Posted in Other 30+ days ago.
Location: Hampton, Virginia
Role Summary:
The Population Health Quality Specialist conducts oversight of population health management programs aimed at improving the health and wellness of our members. This position has the responsibility of implementing a goal-driven population strategy to maximize engagement and define and monitor success metrics. Provides support to the overall maintenance of the health plans National Committee for Healthcare Quality Assurance (NCQA) accreditation, which includes project coordination of benchmarking related to clinical performance and patient experience through Health Plan Effectivess Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS).
This position will coordinate, educate, and provide expertise to customers in regards to WPS Health Insurance's Population Health Programs. In addition, the role will provide recommendations and direction on population health programs with the goal of providing the best possible health outcomes for members
In this role you will:
This role could be a good fit if you:
You'll benefit from this experience by:
You need to have:
We also prefer: (Any other possiblepreferredskills?)
This role is open to considering 100% remote work, we are highly interested in applicants that are regionally local to the Madison area, to be able to come into the office on occasion after Covid-19.
Approved States: Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, North Dakota, South Carolina, Texas, Virginia, Wisconsin
Your team:
You will be working with a team of 9 medical and pharmacy clinicians and health insurance professionals.
Compensation and Benefits
Who We Are
WPS Health Solutions is an innovator in health insurance and a worldwide leader in claims administration, serving millions of beneficiaries in the United States and abroad.
Founded in 1946, WPS offers health insurance plans for individuals, families, and seniors, and group plans for small and large businesses. We are a world-class claims processor and program administrator for the government's Medicare program. And we manage benefits for millions of active-duty and retired military personnel and their families.
Our Purpose and Values
Our purpose is to make healthcare easier for those we serve. Click Here
Our values - Customer Focused, Individual Responsibility, Mutual Respect, and Driven & Passionate - are the core of who we are and how we conduct business every day.
WPS Health Insurance
WPS Health Insurance offers high-quality health insurance plans for individuals and families, Medicare supplement plans for seniors, and group health plans for businesses of every size.
http://wpshealthsolutions.com/business-units/wpshi.shtml
Military and Veterans Health
WPS Military and Veterans Health administers claims and provides customer service and related activities for the U.S. Department of Defense and the U.S. Department of Veterans Affairs and their beneficiaries.
http://wpshealthsolutions.com/business-units/wpsmvh.shtml
Government Health Administrators
WPS Government Health Administrators manages Medicare Part A and Part B benefits for more than 7 million beneficiaries. As one of the largest contractors for the Centers for Medicare & Medicare Services, we've served Medicare beneficiaries and their health care providers since 1966.
http://wpshealthsolutions.com/business-units/wpsgha.shtml
WPS Health Plan
WPS Health Plan offers Health Maintenance Organization and Point-of-Service plans to the group and individual markets in eastern and north-central Wisconsin, plus third-party administrator services.
http://wpshealthsolutions.com/business-units/wpshi.shtml
EPIC Specialty Benefits
EPIC Specialty Benefits provides businesses group insurance products that cover:
http://wpshealthsolutions.com/business-units/epicsb.shtml
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