Provider Enrollment Analyst - Remote

Gainwell Technologies; Wisconsin; Remote; USD 60,000 - 80,000; Full time

Job summary

Gainwell Technologies is seeking a Provider Relations Specialist to support Wisconsin’s Bureau of Children’s Services. This fully remote role involves managing provider compliance and claims processing, with occasional travel. The position requires strong knowledge of Medicaid and policy implementation.

Benefits

Flexible vacation

401(k) match

Health benefits

Educational support

Qualifications

• At least 5 years of experience in a human services agency.
• Strong knowledge of Medicaid and cost allocation methods.

Responsibilities

• Manage outlier rate request protocols and oversee county waiver agency authorizations.
• Draft and manage communications such as webinars and bulletins.

Skills

Medicaid

Claims Resolution

Policy Implementation

Data Analysis

Regulatory Guidance Interpretation

Education

Bachelor’s degree in a related field

Tools

Microsoft Office

Job description

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Summary

Gainwell Technologies is hiring a Provider Relations Specialist to support Wisconsin’s Bureau of Children’s Services (BCS) within the Division of Medicaid Services. This remote role reports to the Internal Operations and Systems Support Section Manager and focuses on provider compliance, claims processing, and policy support for the Children’s Long-Term Support (CLTS) Waiver Program.

Your role in our mission

• Manage outlier rate request protocols and oversee county waiver agency (CWA) authorizations.
• Monitor claims compliance with Gainwell Technologies, CWAs, and BCS staff.
• Develop and update procedures for CLTS service rate outlier reviews and fee schedules.
• Manage provider integrity concerns and complaints through structured compliance frameworks.
• Draft and manage communications such as webinars, GovDelivery updates, bulletins, and responses to the provider relations inbox.
• Serve as a subject matter expert during user acceptance testing and implementation of provider registry and directory initiatives.

What we're looking for

• Bachelor’s degree in a related field or equivalent experience.
• At least 5 years of experience, preferably in a human services agency.
• Strong knowledge of Medicaid, CMS HCBS waiver programs, and cost allocation methods.
• Experience in policy implementation, provider training, and claims resolution.
• Ability to analyze financial and operational data to inform decisions.
• Skill in coordinating multi-agency efforts and interpreting regulatory guidance.

What you should expect in this role

• Fully remote position within the U.S.
• Occasional travel within Wisconsin or other states.
• Full-time role with collaboration across Gainwell, BCS, and state stakeholders.
• Proficiency in Microsoft Office tools (Excel, Word, PowerPoint).
• High-impact role with visibility in provider operations and Medicaid services.
• Opportunity to improve provider engagement for community-based services.

The salary range for this position is [[salaryMin]]-[[salaryMid]] per year, with variations based on location, experience, and other factors. Gainwell offers comprehensive benefits, including flexible vacation, 401(k) match, health benefits, and educational support. We foster a culture of collaboration, innovation, and inclusion.

Join Gainwell, an industry leader committed to making healthcare better for everyone. Learn more about us on our website and explore our Careers page for current openings.

Gainwell Technologies is an Equal Opportunity Employer, committed to diversity, equity, and inclusion. All qualified applicants will receive consideration regardless of race, religion, gender, sexual orientation, age, veteran status, disability, or other protected characteristics. We celebrate diversity and strive to create an inclusive environment for all employees.