Senior Public Policy Analyst – Long-Term Care, Rate Setting

🕒 June 13

⛰️ Colorado, Wisconsin – Remote

⛰️ Colorado – Remote 🧀 Wisconsin – Remote

💵 $69.4k - $99.2k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

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

• Play a critical part in ensuring rate-setting and reimbursement strategies meet program, policy, and organizational goals • Lead the development, enhancement, and documentation of rate-setting models for long-term care programs • Use advanced analytical techniques and large datasets to evaluate costs, trends, and reimbursement outcomes • Assess how rate changes, policy updates, and cost drivers affect Managed Care Organizations (MCOs) • Translate business needs into clear data, system, and policy requirements • Research reimbursement methodologies, program operations, and the long-term care ecosystem to recommend improvements • Support the development and implementation of capitated rate-setting methodologies for contracted MCOs • Validate the accuracy and sufficiency of rates produced by established models • Monitor State and Federal policy changes — with emphasis on Wisconsin Medicaid — and assess their operational and financial impact • Partner with internal teams, business leaders, and external stakeholders to promote transparency and alignment in rate-setting practices • Prepare written analyses, presentations, and recommendations for leadership, clients, and technical teams

🎯 Requirements

• 6+ years of experience in business analysis, financial modeling, or health policy analysis • Master's degree in Public Administration or Public Policy • Strong data expertise, including understanding how rate-setting decisions impact Managed Care Organizations (MCO's) • Experience interpreting public policy, preferably within healthcare and/or Wisconsin Medicaid • Understanding of the Long-Term Care (LTC) ecosystem, including program structures and reimbursement models • Advanced skills in Excel and/or analytical tools such as R, SAS, STATA, or SPSS • Strong communication skills to translate complex analytical work into clear, actionable insights • Ability to work independently, manage timelines, and support multiple projects at once

🏖️ Benefits

• generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies