Join the team at Chorus Community Health Plans: Where passion meets purpose
Are you ready to make a difference? Do you believe in the power of health insurance to change lives? At Chorus Community Health Plans, we don't just offer jobs, we offer opportunities to be part of something bigger, something that matters. By Joining our team, you'll become a vital force in improving access to healthcare, promoting health equity and strengthening communities. Join us in our mission to make quality healthcare accessible to all.
About us
Chorus Community Health Plans (CCHP) is not just another health insurance company; we are a community committed to transforming lives. Founded in 2005, CCHP is a trusted health maintenance organization (HMO) based in Wisconsin. We are a part of Children's Wisconsin , one of the state's most respected healthcare organizations. At CCHP, our core values - Purpose, Collaboration, Health, Innovation, and Integrity - drive us to provide exceptional service to the individuals, children, and families we serve.
Our programs
BadgerCare Plus : CCHP, the second largest BadgerCare health plan in Wisconsin serves over 130,000 adults and children in 27 counties in eastern Wisconsin.
Care4Kids : We're the pioneers of Wisconsin's Foster Care Medical Home initiative, providing vital health care coordination services to 2,800 children in out-of-home care in Southeastern Wisconsin. Through our "medical home" model, we strengthen care quality, access, and timeliness, shaping healthier futures for these children.
Individual and Family Plans : Tailored to meet the diverse needs of individuals and families in a 15-county service area, our plans serve more than 13,000 members. Our extensive network, including renowned institutions like Ascension, Froedtert, and Medical College of Wisconsin, ensures comprehensive coverage both on and off the exchange.
What we offer
Thriving work environment : Immerse yourself in a vibrant, inclusive, and collaborative workplace that fosters creativity and innovation.
Competitive compensation : Enjoy a competitive salary and benefits package that values your skills and dedication.
Exceptional team dynamics : Join a team recognized for its top-notch employee engagement scores, making every day a rewarding experience.
Impactful contribution : Seize the chance to create a positive impact in the lives of others, turning your passion into a meaningful difference.
Your opportunity
We invite dedicated individuals to join our mission-driven organization. Be a part of something where your skills and enthusiasm translate into meaningful change. Discover a career where your passion meets purpose. Apply today and help us shape a healthier tomorrow.
Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/
Manages the medical record retrieval process for Risk Adjustment, the Risk Adjustment Data Validation (RADV) audit and HEDIS processes. Responsible for accurately and timely requesting and obtaining medical records from external providers, sorting the records in appropriate systems and managing the invoice payment process. This position will also support the Individual and Family Plan department with administrative tasks and other duties as time allows.
- Corresponds with Chorus Community Health Plan (CCHP) contracted providers and their office administrators through fax, mail and electronic health records systems to obtain medical records and any other documents as appropriate.
- Communicates via phone calls and emails with providers and their office administrators in a timely manner to follow-up on requests as necessary. Investigates and escalates issues as appropriate.
- As medical records are obtained, saves and organizes files and documents within internal systems and communicates receipt of records to appropriate teams.
- Meets all associated deadlines for medical record retrieval for Risk Adjustment, the RADV audit and HEDIS.
- References provider contracts to ensure appropriate payment for obtained medical records. Manages payment process and acts as the liaison between providers, associated systems and internal Accounts Payable department.
- Participates in regular meetings and collaborates with RA and HEDIS teams for support.
- Works with the Individual and Family Plan and Quality departments’ leadership on additional administrative tasks and special projects as assigned.
Exhibits guiding behaviors that reflect Children’s values and support our mission and vision.
Ability to maintain a high level of confidentiality.
Must be organized, have strong communication and attention to detail to coordinate across teams to organize and track progress on associated tasks.
Strong ability to learn and navigate computing platforms and technology.
Effective written and oral communication skills.
Able to meet daily demands and deadlines, as well as respond to urgent situations.
Demonstrated time management and strong organizational skills.
Interpersonal and communication skills to interact effectively with interdisciplinary health team members and providers.
Independent judgment, analytical ability, and systems thinking to work in complex systems.
- The required schedule will be daily, Monday-Friday, with standard core hours of 8:00am-5:00pm. This is a full-time 40 hour/week role.
- This role may be remote/work from home, unless selected candidate prefers to work in office. CCHP is located at Summit Place in West Allis. A candidate located in Wisconsin, within reasonable distance to Milwaukee is preferred to allow for attendance to periodic on-site team meetings. (for approved remote state)
Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.