Description

Who We Are

WPS Health Solutions (https://www.wpshealthsolutions.com/about/index.shtml) 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 (https://www.wpshealthsolutions.com/75/) . 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 (https://www.wpshealthsolutions.com/news/?c=awards)

This position can be hired at the Professional or Senior Level

Role Snapshot

An Provider Outreach and Education Specialist impacts the Medicare Program by developing and delivering education to a variety of provider communities such as but not limited to independent providers, group practices, facilities, associations, societies, etc., who utilize the Medicare Program for payment. Ensuring a positive customer experience by fostering relationships with members of the provider communities, CMS, Medicare Administrative Contractors (MACs), and internal units. This role performs in the top tier of Medicare contractors as measured by CMS evaluations of operating performance.

• Learn and maintain knowledge of the Medicare Program such as reading and interpreting guidelines, IOM, communications, coding and billing, etc.

• Strong knowledge of evaluation and management services and associated coding

• Develop educational materials to host both virtual live events and in-person presentations, share content through various techniques such as YouTube videos, news articles, resources on website, self-service tools, etc.

• Foster collaborative partnerships with internal units to identify education needs and develop effective plans for continued improvement

• Foster collaborative partnerships with external entities such as provider communities, CMS, Medicare Administrative Contractors (MACs), and other entities that assist in dissemination of Medicare provider education materials

• Researches, analyzes, recommends, and facilitates education plan to reduce/prevent billing errors

• Prioritize and work on multiple projects within a fast-paced, ever changing work environment

How do I know this opportunity is right for me? If you:

• Enjoy being the face of the company and creating a positive customer experience for the provider communities we serve fostering satisfaction

• Enjoy working with people, collaborating, and building relationships in a remote work environment

• Has a strong understanding and working knowledge of evaluation and management services and the associated coding and billing rules within the Medicare Program

• Effectively research challenges, determine impactful educational solutions, and analyze data before and after education for direct impact – while enjoying the process of learning and continuous improvement

• Enjoy sharing your knowledge with others using effective education strategies and with creativity

• Having fun utilizing various modes of technology to create and publish educational content that resonates with providers

• Enjoys public speaking

• Working from home with a fully remote team

• Enjoys the challenges of working in an ever changing and fast paced work environment

• Are able to commit to business travel up to 10% for in-person events, meetings, etc.

What will I gain from this role?

• Experience working in an environment that serves our nation’s military, veterans, Guard and Reserves, and Medicare beneficiaries

• Working in a continuous performance feedback environment

• Having the freedom to determine education needs and best course of action to deliver

• Sharing input with CMS on processes and initiatives with an impact on the Medicare Trust Fund

• Working collaboratively with various CMS workgroups to help develop and share information with the provider community

• Establish relationships throughout the provider community and other external entities such as CMS, MACs and internally with a wide range of roles and levels of leadership

• Deep understanding of Medicare Program from the Medicare Administrative Contractors perspective

Minimum Qualifications

• Bachelor’s Degree in related field or equivalent post high school and/or related work experience

• 1 or more years of working with the Medicare Program to include at least 1 year of Medicare communications (written and oral)

• 1 or more years of experience in developing educational materials and delivering education, or public speaking

• 2 or more years working with medical coding

• Senior Level: 2 or more years of working with the Medicare Program to include at least 1 year of Medicare communications (written and oral)

Preferred Qualifications

• Senior Level: 3 or more years or more working with the Medicare Program to include at least 2 year of Medicare communications (written and oral

• 3 or more years working with coding

• Certified Evaluation and Management Coder (CEMC) or Certified Professional Coder (CPC)

• Experience with various applications or technology

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 https://speedtest.net)

• Please review Remote Worker FAQs (https://secure.wpsic.com/files/remote-work-faqs.pdf) for additional information

Salary Range

• Based on experience and skill level - $61,000 – $80,000

The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.

Travel

10% of travel is required for in person educational events and conferences that can be located anywhere within the U.S.

Work Location

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 services start DAY 1

• Employee Resource Groups

• Professional and Leadership Development Programs

• Review additional benefits: ( https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml )

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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)