AMVETS Jobs

JOB REQUIREMENTS: 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\' 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 Our Case Management RN will work in our WPS Health Insurance business line. As a WPS Case Manager, your role will be to assist the member to navigate their healthcare journey by developing a care plan to coordinate care, provide benefits and network information, coordinate with providers, and provide member education and needed support. In addition, you will have the opportunity to be crossed-trained in Utilization Management where you will become a thoughtful steward of our members healthcare benefits by evaluating the efficiency, appropriateness, and medical necessity of medical services, procedures, and facilities. This is done by reviewing evidence-based criteria and jurisdictional guidelines to make final determinations. How do I know this opportunity is right for me? If you: Are a critical thinker who enjoys the challenge of identifying opportunities to refine and improve processes. Excel at identifying potential issues/problems before they come to fruition. Champion change and have a growth mindset. Are keeping current in medical knowledge and technical advances in the health care industry. Excel in problem solving and independent decision making. Excel at continuous learning and embrace learning new ways of performing work. Thrive in a production environment where quality and production metrics are critical to individual, team, and WPS success. Are familiar with MCG criteria and Care Management platforms (e.g., Medecision-Aerial) for cross training opportunity in... For full info follow application link. Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/2FF79942A19B4983 Qualified females, minorities, and special disabled veterans and other veterans are encouraged to apply.