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Clinical Supervisor (RN) at WPS Health Solutions in Rothschild, Wisconsin

Posted in Other 30+ days ago.

Job Description:


Role Summary:

The Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurse Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare contract. The primary purpose of this leadership role is to provide coaching to team members on production of work, quality of their reviews and education delivery to providers. This role contributes to WPS by ensuring that our Medical Review strategy is implemented in accordance with Centers for Medicare & Medicaid Services (CMS) guidelines to achieve award fee validation and contract reviewal. This is a hybrid role that will work from home and in the office. You will report to one of our WPS offices approximately 4 to 8 times a month.

In this role you will:

  • Monitor team and individual quality and quantity metrics

  • Coach and train team members

  • Ensure proper workload distribution and timely completion

  • Ensure provider education is delivered professionally and timely

This job profile is not intended to be an exhaustive list of all duties or responsibilities associated with the job. Other job-related duties may be assigned.

This role could be a good fit if you:

  • Enjoy leading and helping teams grow

  • Are looking to move away from direct patient care and want to use your nursing knowledge in a new and different way

  • Are technically strong on computers

  • Desire day hours with no on-call work, limited weekend work, and holidays off

  • Are process improvement minded and actively seek out ways to work smarter, not harder

You'll benefit from this experience by:

  • Collaborating with a team of both clinicians and non-clinicians

  • Better understanding how government contractors, like WPS Health Solutions, serve our Medicare beneficiaries

  • Learning about our Hyland OnBase tool which is our content management system used for viewing electronic records

  • Having the opportunity to work in a hybrid role where you will work from home and in the office

You need to have:

  • Bachelor's degree in related field or equivalent post high school and/or related work experience

  • 1 or more years of related work and/or leadership experience

  • Active RN license, applicable to state of practice

We also prefer:

  • A minimum of 4 or more years of experience in clinical nursing

  • Experience leading a team of 10 or more members successfully either in-person or remotely

  • Background in Medicare principles and guidelines

  • Strong computer skills including:

    • Ability to utilize multiple screens and learn new applications with ease

    • Intermediate knowledge in MS Word and MS Excel (creating, sorting, and filtering spreadsheets)

Compensation and Benefits

  • Eligible for annual Performance Bonus Program

  • 401(k) with dollar-per-dollar match up to 6% of salary

  • Competitive paid time off

  • Health and dental insurance start DAY 1

  • Vision insurance

  • Flexible spending, dependent care, and health savings accounts

  • Short- and long-term disability, group life insurance

  • Dress for your day

  • Innovative professional and cognitive development programs

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.

WPS has been named one of the World's Most Ethical Companies by the Ethisphere Institute for 10 years in a row.

Learn more about WPS.

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.

Links and descriptions for:

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.

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.

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.


Arise Health Plan provides innovative and high-value health plans to groups and individuals in eastern and northeastern Wisconsin. With our quality Wisconsin-based customer service, Arise offers health care expertise with a personal touch.

EPIC Specialty Benefits

EPIC Specialty Benefits provides businesses group insurance products that cover:

  • Life

  • Disability

  • Dental

  • Vision

  • Voluntary benefits

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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