Senior Manager, Medicaid Systems Operations

🕒 September 23

🇺🇸 United States – Remote

💵 $108.4k - $154.8k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

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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

• Manage a team of 30+ System Operations Managers • Manage daily operations for Gainwell’s MMIS and integrated Medicaid systems • Ensure system availability, reliability, scalability, and performance meet SLAs and operational targets • Lead production support, monitoring, triage, issue resolution, and root cause analysis • Establish operational procedures, standards, and governance processes • Coordinate operational readiness for releases and system enhancements • Develop operational metrics, dashboards, and executive reporting • Lead ITIL-based incident, problem, and change management • Coordinate high-severity production incident resolution and war-room activities • Conduct post-incident reviews and implement corrective/preventive actions • Oversee change control and production deployment coordination • Support core Medicaid modules, including claims processing, provider management, member eligibility, prior authorization, care management, financial management, pharmacy systems, and data warehouse/reporting • Ensure compliance with CMS regulations, HIPAA requirements, Medicaid Enterprise Standards, state security policies, and data retention and audit requirements • Monitor vendor performance against contractual SLAs and KPIs • Collaborate with business operations, PMO, infrastructure, security, and application development teams • Coordinate release planning and production deployments • Act as production gatekeeper by ensuring operational acceptance criteria are met • Support CMS certification activities, operational readiness reviews, audits, and regulatory reviews • Drive automation for monitoring, alerting, batch operations, and reporting • Implement operational best practices and process improvements • Drive root cause analysis and permanent correction

🎯 Requirements

• 7–10+ years of IT operations or Medicaid systems experience • 5+ years managing large-scale healthcare or Medicaid system operations • Experience supporting MMIS, Medicaid Enterprise Systems (MES), or healthcare payer platforms • Experience with production support and IT service management processes • ITIL Foundation or ITIL v4 Certification preferred • PMP Certification preferred • Video cameras must be used during all interviews and during the initial week of orientation • Must be based in the United States

🏖️ Benefits

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