Network Health

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking a Director of Treasury. The Director of Treasury is responsible for leading the organization's treasury function, including cash management, banking relationships, liquidit

Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking an Actuarial Intern to support our Actuarial team. The Actuarial Intern will have

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking an Encounter Data Analyst to support the critical encounter data functions for our Medicaid TPA line of business. This position is responsible for the identification and co

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking a Director of Communications to lead how we communicate internally, externally and at the executive level. This highly visible role will serve as a strategic communications

The Chief Information Security Officer (CISO) is a director level role responsible for establishing and maintaining the information security program to ensure that information assets and associated technology, applications, systems, infrastructure and processes are adequately protected in the digita

The Director of Information Systems (IS) is charged with supporting the technology strategy to enhance business activities. This individual is responsible for the maintenance of technology systems and services for enterprise business functions. The Director of IS will promote ongoing relationship-bu

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment. Location: Candi

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager advocates for options and services to meet an indivi

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment. Location: Candi

The Provider Integration Representative will support personnel for Credentialing and Provider Informatics. This role is responsible for aiding provider data management, provider credentialing needs, and maintenance of accurate provider information across all lines of business. This role supports pro

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. Network Health is seeking a Compliance Process Administrator to join our organization. The Compliance Process Administrator is responsible for the management of compliance processes, including the o

The Pharmacy Benefits Specialist I provide basic operational, planning, implementation and reporting support for the Pharmaceutical Benefits area of Network Health Plan. In addition to providing administrative support for the pharmaceutical area of Network Health, this role will build report queries

Network Health is seeking a Supervisor of Payment Integrity. This role provides leadership support to strengthen and sustain payment integrity efforts at Network Health by providing guidance, coordination and oversight of the team activities. The supervisor oversees the collection, reporting and ana

The Manager of Service Now (SN) will focus on further development and deployment of SN for IS and business team use. The Manager of SN is charged with championing the use of SN within NH along with creating new standards and tool usage for movement of data. This role will align stated business needs

The Manager of IS Operations will focus on improving interactions between IS and the business teams. The Manager of IS Operations will guide IS to having a better understanding business needs and promote a collaborative culture between technology teams and business teams. Location: Candidates must r

The Manager of Cloud Engineering will focus on and accelerate changes to our data centers and deploy cloud technologies to remedy shortcomings found in the IS Infrastructure and QNXT Assessments. The Manager of Cloud Engineering is charged with migrating to a new data center strategy combined with c

The Database Administrator will design, install, monitor, maintain, and optimize Network Health Plan databases while ensuring high levels of data availability. This position is responsible for developing, implementing, and overseeing policies and procedures that ensure the security, integrity and pe

The Pharmacist is responsible for providing clinical support for NHP's pharmacy, quality, compliance and health management efforts. This may include Case Management, Disease Management, Medication Therapy Management, Drug Utilization Review and creation of Clinical Programs to outcomes and cost effe

In support of the CMO, the Associate Medical Director is responsible for the administration of procedures, protocols, and standards regarding the efficiency and quality of the health care delivered to Network Health (NH) members. This individual will be chair of at least 3 committees related to qual