu003enu003c/ulu003enu003cpu003eu003cemu003eThis job profile is not intended to be an exhaustive list of all duties or responsibilities associated with the job. Other job-related duties may be assigned.u003c/emu003eu003c/pu003enu003cpu003eu003cstrongu003eThis role could be a good fit if you: u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eEnjoy leading and helping teams growu003c/liu003enu003cliu003eAre looking to move away from direct patient care and want to use your nursing knowledge in a new and different wayu003c/liu003enu003cliu003eAre technically strong on computersu003c/liu003enu003cliu003eDesire day hours with no on-call work, limited weekend work, and holidays offu003c/liu003enu003cliu003eAre process improvement minded and actively seek out ways to work smarter, not harderu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eYouu0026rsquo;ll benefit from this experience by:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eCollaborating with a team of both clinicians and non-cliniciansu003c/liu003enu003cliu003eBetter understanding how government contractors, like WPS Health Solutions, serve our Medicare beneficiariesu003c/liu003enu003cliu003eLearning about our Hyland OnBase tool which is our content management system used for viewing electronic recordsu003c/liu003enu003cliu003eHaving the opportunity to work in a hybrid role where you will work from home and in the officeu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eYou need to have: u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eBacheloru0026rsquo;s degree in related field or equivalent post high school and/or related work experienceu003c/liu003enu003cliu003e1 or more years of related work and/or leadership experienceu003c/liu003enu003cliu003eActive RN license, applicable to state of practiceu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eWe also prefer: u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eA minimum of 4 or more years of experience in clinical nursingu003c/liu003enu003cliu003eExperience leading a team of 10 or more members successfully either in-person or remotelyu003c/liu003enu003cliu003eBackground in Medicare principles and guidelinesu003c/liu003enu003cliu003eStrong computer skills including:nu003culu003enu003cliu003eAbility to utilize multiple screens and learn new applications with easeu003c/liu003enu003cliu003eIntermediate knowledge in MS Word and MS Excel (creating, sorting, and filtering spreadsheets)u003c/liu003enu003c/ulu003enu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eCompensation and Benefitsu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eEligible for annual Performance Bonus Programu003c/liu003enu003cliu003e401(k) with u003cstrongu003edollar-per-dollar match up to 6% of salaryu003c/strongu003eu003c/liu003enu003cliu003eCompetitive paid time offu003c/liu003enu003cliu003eHealth and dental insurance start u003cstrongu003eDAY 1u003c/strongu003eu003c/liu003enu003cliu003eVision insuranceu003c/liu003enu003cliu003eFlexible spending, dependent care, and health savings accountsu003c/liu003enu003cliu003eShort- and long-term disability, group life insuranceu003c/liu003enu003cliu003eDress for your dayu003c/liu003enu003cliu003eInnovative professional and cognitive development programsu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eWho We Areu003c/strongu003eu003c/pu003enu003cpu003eWPS Health Solutions is an innovator in health insurance and a worldwide leader in claims administration, serving millions of beneficiaries in the United States and abroad.u003c/pu003enu003cpu003eFounded in 1946, WPS offers health insurance plans for individuals, families, and seniors, and group plans for small and large businesses. We are a world-class claims processor and program administrator for the governmentu0026rsquo;s Medicare program. And we manage benefits for millions of active-duty and retired military personnel and their families.u003c/pu003enu003cpu003eWPS has been named one of the u003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eWorldu0027s Most Ethical Companiesu003csupu003eu0026reg;u003c/supu003eu003c/au003e by the Ethisphereu003csupu003eu0026reg;u003c/supu003e Institute for 10 years in a rowu003cstrongu003eu003cemu003e.u003c/emu003eu003c/strongu003eu003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eLearn more about WPSu003c/strongu003eu003c/au003eu003cstrongu003e. u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eOur Purpose and Valuesu003c/strongu003eu003c/pu003enu003cpu003eOur purpose is to make healthcare easier for those we serve. u003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eClick Hereu003c/strongu003eu003c/au003eu003c/pu003enu003cpu003eOur values u0026ndash; Customer Focused, Individual Responsibility, Mutual Respect, and Driven u0026amp; Passionate u0026ndash; are the core of who we are and how we conduct business every day.u003c/pu003enu003cpu003eu003cstrongu003eLinks and descriptions for:u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eHealth Insuranceu003c/strongu003eu003c/pu003enu003cpu003eWPS Health Insurance offers high-quality health insurance plans for individuals and families, Medicare supplement plans for seniors, and group health plans for businesses of every size.u003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003****and Veterans Healthu003c/strongu003eu003c/pu003enu003cpu003eWPS Military and Veterans Health administers claims and provides customer service and related activities for the U.S. Department of Defense and the U.S. Department of Veterans Affairs and their beneficiaries.u003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003****Health Administrators u003c/strongu003eu003c/pu003enu003cpu003eWPS Government Health Administrators manages Medicare Part A and Part B benefits for more than 7 million beneficiaries. As one of the largest contractors for the Centers for Medicare u0026amp; Medicare Services, weu0026rsquo;ve served Medicare beneficiaries and their health care providers since 1966.u003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003****Health Plan provides innovative and high-value health plans to groups and individuals in eastern and northeastern Wisconsin. With our quality Wisconsin-based customer service, Arise offers health care expertise with a personal touch.u003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003****Specialty Benefitsu003c/strongu003eu003c/pu003enu003cpu003eEPIC Specialty Benefits provides businesses group insurance products that cover:u003c/pu003enu003culu003enu003cliu003eLifeu003c/liu003enu003cliu003eDisabilityu003c/liu003enu003cliu003eDentalu003c/liu003enu003cliu003eVisionu003c/liu003enu003cliu003eVoluntary benefitsu003c/liu003enu003c/ulu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003****connected:u0026nbsp;u003c/strongu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eSign-up for Job Alertsu003c/strongu003eu003c/au003eu003c/pu003enu003cpu003eu003cstrongu003eFOLLOW US!u003c/strongu003eu003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eFacebooku003c/strongu003eu003c/au003eu003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eTwitteru003c/strongu003eu003c/au003eu003c/pu003enu003cpu003eu003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003eu003cstrongu003eLinkedInu003c/strongu003eu003c/au003eu003c/pu003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement:The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:true,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:cdefa8ae-f907-5c13-2775-f0106d0aa34a,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2021-08-31T23:33:46.646Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2021-08-31T23:33:46.646Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null,CompensationAnnualMinimum:null,CompensationAnnualMaximum:null,CompensationHourlyMinimum:null,CompensationHourlyMaximum:null,CompensationCurrency:null});
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