Job Description

Description

Role Snapshot

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, host events, and analyze 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 protects 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 on 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 (i.e., Claims, Appeals, Systems, Medicare Internal Processes, Provider Enrollment) to ensure identified issues are communicated and shared with Provider Outreach & Education (POE) 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

• Bachelor's Degree in Communications, Health Education, Nursing OR related field OR equivalent combination of education and experience.
• 2 or more years of experience as a Medical Review Nurse Analyst with background in Medicare principles and guidelines.
• 3 or more years of experience in a role supporting Medicare.
• 1 or more years specifically in Medicare communications.
• Demonstrated experience developing educational materials and presentations.
• Extensive knowledge of Medicare Part A, Part B and/or Home Health and Hospice program guidelines and Provider Outreach & Education processes.
• Solid knowledge and understanding of medical billing, coding, and insurance processes.
• Proficient with Microsoft Office Suite and using various modes of technology to deliver training (i.e., YouTube Channel, WebEx, etc.).
• Excellent written and verbal communication skills with the ability to present complex information clearly and effectively to diverse audiences.
• Strong interpersonal and relationship-building skills.
• Ability to travel for onsite training and education sessions - Travel will be approximately 15% in the future.

Preferred Qualifications

• 4 or more years of clinical nursing experience.
• CMS knowledge of the Home Health and Hospice program.
• Strong facilitation, presentation and training experience to large groups of people.
• Experience processing Home Health and Hospice appeals.
• MAC contractor experience with FISS, MCS and MAS systems.

Remote Work Requirements

• Wired (ethernet cable) internet connection from your router to your computer
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at
• Please review Remote Worker FAQs for additional information

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately )
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional 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 organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.

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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.

Job Tags

Contract work, For contractors, Work at office, Local area, Immediate start, Remote work,

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