Our Clinical Manager is accountable to plan, organize, manage, and evaluate clinical operations for Medical Review. This includes developing Centers for Medicare & Medicaid Services (CMS) reports as well as managing activities to ensure accurate rendering of claim decisions. They collaborate with other business areas to ensure WPS and CMS goals and objectives are met utilizing cost-effective, timely, accurate, and innovative methods. This Clinical Manager is accountable to ensure compliance with regulatory and payor guidelines.
Salary Range
$100,000 ~ $120,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.
Work Location: Remote OR Hybrid
We are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin
**Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to come into the office 2 days a week on a regular basis.
How do I know this opportunity is right for me? If you:
Minimum Qualifications
Preferred Qualifications
Remote Work Requirements
Benefits
Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
Sign up for Job Alerts
FOLLOW US!
Instagram
LinkedIn
Facebook
WPS Health Blog
This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services
...Fusion innovation demands world-class safetycome build it with us. The EHS Manager will lead the development, implementation, and continuous improvement of Realta Fusions Environment, Health, and Safety programs during a critical phase of company growth. This role will...
...to Take Your Career into Your Own Hands With An Amazing Company? WE NEED YOU ! HIRING NOW.... SALES REPRESENTATIVE- TITLE INSURANCE/ REAL ESTATE Location: Springfield, Massachusetts; Boston, Massachusetts; Worcester, Massachusetts HYBRID - Boston, MA/...
...Assignment Level: Job Title: Talent Acquisition Coordinator School: Trinity Basin Preparatory... ...Education Certification (SBEC), universities, colleges, and education agencies in other states. Assists with the maintenance of complete job...
...Pay ~ Teladoc (online care)~ Referral Bonus Incentive ~ Weekly Pay ~401k ~ And More! Chobani Case Packer Details: ~ Temp-to-Hire position ~$20.50 / hour ~ Full Time work available ~ Weekend work required ~ Various shifts available Monitor...
**Assistant Property Manager We pride ourselves on exceptional service, strong operational standards, and a collaborative management environment. We are seeking a highly organized, proactive, and detailoriented Assistant Property Manager (APM) to support daily operations...