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    1 job found in Middleton, Wisconsin

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      • Madison, Wisconsin
      • Permanent
      • $29.00 - $33.00 per hour
      • 8:00 AM - 4:30 PM
      Spherion, in partnership with the State of Wisconsin Department of Health Services, is looking for an Oversight Analyst to join the Bureau of Quality Oversight team! This position is responsible for providing state oversight of programs that demonstrate consumer-responsive ways of reforming health and long-term care systems. As part of the Program Oversight Team, you will provide program and administrative support to Managed Care Organizations (MCOs), Health Management Organizations (HMOs), managed care contract agencies, Tribal agencies, and other providers of Department programs and services. The objective is to assure that individuals have access to all needed supports and services, and to assure coordination, communication, and collaboration among entities so that federal and state resources are used in the most cost-efficient and effective manner.The PTO policy for this position mirrors the State of Wisconsin policy! Benefits will be discussed during the interview process.Responsibilities:- Serve as the primary point of contact between assigned MCOs, HMOs, and the Bureau of Quality Oversight- Assure the MCOs and HMOs are meeting contracted Department program requirements and continually improving their performance in meeting the outcomes of their members- Take corrective action if MCOs or HMOs are not following contracts or staying in compliance- Take and write up complaints, implement and write policies, and assist with member enrollment- Provide administrative consultation in quality improvement activities and compliance with performance and outcome standards to assure that services are integrated, available, accessible, and efficiently delivered to all enrollees- Maintain knowledge regarding all facets of the MCOs or HMOs operations, including business systems developed to support the MCOs or HMOs core activity of care management and service provision- Be an expert in all areas of long term care and Medicaid managed care requirements including understanding the philosophy of person-centered care and personal outcomes, as well as working closely with assigned Member Care Quality Specialists/Contract Coordinator/Managed Care AnalystWorking hours: 8:00 AM - 4:30 PMSkills:- Excellent skill in Microsoft Excel and other Microsoft programs- Strong, professional written and oral communication skills- Ability to collaborate and work well in a team-oriented environmentEducation:BachelorsExperience:1-4 yearsQualifications:- Bachelors degree in a related field required- Previous experience with Medicaid and public program policy desired- Previous experience with healthcare and Health Management Organizations desired- Previous billing experience desired Apply Today!Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. No one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.
      Spherion, in partnership with the State of Wisconsin Department of Health Services, is looking for an Oversight Analyst to join the Bureau of Quality Oversight team! This position is responsible for providing state oversight of programs that demonstrate consumer-responsive ways of reforming health and long-term care systems. As part of the Program Oversight Team, you will provide program and administrative support to Managed Care Organizations (MCOs), Health Management Organizations (HMOs), managed care contract agencies, Tribal agencies, and other providers of Department programs and services. The objective is to assure that individuals have access to all needed supports and services, and to assure coordination, communication, and collaboration among entities so that federal and state resources are used in the most cost-efficient and effective manner.The PTO policy for this position mirrors the State of Wisconsin policy! Benefits will be discussed during the interview process.Responsibilities:- Serve as the primary point of contact between assigned MCOs, HMOs, and the Bureau of Quality Oversight- Assure the MCOs and HMOs are meeting contracted Department program requirements and continually improving their performance in meeting the outcomes of their members- Take corrective action if MCOs or HMOs are not following contracts or staying in compliance- Take and write up complaints, implement and write policies, and assist with member enrollment- Provide administrative consultation in quality improvement activities and compliance with performance and outcome standards to assure that services are integrated, available, accessible, and efficiently delivered to all enrollees- Maintain knowledge regarding all facets of the MCOs or HMOs operations, including business systems developed to support the MCOs or HMOs core activity of care management and service provision- Be an expert in all areas of long term care and Medicaid managed care requirements including understanding the philosophy of person-centered care and personal outcomes, as well as working closely with assigned Member Care Quality Specialists/Contract Coordinator/Managed Care AnalystWorking hours: 8:00 AM - 4:30 PMSkills:- Excellent skill in Microsoft Excel and other Microsoft programs- Strong, professional written and oral communication skills- Ability to collaborate and work well in a team-oriented environmentEducation:BachelorsExperience:1-4 yearsQualifications:- Bachelors degree in a related field required- Previous experience with Medicaid and public program policy desired- Previous experience with healthcare and Health Management Organizations desired- Previous billing experience desired Apply Today!Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. No one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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