Jobs at WPS Health Solutions

The Cost Report Auditor conducts audits of Medicare Cost Reports, ensuring compliance with CMS regulations and integrity of financial data for healthcare providers.

The Grievance & Appeals Specialist reviews and resolves member and provider grievances, coordinating with multiple internal teams to ensure compliance and timely case resolutions.

The Provider Contract Manager oversees provider agreements, negotiates terms, ensures compliance, manages contracts, builds relationships, and analyzes performance to support healthcare delivery.

The Director leads the strategic direction and growth of the product portfolio in commercial health insurance, ensuring alignment with market opportunities and enterprise objectives. They drive innovation while overseeing cross-functional teams to optimize product performance and compliance within a regulated environment.

The Claims Examiner II reviews and assesses claims for fraud, maintains case files, prepares decisions, and partners with medical staff for appeals.

The Manager of Quality Engineering leads QE strategy, governance, automation, and compliance across platforms, ensuring performance and quality standards. Responsibilities include team leadership, managing budgets, and implementing enterprise-wide QE practices.

The Data Analyst gathers and analyzes data to provide insights for decision-making, focusing on process improvement and technology innovation. Responsibilities include data visualization, statistical analysis, and collaboration with cross-functional teams.

Support HR operations by handling employee inquiries, managing personnel files, assisting HR initiatives and change-management projects, maintaining process documentation, and participating in team meetings to improve HR processes.

Support the full recruiting lifecycle by assisting with recruiting workflows, candidate outreach and communication, screening, cultural-fit evaluation, and tracking recruiting metrics to improve processes.

Lead and manage the IT change management process, monitor and schedule changes, handle expedited/emergency changes, run CAB meetings, coordinate with stakeholders, support major incident management, maintain documentation, and provide change metrics and continuous improvement.