Onsite Provider Enrollment Quality Analyst - Jackson, MS

Gainwell Technologies; Jackson (MS); On-site; USD 47,000 - 67,000; Full time

Benefits offered by this job

Health benefits

401(k) with company match

Flexible vacation policy

Company-provided computer

Educational assistance

Job summary

Gainwell Technologies in Jackson, MS is seeking a Provider Enrollment Quality Analyst to ensure accuracy, quality, and compliance of provider enrollment, credentialing, and maintenance activities.

The role conducts audits, identifies gaps, and partners with Enrollment Specialists, Credentialing, Operations, and Compliance to drive improvements. On-site with potential for hybrid after orientation; competitive benefits and career growth opportunities.

Qualifications

• Associates degree in Healthcare Administration, Business Administration, or related field preferred; equivalent experience may be considered.
• 2 or more years of experience in provider enrollment, credentialing, provider data management, healthcare operations, quality assurance, auditing, or compliance‑related functions preferred.
• Experience working with Medicaid, Medicare, managed care organizations, or healthcare payers preferred.
• Advanced analytical, problem‑solving, and organizational skills.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office Suite, reporting tools, and provider management systems.

Responsibilities

• Conduct quality audits of provider enrollment, recredentialing, demographic maintenance, and provider data management transactions.
• Review enrollment documentation for completeness, accuracy, and compliance with state, federal, client, and organizational requirements.
• Monitor adherence to service level agreements (SLAs), quality standards, and operational procedures.
• Identify trends, defects, and process gaps, and provide actionable recommendations for improvement.
• Perform root cause analysis on quality issues and partner with leadership to implement corrective actions.
• Prepare and distribute audit findings to leadership.
• Track and trend audit results to identify refresher training, as needed.
• Assist in developing quality assurance methodologies, audit tools, and monitoring processes.
• Collaborate with Provider Enrollment Specialists, Credentialing teams, Operations leadership, and Compliance partners to improve overall quality performance.
• Support internal audits by providing documentation, reports, and quality metrics.
• Participate in training initiatives and provide coaching based on audit findings and performance trends.
• Maintain expertise in provider enrollment regulations, credentialing requirements, payer guidelines, CMS requirements, and state‑specific policies.

Skills

Analytical skills

Problem-solving

Organizational skills

Written communication

Verbal communication

Education

Associate degree in Healthcare Administration or related field

Tools

Microsoft Office Suite

Reporting tools

Provider management systems

Job description

Gainwell Technologies in Jackson, MS is seeking a Provider Enrollment Quality Analyst to ensure accuracy, quality, and compliance of provider enrollment, credentialing, and maintenance activities.

The role conducts audits, identifies gaps, and partners with Enrollment Specialists, Credentialing, Operations, and Compliance to drive improvements. On-site with potential for hybrid after orientation; competitive benefits and career growth opportunities.