What are the responsibilities and job description for the Clinical Medical Management Supervisor position at WPS Health Solutions?
Description
Role Snapshot
The Clinical Supervisor (RN) will oversee a team of 15-25 remote Medical Review Nurse Analysts that complete Prior Authorization (PA) 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) PA 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
- Collaborate with other Clinical Supervisors on education planning
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.
How do I know this opportunity is right for me? If you :
What will I gain from this role?
Minimum Qualifications
Preferred Qualifications
Ability to utilize multiple screens and learn new applications with ease
Remote Work Requirements
Work Location
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
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
Hybrid Work Location
Benefits
Who We Are
WPS Health Solutions 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 75 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 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.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace : WPS Newsroom - Awards and Recognition
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Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities
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)
Salary : $75,000 - $90,000
