Wisconsin Population Health Specialist

Job Summary

Providing operational support for various departments, the full-time Wisconsin Population Health Specialist will manage medical records requests, conduct member outreach, and ensure compliance with CMS and NCQA standards, with occasional in-office attendance required in Menasha, WI.

Key responsibilities:

• Apply organizational, regulatory, and credentialing principles in daily operations
• Assign case and condition candidates to appropriate coordinators based on referrals
• Interact with members and providers regarding authorizations and case management inquiries

Required qualifications:

• High School Diploma required
• 1 year of healthcare experience in a clinical or insurance setting preferred
• Ability to work from home with reliable internet access
• Willingness to travel to the corporate office occasionally