Contact Center Provider Services Remote USA
Provide knowledgeable responses to client inquiries and resolve issues while adhering to service level agreements. Collaborate with team members to update account history and improve workflow processes.
Gainwell Technologies LLC
Remote Job Openings at Gainwell Technologies LLC (245)
Contact Center Provider Services Remote USA
Provide knowledgeable responses to client inquiries and resolve issues while maintaining accurate account history. Collaborate with team members to improve workflow efficiency and ensure adherence to service level agreements.
Prior Authorization Manager
You will lead and develop teams to deliver superior healthcare services while managing performance and engagement. Additionally, you will cultivate relationships with account leaders to optimize operational processes and ensure compliance with service level agreements.
TSQL Developer
The SQL Developer Analyst will analyze, design, and program SQL-based solutions while collaborating with cross-functional teams to meet business objectives. They are responsible for data mining, modeling, and providing technical guidance and mentoring to the development team.
Claims Examiner - Remote US
The Claims Examiner is responsible for reviewing, evaluating, and processing insurance claims to ensure accuracy and compliance with policies. They also research claim discrepancies and respond to inquiries from customers, providers, and internal teams.
Experienced Database Administrator
You will design, develop, and maintain scalable database systems to support critical healthcare operations. Additionally, you will monitor performance, automate data processes, and provide technical guidance to team members.
DRG Clinical and Coding Educator- Remote
Develop and deliver comprehensive training programs for clinical reviewers, coders, and auditors regarding DRG validation and coding guidelines. Serve as a subject matter expert to mentor teams, monitor quality metrics, and ensure compliance with industry standards and clinical policies.
Medicaid Product Strategy Lead(Medicaid Products & AI Enabled Modernization)
The Principal Product Manager will own the strategy, roadmap, and outcomes for Medicaid product domains by turning complex business knowledge into reusable, configurable products. They will lead cross-functional teams to integrate AI, define business rules, and ensure product usability while mentoring other product managers.
FileNet with Java Developer
Design, develop, and maintain enterprise content management solutions using IBM FileNet, CMOD, and Content Navigator. Perform system integration, platform administration, and production support across the ECM ecosystem.
Senior C/Unix Developer
You will code, test, debug, and implement complex healthcare administration programs while analyzing requirements to design effective system components. Additionally, you will provide technical consulting to clients and lead a small sub-team of developers to ensure project success.
Senior C/Unix Developer
You will code, test, debug, and implement complex healthcare administration programs while designing systems to meet business needs. Additionally, you will provide technical advice, conduct quality assurance, and serve as a technical project lead for the team.
Tax Director
The Tax Director will lead the company's tax accounting, compliance, planning, and audit functions across federal, state, and international jurisdictions. This role involves managing external financial reporting, resolving tax audits, and providing strategic tax advice for acquisitions and corporate initiatives.
Nursing Services Reviewer, Specialist
The Nurse Reviewer performs clinical reviews of medical records to determine the medical necessity of services based on established criteria and policies. They also document findings, manage prior authorizations, and assist in training and mentoring new staff members.
Non-Medical Transportation (NMT) Processor - Remote California
The NMT Processor coordinates transportation for Medi-Cal beneficiaries by reviewing requests and scheduling rides with providers. They ensure all documentation is accurate and compliant with DHCS guidelines and internal service standards.
Non-Medical Transportation (NMT) Processor - West Sacramento, CA - Remote
The NMT Processor coordinates transportation for Medi-Cal beneficiaries by scheduling rides for medical appointments and verifying eligibility. They also document all request details in the system and respond to inquiries from beneficiaries and providers.
Data Science AI Engineer, Advisor
Design, develop, and deploy advanced AI and Generative AI solutions across healthcare technology platforms. Collaborate with software engineers to integrate models while ensuring compliance with HIPAA and other regulatory standards.
Security Compliance Officer
The Security Compliance Officer serves as a subject matter expert for security procedures and audit compliance, managing external audits like SOC 1, SOC 2, and NIST 800-53. They also oversee security administrator teams, conduct identity access reviews, and investigate security violations to ensure organizational compliance.
Security Compliance Officer
The Security Compliance Officer serves as a subject matter expert for security procedures, managing external audits such as SOC 1, SOC 2, and NIST 800-53. They oversee security administrator teams, conduct identity access reviews, and ensure compliance with government and corporate security regulations.
Pharmacy Technician - Remote Mississippi
The Pharmacy Technician will support members and providers with pharmacy benefit, claims, and prior authorization inquiries via phone and other channels. They are responsible for accurately documenting interactions and processing requests according to established procedures and urgency.
Contract Management Specialist
The Contract Management Specialist will lead the development, negotiation, and administration of complex contracts while ensuring regulatory compliance and risk mitigation. They will collaborate with cross-functional teams to manage the full contract lifecycle and provide guidance on contractual obligations and business implications.
Senior Business Analyst (Medicaid Programs)
Lead business analysis for Wisconsin's Children's Long-Term Support program, coordinating operational work, maintenance, enhancements, and projects from initiation through implementation and closure. Serve as the primary liaison between client, business, project, and technical teams; manage requirements, testing, risks, process improvements, and staff guidance.
Quality Professional - Remote US
Evaluate customer interactions, transactions, and business processes for quality, accuracy, and compliance with established standards. Analyze and report findings, contribute to calibration and quality initiatives, and recommend improvements that strengthen customer and employee experiences.
Senior Technical Business Analyst - CEF Configuration
Develop, document, test, and maintain advanced SQL solutions, stored procedures, audit processes, and controlled data corrections supporting Medicaid claims and healthcare systems. Analyze claims and production issues, validate implementations, and collaborate with business and technical teams through requirements, release, and post-production support.
Senior Project Manager
The Senior Project Manager will lead medium-sized project management teams to deliver innovative healthcare technology solutions while overseeing project metrics and budgets. They are responsible for identifying risks, managing stakeholder expectations, and ensuring the timely delivery of high-quality project milestones.
Account Business Manager
The Account Business Manager leads financial operations, including forecasting, budgeting, and variance reporting to support account and sector leadership. They act as a strategic integrator by driving operational excellence, managing cash flow, and ensuring compliance with financial and contractual standards.
Lead AI Engineer
The Lead AI Engineer will design, develop, and deploy advanced AI solutions, including Generative AI, across healthcare technology platforms. This role involves integrating models into existing systems, ensuring compliance with healthcare regulations, and optimizing performance for scalability and impact.
Director, Medicaid Rebate Operations and Implementations
Provides executive leadership for the end-to-end delivery of drug rebate solutions, overseeing implementation, operations, and technical support teams. Acts as a strategic advisor to clients regarding rebate performance, policy changes, and financial outcomes while ensuring contractual and regulatory compliance.
Information Security Officer
The Information Security Officer will lead security operational governance, manage audit preparation, and ensure adherence to security policies and contractual obligations. They are responsible for managing security incidents, risks, and exceptions while maintaining account security plans.
Information Security Officer
The Information Security Officer will lead security operational governance, drive remediation efforts, and ensure adherence to SLAs and contractual compliance. They are responsible for managing security incidents, facilitating audits, and maintaining account security plans while fostering strong relationships with suppliers and clients.
IT Program Management Lead (PMO)
The IT Program Management Lead oversees the planning and delivery of application development initiatives while managing project governance and client correspondence. This role drives the end-to-end program lifecycle, including risk management, resource allocation, and the promotion of Agile and DevOps practices.