Clinical Medical Management Supervisor (RN) - REMO

at WPS Health Solutions in Marion, Illinois, United States

Job Description

Description Who We Are is a leading not-for-profit health insurer and federal government contractor headquartered in 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 Health Solutions has been making health care easier for the people we serve for more than . Proud to be military and veteran ready. Culture Drives Our Success WPS' Performance-Based Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse 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. From 2021 to 2023, WPS Health Solutions was recognized for several awards: Role Snapshot The Clinical Supervisor (RN) will oversee a team of 15-25 remote Medical Review Nurse Analysts that complete Targeted Probe & Educate (TPE) work for our Medicare contract. 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. This role contributes to WPS by ensuring that we meet program requirements for the Centers for Medicare & Medicaid Services (CMS) TPE program. In this role you will: Monitor team and individual quality and quantity metrics Coach and train team members Ensure proper workload distribution and timely completion Ensure provider education is delivered professionally and timely Collaborate with other Clinical Supervisors on education planning How do I know this opportunity is right for me? If you: Enjoy leading and helping teams grow Are strong at making decisions independently without guidance Are looking to move away from direct patient care and want to use your nursing knowledge in a new and different way Are technically strong on computers Desire day hours with no on-call work, limited weekend work, and holidays off Are process improvement minded and actively seek out ways to work smarter, not harder What will I gain from this role? Collaborating with a team of both clinicians and non-clinicians Better understanding how government contractors, like WPS Health Solutions, serve our Medicare beneficiaries Learning about our Hyland OnBase tool which is our content management system used for viewing electronic records Enjoying a work from home position with daytime hours, no on-call work, no travel, and holidays off Minimum Qualifications Bachelor's degree in related field or equivalent post high school and/or related work experience 1 or more years of related work and/or leadership experience Active RN license, applicable to state of practice Preferred Qualifications A minimum of 4 or more years of experience in clinical nursing Experience leading a team of 10 or more members successfully either in-person or remotely Background in Medicare principles and guidelines Strong computer skills including: Ability to utilize multiple screens and learn new applications with ease Intermediate knowledge in MS Word and MS Excel (creating, sorting, and filtering spreadsheets) Remote Work Requirements High speed cable or fiber internet Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at ) Please review for additional information Salary Range $75,000-90,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills and experience. Travel Minimal to no travel. Employee may be expected to travel to 1 CMS conference and 1 department management meeting at most per year Remote Worker Requirements We are a remote-first organization and offer remote work in the following approved states: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin Benefits Remote and hybrid work options available Performance bonus and/or merit increase opportunities 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately) Competitive paid time off Health insurance, dental insurance, and telehealth... For full info follow application link. Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.
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Job Posting: 11490944

Posted On: Nov 30, 2023

Updated On: Dec 30, 2023

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