Clinical Medicare Outreach and Education Specialist (HH & H)

Overview

Clinical Medicare Outreach and Education Specialist (HH & H) role at WPS—A health solutions company. The specialist develops and delivers educational content to the provider community regarding current and upcoming CMS regulations, creates and develops educational materials, hosts events, and analyzes data to improve provider education and reduce billing errors in a fast-paced, remote environment. The education is provided to Medicare providers such as physicians, non-physician practitioners, nurses, therapists, coders, billers, and compliance staff to help them understand the Medicare program and be informed about changes. The role focuses on ensuring a positive customer experience through relationship building with providers, CMS, and other stakeholders.

Responsibilities

• Develop and deliver educational content related to CMS regulations for Medicare providers (e.g., physicians, non-physician practitioners, nurses, therapists, coders, billers, compliance staff).
• Create and develop educational materials, host events, and analyze data to improve provider education and reduce billing errors.
• Collaborate with internal teams (e.g., Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to communicate identified issues to Provider Outreach & Education (POE) staff.
• Establish and maintain a POE Advisory Group (POE AG) to assist contractors in the creation, implementation, and review of provider education strategies and efforts.
• Assist providers in developing best practices to avoid coverage and billing errors and protect the Medicare Trust Fund.
• Coordinate outreach activities to increase provider engagement and awareness of organizational services, programs, and initiatives.

Minimum Qualifications

Preferred Qualifications

Remote Work & Technical Requirements

Salary & Location

Benefits

About WPS

WPS is a not-for-profit health insurer and federal government contractor based in Madison, Wisconsin. We provide services to beneficiaries of the Medicare program and manage benefits for active-duty and retired military personnel. WPS emphasizes an open and empowering employee experience and values diverse perspectives.

Compliance & Screening

This position supports services under CMS contract(s). Roles are subject to applicable federal regulations, CMS contract requirements, and WPS policies, including data security, privacy, confidentiality, and program integrity. CMS contractors and personnel may be subject to background screening prior to access to information systems and sensitive data.

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