Company · 45 open roles
Careers at WIS
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45 positions at WIS
Intake Specialist
WIS·Madison, WI
Role Snapshot The Intake Specialist manages inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. This role supports prior authorizations, claims processing including writing authorization and denial letters, case …
Case Management RN
WIS·Madison, WI
Role Snapshot Our Case Management RN (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 …
Claims Representative 2
WIS·Madison, WI
Role Snapshot The Claims Rep 2 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 cust…
Actuarial Intern-Summer 2027
WIS·Madison, WI
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 a…
Claims Examiner III - LPN
WIS·Madison, WI
U.S. citizenship is required for this position due to Department of Defense restrictions. Our Claims Examiner III LPN protects the integrity of the Military Veteran Health (MVH) program by identifying, investigating, and preventing potential fraud, waste, and abuse. They blend c…
Utilization Management RN
WIS·Madison, WI
Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to review medical services with evidence-based criteria, a…
Senior Business Systems Administrator
WIS·Madison, WI
Role Snapshot The Senior Business Systems Administrator serves as the technical subject‑matter expert for Costpoint and related financial systems, ensuring secure, stable, and optimized performance across all finance applications and integrations. This role leads complex system…
Director, Next-Gen Product Solutions
WIS·Madison, WI
Role Snapshot The Director, Next-Gen Solutions leads the health plan's efforts to create novel/transformational offerings to the market, with an initial focus on designing, developing, building and launching the organization's next-generation commercial health plan model. This …
Transformation Consultant
WIS·Madison, WI
Our Transformation Consultant is a strategic advisor and change leader within the IT organization, responsible for guiding enterprise-level transformation initiatives and optimizing critical business and technology processes. They partner with executives, business leaders, and pr…
Principal, SOC Analyst
WIS·Madison, WI
U.S. citizenship is required for this position due to Department of Defense restrictions. Our Principal, Security Operations Center (SOC) Analyst serves as the senior technical leader for detecting, investigating, and responding to cyber threats across WPS's Government and Comme…
Senior Overpayment Recovery Specialist
WIS·Madison, WI
Role Snapshot The Senior Overpayment Recovery Specialist will assist the Overpayment Recovery Team with work direction, workflow, inventory, and coordination of activities and processes within the department. The role will advise and assist employees in the unit and support the …
Medicare Pricing Analyst
WIS·Madison, WI
Role Snapshot The Medicare Pricing Analyst is responsible for researching complex Medicare pricing and reimbursement issues while ensuring the accuracy and effectiveness of Medicare claims processing and coding guidelines. This role supports the implementation and validation of …
Principal Application Security Analyst
WIS·Madison, WI
U.S. Citizenship is required for this position due to Department of Defense restrictions. Our Principal Application Security Analyst builds and operates WPS's enterprise Application Security program, reducing application risk by operationalizing secure-development standards, str…
Quality Assurance Manager
WIS·Madison, WI
Our Quality Assurance Manager coordinates and oversees the continued development, implementation, and monitoring of the Quality Assurance activities for the Audit and Reimbursement department. They serve as a subject matter expert in Medicare reimbursement and cost reporting, pro…
Claims Examiner III, Fraud and Abuse - LPN (Must live in vicinity of Madison, WI WPS campus)
WIS·Madison, WI
U.S. citizenship is required for this position due to Department of Defense restrictions. Our Claims Examiner III, Fraud and Abuse focuses on identifying, developing, and reporting fraudulent or abusive practices. They provide support to Military Veterans Health (MVH) Management…
Full-Stack Implementation Engineer
WIS·Madison, WI
U.S. Citizenship is required for this position due to Department of Defense restrictions. Our Implementation Engineer is a Full Stack Engineer that will build, configure, and maintain scalable data extraction workflows using intelligent document processing as well as performing …
Manager, Cyber Business Enablement
WIS·Madison, WI
U.S. citizenship is required for this position due to Department of Defense restrictions. Our Manager, Cyber Business Enablement is the primary relationship and engagement leader between Enterprise Cyber Resilience and WPS's business and technology stakeholders, reporting direct…
Director Cyber Trust & Architecture
WIS·Madison, WI
U.S. Citizenship is required for this position due to Department of Defense restrictions. Our Director, Cyber Trust & Architecture provides enterprise leadership for cybersecurity architecture, identity strategy, Zero Trust, and secure-by-design practices across WPS, reporting d…
Contract Coordinator
WIS·Madison, WI
Role Snapshot The Contract Coordinator is accountable to maintain and strengthen WPS provider networks by managing existing provider contracts and prospecting and proposing new contracts based on adequacy needs and financial considerations. The role serves as a liaison between W…
Director, Agile Program & Roadmap Governance
WIS·Madison, WI
Role Snapshot The Director, Agile Program & Roadmap Governance is accountable for governing, orchestrating, and maturing the Health Plan's Agile delivery framework and strategic roadmap execution. This role ensures alignment between organizational strategy, portfolio governance,…
Intake Specialist
WIS·Madison, WI
Role Snapshot The Intake Specialist manages inbound and outbound communications for Health Services, ensuring accurate intake, documentation and routing of cases. This role supports prior authorizations, claims processing including writing authorization and denial letters, case…
Manager, Cyber Threat Management
WIS·Madison, WI
U.S. Citizenship is required for this position due to Department of Defense restrictions. Our Manager, Cyber Threat Management leads WPS's detection, prevention, and response capabilities and reports directly to the Chief Information Security Officer. This Manager owns cyber inc…
Senior Overpayment Recovery Specialist
WIS·Madison, WI
Role Snapshot The Senior Overpayment Recovery Specialist will assist the Overpayment Recovery Team with work direction, workflow, inventory, and coordination of activities and processes within the department. The role will advise and assist employees in the unit and support t…
Pharmacy Vendor Coordinator
WIS·Madison, WI
Role Snapshot The Pharmacy Coordinator will oversee development and execution of audit processes that monitor delegated activities performed by the Pharmacy Benefits Manager (PBM). The role will build working expertise in the PBM's online claims system and its capabilities, ser…
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