Wps Health Insurance jobs - 57 jobs

Role Snapshot Our Internship Program with WPS Health Solutions is comprised of two key components. The first component involves gaining practical experience to supplement academic coursework and prepare for future career pursuits. This will be comprised of a hands-on role within a functional area related to a relevant field of study. Each internship incorporates responsibilities and tasks which support the business objectives and client service offerings, while providing ongoing collaboration with experienced departmental colleagues and exposure to "real world" business demands. The second element centers on exposure to corporate culture and professional development: Interns will participate in discussions focused on building soft-skills and business acumen. This intern will focus on ensuring data is accurate, secure, and responsibly managed. They may assist with data quality checks, metadata and cataloging, and documentation that promotes transparency and auditability. They will also gain exposure to how governance practices extend to AI, including ethical use, compliance, and risk awareness. This experience builds practical skills in strengthening data foundations while supporting the responsible adoption of AI. Start Date: June 2025 Pay Rate: $22.00/hour Hybrid Work Location: This position will be hybrid, having the regional availability to come into our Office 3 days a week cadence. Our office location: WPS Corporate Center Building - 1717 W. Broadway in Madison, WI. What you will do as a Data & AI Governance Analyst Intern: Support data quality, metadata, and cataloging efforts by running validation checks, tagging datasets, updating lineage information, and assisting with the configuration and upkeep of governance platforms. Contribute to governance and risk management activities by identifying data or AI-related risks, drafting mitigation notes, maintaining dashboards, and supporting the tools and systems that track compliance and risk. Advance responsible AI and governance practices by researching ethical frameworks and compliance requirements, and by developing documentation, checklists, training materials, and platform-based resources that promote transparency, accountability, and audit-readiness. How do I know this opportunity is right for me? If you: Are passionate about data management, accuracy, and security, and want to help ensure that data is handled responsibly and transparently. Are interested in the ethical use of AI and want to understand how governance practices are applied to both data and AI technologies. Enjoy working with data quality checks, metadata, and documentation to promote clarity, accountability, and compliance. What will I gain from this role? Gain practical experience in ensuring data accuracy, security, and transparency through tasks like data quality checks, metadata management, and documentation. Strengthen your ability to assess and maintain data quality, improve data cataloging practices, and ensure compliance with data governance standards. Learn how governance practices are applied to AI technologies, including ethical considerations, compliance requirements, and risk management in AI adoption. Minimum Qualifications US. Citizenship is required for this position due to Department of Defense restrictions. Be currently pursuing a degree in higher education or recent graduate. Have experience with Microsoft Office (i.e., Word, Excel, Outlook, etc.). Preferred Qualifications Currently pursuing a degree in Information Systems, Computer Science, Business Analytics, Data Science or related field. Remote Work Requirements 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 Hybrid work available Holiday pay and On-demand PTO 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.

About the job Customer Service Associate - Work From Home Who We Are Were the worlds only 100% union-label supplemental benefits provider, proudly partnering with over 40,000 unions and associations worldwide. For more than 60 years, we've been dedicated to protecting hardworking families by providing supplemental and permanent benefit solutions they can count on for financial security. The Opportunity Were looking for driven, service-minded professionals to join our fully remote team. You'll connect with union members who have already requested benefits information explaining their options, answering questions, and guiding them through the enrollment process. No cold calling or lead chasing just meaningful conversations with people who need what we offer. Your Responsibilities Handle inbound and outbound calls with prospective clients Schedule and lead virtual benefits presentations Explain available programs and coverage options in clear, simple terms Complete all applications and documentation with accuracy Deliver outstanding service and maintain organized client records Participate in leadership training and skill development programs What You Bring Excellent communication and people skills Professional, positive, and energetic approach Customer service or sales background (preferred, not required) Basic computer skills and comfort in a virtual environment Ability to collaborate effectively with all levels of the team Legal authorization to work in the U.S. or Canada What You'll Get Full benefits package after initial period 100% remote position no commuting, no dress code Flexible scheduling that supports your lifestyle Weekly pay plus performance-based monthly bonuses Annual incentive trips to top destinations like Cancun, the Bahamas, and Las Vegas for high performers Rapid career advancement with clear promotion paths If you're ready for a rewarding career where you can help others, grow your skills, and enjoy flexibility and unlimited earning potential apply now and start building a future you're proud of.

About the job Sales Representative We are proud to be the only 100% union-labeled supplemental benefits company in the world, serving over 40,000 unions and associations across North America and beyond. For more than 60 years, we've specialized in providing both supplemental and permanent benefits to hardworking families who need them most. Position Overview: Were looking for motivated individuals to join our remote team as Benefits Representatives. You'll be working with pre-qualified union members who have requested information, guiding them through their benefits options in a consultative and educational manner. Daily Responsibilities: Make and receive inbound/outbound calls Schedule and conduct virtual appointments Present benefits packages to union members who requested them Complete and submit necessary client documentation Maintain accurate records and follow quality control standards Participate in ongoing training and leadership development programs What Were Looking For: Strong verbal communication and interpersonal skills Friendly, professional, and positive attitude Customer service or sales experience is a plus, but not required Tech-savvy with basic computer proficiency Ability to work well with diverse teams and individuals Legally authorized to work in the U.S. or Canada Team-oriented and motivated to grow professionally What We Offer: Full benefits after probationary period 100% remote work work from anywhere Flexible scheduling ideal for those seeking work-life balance Weekly pay with performance-based monthly bonuses Incentive trips earn all-expenses-paid travel for you and a guest to locations like the Bahamas, Cancun, Las Vegas, and more Leadership opportunities fast-track promotions available for top performers If you're passionate about helping others, eager to grow, and ready to join a mission-driven organization that truly makes a difference apply today!

The Year for Growth, Opportunity and Flexibility Are you ready for a career change in 2021? At American Income Life, we are searching for ambitious individuals who are ready to build a successful career while also having a positive impact on the communities around them. American Income Life currently provide supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Why We Stand Out American Income Life provides supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Requirements: Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Time management skills Pass a criminal background check Job Benefits: Full Benefits Paid weekly ($70,000 - $75,000 1st year average) Bonuses Health Insurance Reimbursement Life Insurance Flexible Schedule Retirement Plan American Income Life has served working class families since 1951 with life, accident, and supplemental health products to help protect members of labor unions, credit unions, associations, and their families. AIL representatives develop long-term relationships with clients and meet them where they are most comfortable: their homes Powered by JazzHR

We're seeking a motivated and customer-focused individual to join one of the most respected supplemental benefit organizations in North America - proudly serving families for more than 65 years. As our company continues to grow and expand into new territories, we're looking for someone who's driven, dependable, and eager to succeed in a fast-paced, supportive environment. Your Role Assist clients by providing clear information about available products and services. Address client questions regarding their coverage and benefit options. Stay current on our programs, policies, and evolving services. Review existing plans to ensure clients are receiving the most cost-effective solutions. Qualifications Background in customer service, sales, or client relations preferred. Proven ability to build relationships and maintain trust. Strong organizational skills with the ability to multitask and prioritize effectively. Positive, professional attitude with excellent communication skills (written and verbal). Ideal Candidate Self-starter with an entrepreneurial mindset and strong sense of accountability. Works well independently and thrives as part of a team. Performs well under pressure and maintains professionalism in all interactions. What's Included Comprehensive hands-on training and ongoing mentorship. Weekly pay, bonuses, and long-term residual income potential. Company-sponsored trips and recognition opportunities. 100% remote position offering flexibility and balance. If you're ready to start a rewarding career helping families while enjoying the benefits of remote work and consistent growth, apply today to learn more about joining our team. Powered by JazzHR

March 2024 marked a monumental milestone for AO, as we shattered records for the biggest weekly, monthly, and quarterly achievements in the history of our company. Now, as we continue this incredible growth, we are seeking to expand our team with even more talented individuals. Are you ready to be a part of this extraordinary journey? As an AO team member, you will have access to a world-class support staff, unparalleled mentorship programs, and boundless career opportunities at every level. This could be the transformative change you've been eagerly searching for! • Embrace stability with a work-from-home position that provides you with a solid foundation. • Expand your knowledge and skills with virtual workshops and trainings designed to enhance your professional growth. • Enjoy the satisfaction of weekly pay, supplemented by enticing bonuses that recognize your exceptional performance. • Rest easy with the assurance of a union contract and representation, ensuring your rights are protected. • Safeguard your future with a comprehensive life insurance policy, including accidental death benefits. • Prioritize your well-being with medical insurance reimbursement, putting your health first. • Propel your career forward with industry-leading training and state-of-the-art technology at your fingertips. • Immerse yourself in leadership conventions and conferences that will inspire and motivate you. • Experience the thrill of incentive trips and team bonding activities, forging lifelong connections with your colleagues. To be considered for this incredible opportunity, simply submit your compensation requirements and an updated resume for our review. In line with our commitment to community wellness, all interviews will be conducted via Zoom video conferencing, ensuring the safety and convenience of all applicants. Join AO and become part of an unstoppable force, where history is made and extraordinary growth is Powered by JazzHR

The Director of Managing Counsel will oversee the delivery of legal services and advice for the Company, acting as the main attorney for Blue Cross NC's Privacy Program. This role manages both attorneys and non-attorneys and oversees Blue Cross NC's Privacy Program related to safeguarding employee, customer and corporate information pursuant to legal, regulatory and contractual requirements and standards that govern Privacy, and reports directly to the Vice President of the Legal Department & Deputy General Counsel. The Managing Counsel brings expertise in several areas of law essential to both the Company and its subsidiaries, works closely with Company Officers and senior executives, and leads the team within the Legal Department. What You'll Do Directs the efforts of the legal staff and related support personnel while utilizing legal expertise to ensure the Company and its subsidiaries are in compliance with various laws and regulations that govern Privacy. Serves as the Privacy Officer for the Company, responsible for overseeing the development, implementation, maintenance, and enforcement of privacy policies and procedures in accordance with state and federal laws and regulations. Serves as primary point of contact for privacy-related matters, including regulatory inquiries, customer concerns, and internal escalations. Develops strategy to accomplish objectives and ensures the Company and its subsidiaries maintain a solid legal foundation upon which to conduct business. Advises and counsels Company Officers, senior management, and the Board of Directors on privacy laws that arise in the Company's business operations; researches and prepares legal memoranda and opinions applying technical legal knowledge to varying business situations and personnel issues; assists Company management with risk identification and management. Assists the Company with business transactions and the development of new products, services, and business relationships. Confers and negotiates with attorneys and management in other companies. Attends high-level conferences involving BCBSNC management and management in other companies or senior government positions. Writes legal opinions or otherwise provides legal advice that require extensive research of statutes, regulations, or court decisions in complex areas of law. Leads practice area team (e.g., corporate, health care plans). Supervises direct reports including performance management, coaching, conflict resolution, motivating and engaging. Manages growth and development of personnel, with career development, performance management and succession planning. Assigns projects to team members, coaches and mentors team members. Participates in development of, interprets, and improves Company policies. Assists the Company with implementing existing and new programs, policies, and procedures. Researches, interprets, and advises on statutory and case law, administrative rules, and regulations. Monitors legislative and regulatory proposals, evaluates such proposals, and assists Company management with formulating the Company's position of these matters. Performs management duties include hiring, training, coaching, counseling and evaluating performance of direct reports. Makes decisions regarding retention of outside counsel and manages substantial budget for external legal services. Performs other duties as assigned. What You Bring JD from an accredited law school 10 years of professional legal experience 5 years of leadership experience In lieu of degree, 12+ years of experience in related field Licensed to practice law in North Carolina or must obtain License within 1 year of employment. Bonus Points Certified in Healthcare Privacy and Security (CHPS) or Certified Information Privacy Professional (CIPP) highly preferred. HIPAA and other similar federal and state privacy, security and data protection regulations highly preferred What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $210,268.00 - $336,430.00 Skills Administrative Law, Business Contracts, Commercial Contract Management, Contract Management, Contract Negotiations, Law, Legal Administration, Legal Analysis, Legal Compliance, Legal Consulting, Legal Practices, Legal Research, Legal Services, Legal Support, Negotiation, People Management, Privacy Compliance, Privacy Laws, Procurement, Statutory Interpretation, Vendor Contracts

Role Snapshot The Application Configuration Supervisor leads a team Application Analysts and Configuration Specialists responsible for managing and optimizing the configuration of applications to meet operational, clinical, and regulatory requirements. This role oversees workload distribution, ensures accurate documentation, and supports analysts in resolving system and configuration issues. The supervisor collaborates with cross-functional teams, drives continuous improvement efforts, and ensures application integrity and alignment with business needs. Salary Range $80,000 - $95,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location Our first consideration will be to have this new employee live in the Greater Madison, WI area to take advantage of Hybrid work and collaboration. Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to work in the office 2 days a week. Secondary priority will be given to remote candidates in WI, IL, MN, or IA. **If not regionally local to Madison, WI, frequent monthly travel to our WPS Headquarters will be expected. How do I know this opportunity is right for me? In this role you will: Partner with stakeholders to collect and translate business needs into technical specifications and configuration solutions. Manage workload distribution, establish priorities, and monitor progress to ensure timely and accurate configuration of systems. Ensure accurate setup and maintenance of system configurations including user roles, workflows, rules, structures, or other configurable elements depending on system use. Serve as an escalation point for complex configuration-related issues, identifying root causes, coordinating resolutions and implementing effective solutions. Participate in system implementations, upgrades, and testing efforts, ensuring configuration aligns with technical and functional specifications. Develop and maintain documentation, policies, and standard operating procedures. Identify opportunities for automation and execute to improve efficiency and accuracy in configuration processes. Provide regular updates on configuration activities, metrics, and issues to management and stakeholders. Promote effective communication and coordination within the team and across departments such as development, operations, and business units. Provide coaching, mentorship, and performance feedback to team members, identify training needs and support staff development. Ensure compliance with industry regulations, data standards, and security protocols. Identify and implement opportunities for automation, efficiency, and accuracy improvements within configuration processes. Minimum Qualifications Bachelor's degree in Information Systems, Business, Healthcare Administration, or related field or equivalent combination of education and related work experience. 3 or more years of experience in application configuration, system administration, or business systems analysis. 1 or more years in a supervisory or lead role with experience managing or mentoring staff. Excellent communication skills with the ability to clearly convey technical information to both technical and non-technical audiences. Strong understanding of system configuration principles, workflows, and data management. Experience working with complex enterprise systems such as EHR, claims systems, or CRM. Exceptional organizational and time management skills with ability to manage multiple priorities in a fast-paced environment. Strong Leadership, technical expertise, and communication skills. Remote Work Requirements 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog

Role Snapshot Our Actuarial Analyst, will work in a team setting and will apply mathematics, probability, statistics, and business principles to support rating/pricing, valuation, healthcare economics, and financial forecasting in a Health Plan / Insurance environment. This Analyst assists actuaries and provides actuarial support to various departments, including Network Management, Underwriting, Sales and Marketing, and Finance. Salary Range $80,000 ~ $100,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin **New employee living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to work Hybrid 2 days a week on a regular basis. Onsite work will be tailored for team cohesion, strategy, planning and collaboration. How do I know this opportunity is right for me? If you: Can assist in actuarial research, experience studies, and statistical analyses and calculations. Have built and maintained models for pricing, forecasting, and risk assessment. Thrive when analyzing financial, statistical, and mathematical data and perform actuarial calculations. Can provide support to senior analysts or actuaries. Like to get things done, completing procedural tasks accurately, identifying and resolving issues that arise. Enjoy retrieving and validating data for rate filings and actuarial models; assist in building rate studies, pricing tools, model enhancements, and financial reports. Can perform peer reviews, identify, and communicate errors and risks. Want to assist in preparation and coordination of all rate filings necessary for Commissioner of Insurance. Would like to coordinate with internal and external auditors to support regulatory audits and examinations. Minimum Qualifications Bachelor's degree in actuarial science, statistics, mathematics, or related field. At least 2 exams completed towards the Associate of the Society of Actuaries designation. 2 or more years actuarial experience. Demonstrated skills in planning, organizing, coordinating, and managing multiple tasks and priority projects in a changing work environment. Proficient in Microsoft Excel and actuarial modeling tools and programming languages (e.g., SQL, R, Python). Knowledge and practice in reconciling report results. Preferred Qualifications 4 or more years actuarial experience. Experience working in a health insurance or health plan environment. Diverse Actuarial Analysis exposure that could include: Reserving, Pricing Products, Supporting Underwriting, Network Management, Sales and Marketing, or Finance. Remote Work Requirements 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog

Logistics: Palmetto GBA,- one of BlueCross BlueShield's South Carolina subsidiary companies. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. Location: This a full-time remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday. It may be necessary, given the business need to work occasional overtime. What You'll Do: Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts. Documents all provider contacts/communications in provider tracking system. Conducts formal conference calls and/or in-person educational visits with providers that are consistently over utilizing services, on progressive corrective action, or have unacceptable denial rates and/or error rates under the medical review program. Conducts coverage and documentation workshops for provider staff (Medicare providers and physicians' staff). Researches, composes, and coordinates the preparation of all regulatory based provider education materials. Performs analysis of effective reports to determine actions to be taken regarding medical reviewed its/audits. Determines what providers are over-utilizing services and what services are being over-utilized. Works with medical review department and provides input regarding actions taken in response to provider billing practices. Targets providers where greatest abuse of Medicare program has occurred. Participates in the medical review process and inter reviewer reliability (IRR) studies. Assists in training of medical review associates regarding coverage and medical review process. To Qualify for This Position, You'll Need the Following: Required Education: If LPN, graduate of accredited School of Licensed Practical Nursing; if LVN, graduate of accredited School of Licensed Vocational Nursing; if RN, graduate of approved School of Nursing. Required Experience: If LPN or LVN, 7 years of clinical experience or equivalent combination of clinical and educator experience. If RN, 5 years of clinical experience or equivalent combination of clinical and educator experience. Required Software and tools: Microsoft Office. Required Skills and Abilities: Knowledge of medical terminology and disease processes. Demonstrated proficiency in word processing and spreadsheet software. Good judgment skills. Effective customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar. Analytical or critical thinking skills. Basic business math proficiency. Knowledge of mathematical or statistical concepts. Ability to persuade, negotiate, or influence. Required Licenses and Certificates: Active LPN or LVN licensure in state hired, OR active compact multistate LPN license as defined by the Nurse Licensure Compact (NLC), OR active RN licensure in state hired OR active compact multistate RN license as defined by the Nurse Licensure Compact (NLC) others. Ability to handle confidential or sensitive information with discretion. We Prefer That You Have the Following: Preferred Work Experience: 3 years of provider relations and Medicare experience. Preferred Skills and Abilities: Knowledge of claims processing software. In-depth knowledge of Medicare program, guidelines, regulations governing coverage. Preferred Software and Other Tools: Working knowledge of Microsoft Access or other database software. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

Role Snapshot The Internship Program with WPS Health Solutions is comprised of two key components. The first component involves gaining practical experience to supplement academic coursework and prepare for future career pursuits. This will be comprised of a hands-on role within a functional area related to a relevant field of study. Each internship incorporates responsibilities and tasks which support the business objectives and client service offerings, while providing ongoing collaboration with experienced departmental colleagues and exposure to "real world" business demands. The second element centers on exposure to corporate culture and professional development. This Intern will participate in discussions focused on building soft-skills and business acumen. Start Date: June 2025 Pay Rate: $22.00 - $24.00/hour. The base pay rate offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Hybrid Work Location: This position will be hybrid, having the regional availability to come into our office 2 days a week. Our office location: WPS Corporate Center Building - 1717 W. Broadway in Madison, WI. How do I know this opportunity is right for me? In this role you will: Play an important role in the development and implementation of a new enterprise automated testing and quality platform. Learn from experienced colleagues the skills and techniques needed to develop/engineer and produce high-level Automated Testing solutions. Participate in the creation of testing solutions that will allow for expansion and enhancements to our program as it grows. What will I gain from this role? Working with a highly skilled leadership team, focused on innovation, process improvements and building a strategic path into the future. Being able to help create QA and QE solutions that will have a large impact on many of WPS's business areas and company as a whole. Working in a transformative environment focused on strategic quality, deployment and development throughout the company. Working on new QE automations, planning, collaborating and scripting solutions. Minimum Qualifications U.S. Citizenship is required for this opportunity due to Department of Defense restrictions. Be currently pursuing a degree in higher education or recent graduate. Have experience with Microsoft Office (i.e., Word, Excel, Outlook, etc.). Scripting experience gained from coursework in a higher education setting. Preferred Qualifications An understanding and interest in QA or QE automation. An understanding and interest in automated testing for application development, data transactions and complex administrative operations. Remote Work Requirements 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 Hybrid work Holiday Pay and On-Demand PTO 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.

Job Responsibilities and Requirements The Client Implementation Manager will be responsible for developing and overseeing new client installations for the RSL portfolio of business. This includes overall accountability for the successful new case installation of employee accounts that have core Life, Disability, Absence and/or Voluntary benefits. He/she will drive the process through a combination of direct involvement, partnership with account management, and influence and coordination with internal partners Relationship Management * Provide leadership and subject matter expertise to new client to ensure successful implementation, enrollment and ongoing support for assigned clients / territories. * Lead new client installation calls for assigned clients/sales offices. * Proactively communicate to the client to ensure appropriate setup and understanding of systems, tools and processes, including (but not limited to) billing, contracts and web tools. * Identify, research and coordinate the resolution of client-level issues for new clients. * Interface with IT and service teams to develop solutions to broker and client's specific needs, and to proactively communicate/document potential issues. * Coordinates training and communication strategy * Liaison between client/broker/HR platform and internal resources. * Develop and maintain cooperative partnerships with Administrative Office Departments and work closely to ensure effective communication with Regional Sales Staff, implementation and home (administrative) office counterparts. * Lead discussions at routine client meetings with manager approval of agenda. Administrative * Create and deliver new client administrative kits in an accurate and timely manner. * Coordinate fulfillment, tracking, billing, and inventory process for all enrollment communication materials. * Perform enrollment resource/logistical coordination for extra-territorial and multi-site clients (within and outside assigned territory when required). * Data transfer setup and test plan with internal and external resources * Work with marketing to ensure appropriate delivery of client materials. * Collaborates with team members and management in recommending and implementing improvement opportunities. * Makes decisions within guidelines and policies that impact own priorities and allocation of time to meet deadlines Expertise * Understands the company and its key business drivers; uses this knowledge to guide own work * Expands conceptual knowledge in own discipline and broadens capabilities and displays a wellness to share with others Required Knowledge, Skills, Abilities and/or Related Experience * Bachelor's Degree in Business, Marketing, and /or Communications is preferred. An MBA or advanced degree in a related field is preferred. * Minimum of 3-5 years of directly related experience is required. * Superior organizational, multi-tasking, influencing and presentation skills are required. * Strong written and superior oral communication skills required * Ability to demonstrate internal diplomacy/influencing skills with sales, service and internal cross-functional areas including underwriting, claims and administration. * Professional business demeanor and the ability to work in a fast-paced, entrepreneurial capacity with minimal supervision are required. * Ability to thrive in a fast-paced environment, multi-tasking skills and the ability to work in an autonomous manner. * Proficient in Microsoft Office products and ability to master applicable systems and processes Ability to Travel: Up to 25% The expected hiring range for this position is $66,640.00 - $83,300.00 annually for work performed in the primary location (King of Prussia, PA). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: * An annual performance bonus for all team members * Generous 401(k) company match that is immediately vested * A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account * Multiple options for dental and vision coverage * Company provided Life & Disability Insurance to ensure financial protection when you need it most * Family friendly benefits including Paid Parental Leave & Adoption Assistance * Hybrid work arrangements for eligible roles * Tuition Reimbursement and Continuing Professional Education * Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. * Volunteer days, community partnerships, and Employee Assistance Program * Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: * Integrity * Empowerment * Compassion * Collaboration * Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-MR2

Our company has moved to 100% virtual, work-from-home positions. allows you to earn an incredible living without sacrificing your family life. You'll have the flexibility to choose your working hours when it's convenient for YOU and your family. We're looking for enthusiastic individuals to assist existing and prospective clients within our organization. This position will work with multiple clients through-out the day providing outstanding service and product knowledge. Preferred Skills: • Excellent communication skills, including active listening and problem-solving • Ability to learn, adapt, and adjust on the go • Works well with others and individually • Possesses a strong work ethic and drive to succeed What you can expect: • Flexible Schedule with Weekly Pay • 100% Remote Position • Weekly Trainings lead by Top Leaders • Life Insurance • Health Insurance reimbursement • Industry-leading resources and technology * In the interest of community wellness, AO has adjusted our business operations. As such, all interviews will be conducted via Zoom video conferencing. Powered by JazzHR

Role Snapshot The Personnel Security Specialist is responsible for managing and processing all personnel security requirements and related activities for employees supporting TRICARE, Medicare, and other federal program contracts. The role ensures compliance with Department of Defense (DoD), Centers for Medicare & Medicaid Services (CMS), and other agency regulations, with a primary focus on facilitating and maintaining background investigations and credentialing processes for Common Access Cards (CACs) and Enterprise User Administration (EUA) access and CMS IDs. The Specialist serves as the primary point of contact for employees, government security representatives, and internal stakeholders on personnel security matters. Salary Range $65,000 - $85,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location Our first consideration will be to have this new employee live in the Greater Madison, WI area to take advantage of Hybrid work and collaboration. Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to work in the office 2 days a week. Secondary priority will be given to remote candidates in WI, IL, MN, or IA. **If not regionally local to Madison, WI, frequent monthly travel to our WPS Headquarters will be expected. How do I know this opportunity is right for me? In this role you will: Manage end-to-end personnel security processes for employees and contractors requiring a CAC or EAU access, including identifying applicable requirements, initiating background investigations, reviewing initial employee applications for required information, tracking status, and ensuring timely completion. Ensure compliance with DoD, CMS, and other applicable federal requirements governing identity verification, background investigations, adjudications, and credentialing processes. Serve as the WPS Facility Security Officer for TRICARE and primary liaison with government security offices, contracting officers, internal leadership, and applicants regarding personnel security requirements and status updates. Maintain complete and accurate, audit-ready records and track documentation of identity verification, background checks, investigations, and credentialing activities in accordance with federal and organizational policies. Gather and submit evidence for audit requests and attend auditor interviews and meetings, as needed to provide process insights and clarifications. Provide guidance to employees and contractors on security requirements, documentation and processes related to EAU access and obtaining or reissuance of a CAC. Compile, analyze, and validate data for required routine government reporting. Conduct research and analysis on emerging and new government agency requirements. Create and maintain process and procedure documentation. Recommend process improvements to increase efficiency and productivity. Other job duties may be assigned as required, including but not limited to general support of contract administration activities for WPS ‘federal contracts, third party risk analyses, general support of Enterprise Risk Management program functions, and business resiliency or continuity program activities. Minimum Qualifications Must be a U.S. Citizen in possession of a favorably adjudicated Tier 3/NACLC or equivalent investigation or having the ability to obtain equivalent government determined clearance level. Bachelor's degree in related field or equivalent combination of education and work experience. 5 or more years of experience in personnel security and compliance, background investigations, or related field, preferably in a government contracting environment. Working knowledge of DoD personnel security programs, CMS credentialing requirements, and regulations related to federal background checks, investigations and credentialing. Demonstrated experience with systems such National Background Investigation Services (NBIS) and the NBIS electronic application (eApp), or similar platforms and ability to complete NBIS eApp training to access and use NBIS eApp. Strong analytical skills, attention to detail, and organizational skills with the ability to diligently manage multiple priorities and meet deadlines. Excellent communication and interpersonal skills, both written and oral, needed for interactions with employees, leadership and government stakeholders. Ability to maintain strict confidentiality and privacy. Familiarity with ServiceNow and UKG Pro, as well as expertise with Microsoft Office applications, particularly Excel. Remote Work Requirements 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.

The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies. The Appeals RN works in collaboration with the Appeals Examiners and Reps to ensure redeterminations are medically reviewed as needed and completed timely. Salary Range $66,000 - $68,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin How do I know this opportunity is right for me? If you: Have moved away from direct patient care and want to continue using your nursing knowledge in a new and different way. Excel at analyzing information and critical thinking to make sound medical decisions. A highly organized and adept at researching and finding answers independently using all available resources. Thrive in a production environment where quality and production metrics are critical to individual and team success. Have strength in technical writing. Desire day hours with no on-call work and holidays off. Are technically strong on computers including MS Outlook, Teams, OneNote, Word, and Excel. Are self-motivated and work with a great degree of independence. Are looking for a full-time, permanent position. What will I gain from this role? Collaborating with a team of clinicians and non-clinicians. Learning a variety of systems, including but not limited to, the Medicare Appeal System (MAS) which is a content management system for Part A appeals and our Hyland OnBase tool which is our content management system used for Part B appeals. Experience working in an environment that serves our nation's military, veterans, Guard and Reserves, and Medicare beneficiaries. Working in a continuous performance feedback environment. Minimum Qualifications Associate's Degree in Nursing (ASN) or Bachelor's Degree in Nursing (BSN). Active RN license, applicable to state of practice in good standing. 1 or more years of clinical experience in a healthcare setting (hospital/bedside, case management, MDS/Skilled Nursing, etc.). Excellent written and verbal communication skills, with the ability to communicate complex medical information clearly and concisely. Strong attention to detail and organizational skills to manage multiple cases simultaneously. Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization Review). Solid computer skills with experience working in multiple on-line systems including MS Outlook, Teams, OneNote, Word, and Excel. Preferred Qualifications Experience working for a Medicare Administrative Contractor (MAC). 1 or more years of experience working in Medical Management (e.g., MDS role), Medical Review, Utilization Management/Review, or Appeals. Basic Medicare knowledge and/or experience. 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 Employee Resource Groups Professional and Leadership Development Programs Review additional benefits: (******************************************************************* Who We Are WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in 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 Health Solutions has been making health care easier for the people we serve for more than 75 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog 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.

Role Snapshot The Contract Administration Specialist will oversee all aspects of Medicare Administrative Contractor (MAC) contracts for WPS, serving as the primary point of contact for the Centers for Medicare & Medicaid Services (CMS). This role is responsible for managing contract administration, ensuring compliance with Federal Acquisition Regulation (FAR), and addressing contract-related issues. A deep understanding of FAR and its daily application is essential for success in this position. Salary Range $90,000 - $110,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location Our first consideration will be to have this new employee live in the Greater Madison, WI area to take advantage of Hybrid work and collaboration. Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to work in the office 2 days a week. Secondary priority will be given to remote candidates in the following states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin How do I know this opportunity is right for me? In this role you will: Serve as the primary point of contact with CMS Contracting Officers for MAC contracts, ensuring effective communication and relationship management. Ensure full compliance with contract provisions by collaborating with business units to address and resolve any compliance issues. Manage contract modifications, assess their impact on funding, and produce Requests for Equitable Adjustments in coordination with the Finance department. Prepare and submit required documents, including contract modifications, consents to subcontract, and funding projections, while ensuring accurate financial reporting to CMS. Oversee subcontracting requirements, develop subcontracts with Legal, and notify CMS of proposed subcontracts as necessary. Monitor and report on MAC budgets, identify business development opportunities, and provide recommendations to senior management regarding funding concerns and projections. Minimum Qualifications Must be a U.S. Citizen having the ability to obtain an applicable government determined clearance level. Bachelor's degree in Business Administration or related field OR equivalent post high school education and/or work-related experience. 5 or more years of experience in contract management or administration, or related field, preferably in a government contracting environment. Strong Federal Acquisition Regulation (FAR) knowledge including experience applying such knowledge on a daily basis. Ability to utilize sound reasoning and analysis for creative problem-solving and overcome regular distractions to meet strict deadlines. Excellent communication and interpersonal skills, both written and oral, needed for interactions with employees, leadership and government stakeholders. Ability to maintain strict confidentiality and privacy. Remote Work Requirements 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.

Leads and manages the strategic and operational aspects of complex initiatives for the maternal health program. Leads and coordinates the cross-functional maternal health workgroup to meet program goals and accreditation requirements. Collaborates closely with project team members, business owners and sponsors to develop, implement and monitor initiatives. What You'll Do Gathers input from across the enterprise, division, community, members and through competitive intelligence to identify opportunities, assess needs and develop strategic design of solutions. Ensures alignment of solutions across the enterprise. Develops business cases, strategy concept designs and program requirements. Serves as a subject matter expert, routinely briefing leaders and key stakeholders on program goals and initiatives. Develops project plans and recommendations in support of compliance objectives and leads implementation. Tracks and reports on the status of projects. Assesses project risks, develops mitigation and contingency plans. Identifies analyzes and understands target audiences and their specific program needs. Develops and deploys marketing strategy to increase member engagement in maternal health programs. Leads vendor identification, evaluation, selection and contract negotiations for new vendor relationships. Manages and coordinates activities, analyzes datasets and writes population health reports to meet NCQA accreditation requirements. Establishes and monitors performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs. Documents and presents program results through operational reports, outcomes studies and presentations. Owns and makes needed decisions to ensure the successful resolution of issues within the program to achieve milestones and program deliverables. Incorporates evaluation planning into the overall strategy. Establishes key performance indicators for programs, including process measures, outcomes measures and financial measures. Ensure program is designed in such a way that these metrics can be collected and monitored. What You'll Bring Bachelor's degree or advanced degree (where required) 5+ years of experience in related field (strategic planning and program management) In lieu of degree, 7+ years of experience in related field Bonus Points Clinical experience in maternal health Health Plan experience preferred What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community Work-life balance, flexibility, and the autonomy to do great work Medical, dental, and vision coverage along with numerous health and wellness programs Parental leave and support plus adoption and surrogacy assistance Career development programs and tuition reimbursement for continued education 401k match including an annual company contribution Learn more Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $89,174.00 - $142,679.00 Skills

Role Snapshot The Internship Program with WPS Health Solutions is comprised of two key components. The first component involves gaining practical experience to supplement academic coursework and prepare for future career pursuits. This will be comprised of a hands-on role within a functional area related to a relevant field of study. Each internship incorporates responsibilities and tasks which support the business objectives and client service offerings, while providing ongoing collaboration with experienced departmental colleagues and exposure to "real world" business demands. The second element centers on exposure to corporate culture and professional development. This Intern will participate in discussions focused on building soft-skills and business acumen. This intern will gain mentorship by participating in the full software development lifecycle from design to deployment while working with technologies like C#, JAVA, and SQL. Start Date: June 2025 Pay Rate: $22.00/hour Hybrid Work Location: This position will be hybrid, having the regional availability to come into our office Two days a week. Our office location: WPS Corporate Center Building - 1717 W. Broadway in Madison, WI. In this role you will: Assist in the design, development, testing, and maintenance of software applications. Analyze and prepare specifications and documentation according to department standards. Provide in-depth analysis, design, and support for department applications and programs. Assist in research and issue resolution for processing business data. Help with front-end and back-end development tasks, supporting system deployments. How do I know this opportunity is right for me? If you: Are eager to gain hands-on experience in software development. Enjoy problem-solving and coding and are excited to work on projects that require attention to detail and technical skills. Are looking for mentorship and want to learn from experienced developers who can guide you through best practices, development tools, and techniques. What will I gain from this role? Exposure to the Full Software Development Lifecycle: Participate in each stage of software development, from designing and coding to testing and deployment, helping you understand the entire process of creating and launching applications. Strengthen your ability to solve complex problems, troubleshoot issues, and debug code, all while working on real-world projects. Minimum Qualifications Be currently pursuing a degree in higher education or recent graduate. Have experience with Microsoft Office (i.e., Word, Excel, Outlook, etc.). Preferred Qualifications Currently pursuing a degree in Computer Science, Information Systems, System Administration or related field. Remote Work Requirements 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 Hybrid work Holiday Pay and On-Demand PTO 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. Sign up for Job Alerts FOLLOW US! Instagram LinkedIn Facebook WPS Health Blog This position may from time to time provide support to federal health care programs and other governmental or regulated industries. In accordance with law and/or contractual requirements, individuals in this role are or may be subject to all applicable federal regulations, agency contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. WPS and its personnel are subject to mandatory enhanced screening and background investigation prior to being granted access to information systems and/or sensitive data in order to safeguard regulated information and government resources that provide critical services.

Document Processor / Compliance Analyst (Full-Time - NJ) Business Credentialing Services, Inc. (BCS) is a fast-growing technology company in the insurance and risk management industries. We are growing our Operations department and are looking to hire a Document Processor to assist with data entry and customer support. Today, we have more than 70 employees and two office locations in Parsippany, NJ and Provo, UT. Our compliance and risk management platform helps companies reduce their risk exposure by systematically verifying Vendors/Suppliers they do business with. Blending professional services with web-based applications, BCS continues to maintain its foothold as one of the industry leaders. Job Type: Full-time Employee Pay: $19.50 per hour Responsibilities: Perform data entry tasks, including inputting and updating information in databases. Review incoming documentation to verify pertinent information for our clients. Send emails and make phone calls to provide feedback on the documents received. Assist with administrative tasks as needed. Attend team meetings/phone calls. Requirements: Strong data entry skills with a high level of accuracy and attention to detail. Strong written and verbal communication skills. Excellent organizational and time management skills. Ability to perform data entry tasks within our software platform quickly and accurately. Intermediate computer literacy is required. Bachelor's Degree required in any field. Employee Benefits and Additional Information: Starting Pay Rate: $19.50 per hour. Required to report to the office in Parsippany, NJ Monday - Friday. When an employee reaches six months of employment, they can work remotely one day per week. When an employee reaches three years of service, they can work remotely two days per week. Semi-Annual Pay Increases - Employee can earn up to a 2.5% pay rate increase every six months based on performance. Healthcare Benefits (Medical, Vision, Dental) are available for employees on their first day of employment. 401(k) / Retirement Benefits - An employee is eligible to participate in the BCS 401(k) program with company matching on their three-month anniversary. Paid Federal Holidays and Paid Time Off.