WPS—A health solutions company · 3 weeks ago
Supervisor of Health Services
Illinois, United States
Full-time
Hybrid
Mid, Senior Level
$95K/yr - $115K/yr
5+ years expWPS, a health solutions company, is seeking a Health Services Supervisor to oversee their Health Services Utilization and Case Management nursing teams. The supervisor will manage inventory, support staff mentoring and training, and drive workflow efficiencies while collaborating with the Health Services Manager and nursing teams.
GovernmentHealth CareHealth Insurance
Responsibilities
Ensure utilization management reviews are completed in accordance with department standards
Enjoy coaching and mentoring nursing staff conducting medical necessity reviews, prior authorizations, and appeals
Oversee case management activities to ensure timely and appropriate member interventions to meet individual needs and maximize health outcomes
Collaborate with physicians, providers, and internal departments to coordinate care for complex cases
Monitor team performance, productivity, quality of care and compliance with established metrics and accreditation standards (e.g., URAC, NCQA)
Provide training and professional development opportunities for nursing staff
Serve as a clinical resource for staff, handling escalated provider and member inquiries
Conduct staff quality audits and support the development of clinical guidelines and utilization review protocols
Participate in quality improvement initiatives and contribute to the development of department goals and performance targets
Assist with system testing, configuration, training, and implementation of new systems or upgrades
Qualification
Required
Registered Nurse (RN) with current licensure in the state of Wisconsin OR current Compact License
Active RN license, applicable to state of practice in good standing
Associates Degree in Nursing
5 or more years of clinical experience in a healthcare setting (hospital, clinic, home care, skilled nursing facility, etc.)
Solid knowledge and understanding of medical/clinical review processes
Strong analytical, problem-solving, and organizational skills with the ability to manage multiple cases simultaneously and meet strict deadlines this includes: Excellent reading comprehension, written and verbal communication skills, with the ability to communicate complex medical information clearly and concisely
Proficient in Microsoft Office tools with experience working in electronic health records
Preferred
1 or more years of experience in a supervisory or leadership role
Bachelor's degree in nursing (BSN)
Certified Managed Care Nurse (CMCN)
Health insurance background that could include, Third party Administration (TPA) Point of Service (POS), Preferred Provider Organization (PPO), or Medicare Supplement) plans
Benefits
Remote and hybrid work options available
Performance bonus and/or merit increase opportunities
401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (**100% vested immediately**)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start **DAY 1**
Professional and Leadership Development Programs
Company
WPS—A health solutions company
WPS, a health solutions company, is an independent, not-for-profit, local company based in Madison, Wisconsin.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
HealthX Ventures
2025-10-20Series Unknown
Leadership Team
Frank Gumina
Chief Legal and Administrative Officer
Rochelle Myers
Chief Growth Officer and Head of New Ventures
Recent News
2025-11-22
2025-08-04
Company data provided by crunchbase