Lead Section Manager, Health Care Integrity (Remote

Bureau for Integrity in Care Section Managers (LEES and RIS)

The Bureau of Integrity in Care promotes integrity and accountability across Wisconsin’s healthcare system. In this role, you’ll contribute to protecting the public, improving program transparency, and ensuring equitable access to care. DHS offers a collaborative, mission-driven environment with opportunities for professional growth and meaningful public service.

Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.

Several flex spending accounts: medical, dependent care, commuter, parking and High-Deductible Health Savings.

A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.

• Will work full-time, daytime hours, Monday through Friday.
• Will have the option to work remotely up to 5 days per week. This schedule may vary depending on training or operational needs.
• May need to travel throughout the state up to 5% of the time.
• Is headquartered in the 201
  
  E. Washington Ave. office in downtown Madison.
• Must have access to both a private workspace and secure high-speed internet to work remotely.

As the LEES Section Manager, you will be responsible for the following duties:

• Providing program leadership, standardization, policy direction, and cross-program coordination.
• Providing direct oversight of the Eligibility Reviews Program and the State Enforcement Program operations and staff.
• Providing program leadership for the Division’s provider licensing, certification/approval, eligibility review, and state enforcement functions that establish and maintain provider standards and ensure regulated entities meet applicable state and federal requirements.
• Directing the work of a diverse group of professional staff who evaluate provider entities, regulatory compliance, and quality-related performance outcomes, and ensures that program operations are consistent, timely, equitable, and legally defensible.
• Developing, implementing, and maintaining Bureau policies and procedures necessary to carry out program goals that support the highest possible quality of care and quality of life for individuals receiving services in regulated settings.
• Ensuring the integrity and consistency of initial and renewal licensing/certification processes, eligibility review determinations, and state enforcement actions within assigned scope, and establishes expectations for standardized workflows, timelines, documentation requirements, and decision-making practices.
• Serving as the Bureau’s program lead for emerging licensing and enforcement issues, including development of code interpretations and program policy decisions by synthesizing and analyzing multi-disciplinary and often competing information from relevant parties.
• Directing section staff to implement policies and procedures and providing guidance on complex or high-risk cases requiring elevated review and consistent interpretation.
• Serving as a key liaison with internal and external partners and interfacing with private and public agencies, legislators, provider associations, medical professionals, and attorneys to resolve program issues and support consistent regulatory operations.
• Providing information to leadership on emerging issues and supports the development and communication of program guidance and operational expectations for providers, advocates, consumers, and other relevant parties
• Providing advanced planning, assessment, and evaluation responsibilities, including development and completion of complex studies and analyses, review of program performance trends, and identification of improvement strategies.
• Participating in development of Department policies and administrative rules, recommending legislation, developing or refining public education and training initiatives, and making management decisions that impact Department programs regulating health care providers.
• Supervising professional staff and a subordinate operational supervisor…