Clinical Medicare Outreach and Education Specialist (HH & H)

Overview

Our Clinical Medicare Outreach & Education Specialist (HH & H - Home Health and Hospice) plays a crucial role in our Medicare Program by developing and delivering educational content to the provider community regarding current and upcoming CMS regulations. This specialist creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors, all while working in a fast-paced, remote environment. This education is provided to Medicare providers such as physicians, non-physician practitioners, nurses, therapists, etc., coders, billers, and compliance staff to help them understand the Medicare program and be informed about changes. The role assists providers in developing best practices to avoid coverage and billing errors to reduce error rates and protect the Medicare Trust Fund. The Outreach and Education Specialist focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders.

Salary Range $61,000 ~ $95,000. The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience and may fall outside of this range.

Work Location We are open to remote work in the following approved states : Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin.

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

• Possess experience working with Medicare specifically in the Home Health and Hospice space.
• Thrive in developing and maintaining positive relationships with healthcare providers, clinics, and medical staff.
• Enjoy planning, developing, coordinating and delivering educational sessions, workshops, and training materials tailored to provider needs.
• Can analyze error data, geographical data, track Medicare regulations, WPS policy guidelines, coverage issues, and keep abreast of upcoming legislation to determine areas for additional education needs.
• Like to conduct outreach activities that increase provider engagement and awareness of organizational services, programs, and initiatives.
• Have collaborated with clinical and administrative teams to understand provider challenges and develop targeted solutions.
• Would enjoy serving as a resource for providers regarding updates in guidelines, policies, and documentation and regulatory requirements.
• Can coordinate with internal teams (Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to ensure identified issues are communicated and shared with Provider Outreach & Education staff.
• Can establish and maintain a POE Advisory Group (POE AG) to assist contractors in creation, implementation, and review of provider education strategies and efforts.

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 organizations regarding our culture and workplace : WPS Newsroom - Awards and Recognition.

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Note : 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 prior to being granted access to information systems and / or sensitive data to safeguard government resources that provide critical services.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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