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Results based on filters ( 12 jobs found )

MANAGER OF QUALITY MANAGEMENT SYSTEMS

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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86401648 293233961 Description Role Snapshot Our QMS Manager collaborates ...
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Summary
About the job:
with senior leadership on the development and implementation of an integrated quality strategy that drives operational excellence across the division. Responsible for strengthening the Quality Management System (QMS) to meet CMS, ISO, and other regulatory standards, the role leads process improvement initiatives aimed at enhancing performance and regulatory readiness. This QMS Manager directs the Quality Assurance department, ensuring consistent quality outcomes through audits, reviews, and performance evaluations. They...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Quality Control Systems Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

IT Infrastructure Intern - Summer 2026

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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85587424_1 293227592 Description Role Snapshot Our Internship Program with ...
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Summary
About the job:
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...
Location:
Grove City, OH
Job Type:
Full-Time
Internship
Occupation:
Network and Computer Systems Administrators
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Appeals Claims Rep - Redeterminations

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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86227985 293188390 Description Role Snapshot Our Appeals Claims Rep ...
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Summary
About the job:
(Redetermination Representative) responds to requests for first-level appeals. Reviews and compares processed claims with edit/audit detail and Medicare Policy. Refers cases to appeal nurses for medical necessity determination. Reviews medical documentation and claims history for frequency of service, required coding elements, and accurate fee determinations. Completes decision letters or claim adjustments as required to effectuate first level of appeal decisions. Establishes and maintain a professional rapport with contacts...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Insurance Claims and Policy Processing Clerks
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
3
apply
Detailed Job Information

Medicare Outreach & Education Specialist

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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86073791 293122868 Description Role Snapshot The Medicare Outreach & ...
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Summary
About the job:
Education Specialist 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, coders, billers, and compliance staff to help them understand the Medicare program and be...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Training and Development Specialists
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Case Management RN

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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86054944 293117463 Description Role Snapshot Our Case Management RN ...
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Summary
About the job:
(Registered Nurse) coordinates care and services of select member populations with complex health care needs across continuum of care. The primary focus of the role is the development and continuous monitoring of a member-centric plan of care that promotes effective utilization of health care services while maximizing quality and cost-efficiency of these services for members. Our Case Management RN routinely educates members and family members on plans of care while serving as a liaison between the members, their families and...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Certified Registered Nurse
Certified Case Manager
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
4
apply
Detailed Job Information

Contract Administration Specialist

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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85799105 293098731 Description Role Snapshot The Contract Administration ...
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Summary
About the job:
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...
Location:
Grove City, OH
Job Type:
Full-Time
Contract
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Medicare Claims Representative

Wisconsin Physicians Service Insurance Corp
Darbydale, OH
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85944991 293086711 Description Role Snapshot Our Medicare Claims ...
Details
Summary
About the job:
Representative processes Medicare claims from receipt through resolution in accordance with applicable policies, procedures, and regulatory requirements. This role ensures timely and accurate claim resolution while maintaining high standards for quality and customer service. Hourly Rate of Pay $18.50/hour or more based on county SCA rates. Start Date: 2/24/26 Training Location/Schedule: Mandatory phased training from Monday through Friday will be required over the first 8 months. The first 4-week training sessions will be...
Location:
Darbydale, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
3
apply
Detailed Job Information

Appeals Nurse

Wisconsin Physicians Service Insurance Corp
Darbydale, OH
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85900094 293070744 Description The Appeals Nurse examines medical records ...
Details
Summary
About the job:
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...
Location:
Darbydale, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
4
apply
Detailed Job Information

Supervisor of Health Services

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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85869786 293058623 Description Role Snapshot Our Health Services Supervisor ...
Details
Summary
About the job:
is responsible for overseeing the Health Services Utilization and Case Management nursing teams. This supervisor will manage inventory, support staff mentoring and training, and drive workflow efficiencies within the teams. Will Work closely with the Health Services Manager, and support implementation of departmental and company initiatives while serving as a key daily resource for the nursing teams. Salary Range $95,000 ~ $115,000 The base pay offered for this position may vary within the posted range based on your...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Cost Report Auditor Intern - Summer 2026

Wisconsin Physicians Service Insurance Corp
Grove City, OH
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85845324 293046565 Description Role Snapshot The Internship Program with WPS ...
Details
Summary
About the job:
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"...
Location:
Grove City, OH
Job Type:
Full-Time
Internship
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
6
apply
Detailed Job Information
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