Medicaid Claims Manager — Hybrid Leadership

Gainwell Technologies; Indianapolis (IN); Hybrid; USD 100,000 - 124,000; Full time

Benefits offered by this job

401(k) employer match

Health benefits

Flexible vacation policy

Educational assistance

Job summary

Gainwell Technologies in Indianapolis, IN seeks a Claims Manager to lead Medicaid claims operations, ensuring service levels, regulatory compliance, and operational efficiency across processing, adjudication, and client relationships.

This hybrid role oversees teams, emphasizes performance metrics, and collaborates with cross-functional stakeholders. The position offers a $100,000–$123,900 yearly pay range with strong benefits including a 401(k) match and comprehensive health coverage.

Qualifications

• 5+ years of healthcare claims processing experience including adjudication and operations.
• 3+ years of leadership experience managing claims teams.
• Strong knowledge of Medicaid claims processing and regulations.
• Experience with claims systems, operational reporting, dashboards, and performance metrics.
• Indiana Medicaid and MCO experience preferred.

Responsibilities

• Lead daily claims operations to ensure service levels and quality.
• Manage teams responsible for adjudication, adjustments, escalations, and issue resolution.
• Monitor metrics and drive productivity, accuracy, compliance, and customer satisfaction.
• Partner with clients and cross-functional teams to support initiatives and claims enhancements.
• Ensure compliance with federal and state regulations, including HIPAA.
• Coach and develop team members to foster accountability and continuous improvement.

Skills

Healthcare claims

Claims adjudication

Leadership

Medicaid knowledge

Operational reporting

Cross-functional leadership

Regulatory compliance

Tools

Claims systems

Dashboards

Job description

Gainwell Technologies in Indianapolis, IN seeks a Claims Manager to lead Medicaid claims operations, ensuring service levels, regulatory compliance, and operational efficiency across processing, adjudication, and client relationships.

This hybrid role oversees teams, emphasizes performance metrics, and collaborates with cross-functional stakeholders. The position offers a $100,000–$123,900 yearly pay range with strong benefits including a 401(k) match and comprehensive health coverage.