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Policy Development Coordinator RN (Remote Work Available)

WPS Health Solutions Omaha, NE

Job Description

Who We Are

We are a leading not-for-profit health insurer in Wisconsin, and our services have grown to reach active-duty and retired military personnel, seniors, and families in Wisconsin, across the U.S., and around the world. Learn more!

WPS receives World's Most Ethical Company Award for 9th Year in a Row 2018 Most Ethical Companies Announcement

At Our Core

WPS Health Solutions has earned a reputation as a leader in the insurance and benefits administration industry through our commitment to excellence and high-quality service. Our corporate values reflect the core of who we are and how we conduct business every day.

Customer Focused

I recognize how my actions impact internal and external customers by being responsible for the customer experience. I look beyond the immediate issue to recognize and solve the problem.

Individual Responsibility

I own my actions. I am accountable and dedicated to achieving the best results for WPS Health Solutions and our customers. I embrace my role in helping the company achieve a high-performance workplace.

Mutual Respect

I lead by example and act ethically, honestly and am trustworthy. I show appreciation for others by giving and taking constructive feedback and encouragement. 

Driven and Passionate

I approach my work with enthusiasm, and personal commitment to the success of our business. I keep the importance of the work we do for our customers alive in my attitude and interactions with others, and demonstrate pride in the worthiness of our purpose.

Position Summary

The Policy Development Coordinator (RN) will initiate, coordinate, and maintain healthcare policy development for Medicare program affecting millions of recipients in company contracted jurisdictions throughout United States.

Remote Work Option :  After 1 year of employment on-site, remote work option available.

In this role you will:

  • Initiate, coordinate, and maintain healthcare policy development for Medicare program.
  • Respond to Centers for Medicare & Medicaid Services (CMS) mandates from federal government as they relate to healthcare and policy.
  • Assist contractor medical director in development of healthcare policies.
  • Utilize excellent writing, verbal, and organization skills to communicate decisions and meet deadlines.
  • Serve as a resource to various internal departments, including Customer Service and Medical Review regarding company medical policies.
  • Update and maintain company knowledge of current medical practices.
  • Ensure privacy and confidentiality of Medicare work.
  • Communicate with external providers and Contractor Advisory Committee (CAC) to help define CMS requests.
  • Communicate policy changes externally through correspondence in partnership with Provider Outreach Education (POE) and customer service activities.

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

You should have:

  • Associate’s degree in Nursing OR equivalent post high school education and/or work-related experience
  • RN state license
  • Two (2) years in similar role
  • Knowledge of nursing and medical care
  • Strong ability to perform independent research on policy items


Job Details

Date Posted October 30, 2018
Date Closes November 29, 2018
Located In Omaha, NE
Job Type Full-time Employee
SOC Category 29-1141.00 Registered Nurses
Zipcode 68164

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