Senior Manager – Medicaid Business Solutions

Job not on LinkedIn

🕒 October 2

☕ Washington – Remote

☕ Washington – Remote

💵 $115.9k - $165.6k / year

⏰ Full Time

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Lead service delivery and operational execution for Medicaid Claims, Business Policy Administration, and Reference Data Maintenance teams • Manage multiple clients and domain leads responsible for Medicaid claims, business policy administration, reference data maintenance, provider setup, and adjudication logic • Drive standardization and process improvements across design, build, test, deployment, and operational support • Develop and manage demand forecasts with account and product teams • Align team capacity with client priorities • Identify workload, capacity, and delivery timeline risks and recommend mitigation strategies • Lead relationships between delivery teams, product engineering, and client stakeholders • Resolve escalations and ensure timely issue resolution • Drive continuous service improvements focused on claims accuracy, policy administration quality, reference data integrity, defect reduction, and turnaround times • Ensure delivery outcomes meet client expectations for quality, compliance, and timeliness • Select and hire employees with Medicaid domain expertise • Coach and develop team members • Address performance issues and drive accountability for results

🎯 Requirements

• Twelve or more years of experience in healthcare technology, Medicaid claims, business policy administration, reference data maintenance, or related delivery roles • Eight or more years of leadership or supervisory experience • Experience working in healthcare payer systems, including Medicaid or Medicare environments • Experience working with MMIS systems or equivalent healthcare claims systems • Strong stakeholder and client relationship management skills • Video cameras must be used during all interviews and the initial week of orientation

🏖️ Benefits

• Work flexibility • Learning and career development opportunities • Technical credentials and certifications • Generous, flexible vacation policy • Educational assistance • Leadership and technical development academies • 401(k) employer match • Comprehensive health benefits • Occasional travel opportunities