Provider Enrollment Field Representative- Richmond, VA (Hybrid)

Gainwell Technologies; Virginia; Hybrid; USD 56.000 - 80.000; Vollzeit

Benefits dieser Stelle

401(k) match

Health benefits

Educational assistance

Generous vacation policy

Zusammenfassung

Gainwell Technologies is recruiting a Provider Enrollment Field Representative for the Richmond, VA region in a hybrid role. You will act as the main liaison between providers, Virginia Medicaid, and Gainwell to support enrollment, revalidation, screening, and compliance initiatives.

You will conduct outreach, deliver education, perform on-site visits, resolve inquiries, and build strong provider relationships to ensure program integrity and access to care for Virginia Medicaid members.

Qualifikationen

• Two (2) or more years of experience in provider enrollment, provider relations, revalidation, Medicaid operations, healthcare administration, credentialing, medical billing, compliance, customer service, or related healthcare environment.

Aufgaben

• Serve as the primary point of contact for providers regarding enrollment, revalidation, participation requirements, credentialing, provider maintenance, and program compliance activities.
• Conduct proactive outreach to providers regarding enrollment applications, revalidation requirements, deadlines, corrective actions, and other Virginia Medicaid initiatives.
• Perform in-state site visits for moderate- and high-risk provider enrollments in accordance with CMS, federal, state, and Virginia Medicaid screening requirements.
• Complete site visit documentation, identify potential compliance concerns, and communicate findings in accordance with program policies and established procedures.
• Research, investigate, and resolve provider inquiries related to enrollment, participation requirements, claims, billing, site visits, and Virginia Medicaid provider operations.
• Deliver provider education through webinars, workshops, provider forums, conferences, presentations, and one-on-one consultations.
• Build and maintain productive relationships with healthcare providers, provider associations, community stakeholders, and state partners throughout Virginia.
• Monitor provider participation and outreach activities, identify barriers to enrollment and revalidation completion, and recommend opportunities for process improvement.
• Collaborate with Provider Enrollment, Operations, Quality Assurance, Compliance, Program Integrity, and Client teams to support provider satisfaction and operational excellence.
• Document provider interactions, outreach activities, site visits, and issue resolutions in accordance with contract requirements and established procedures.
• Support special projects and provider engagement initiatives designed to improve provider participation, compliance, data quality, and enrollment outcomes.
• Serve as a trusted resource to Virginia Medicaid providers throughout the enrollment and participation lifecycle.
• Collaborate with operational, compliance, quality, program integrity, and client teams to improve provider engagement and operational performance.
• Participate in provider-focused meetings, conferences, training events, and stakeholder engagement activities.

Kenntnisse

Provider enrollment

Medicaid operations

Healthcare administration

Customer service

MS Office

Tools

MS Office

Jobbeschreibung

Provider Enrollment Field Representative- Richmond, VA (Hybrid)

Date: Oct 16, 2026

Location: Any city, VA, US, 99999

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

The Provider Field Representative serves as the primary liaison between Gainwell Technologies, Virginia Medicaid, and the provider community throughout the Commonwealth of Virginia. This role supports provider enrollment, revalidation, screening, participation, and compliance initiatives by serving as a trusted resource for healthcare providers and provider organizations.

The Provider Field Representative partners directly with physicians, clinics, hospitals, behavioral health providers, long-term care facilities, and other healthcare organizations to promote successful participation in the Virginia Medicaid program. This position is responsible for conducting provider outreach, delivering provider education, performing on-site screening activities, resolving provider inquiries, and fostering strong provider relationships that support program integrity, provider compliance, and access to care for Virginia Medicaid members.

Your role in our mission

• Serve as the primary point of contact for providers regarding enrollment, revalidation, participation requirements, credentialing, provider maintenance, and program compliance activities.
• Conduct proactive outreach to providers regarding enrollment applications, revalidation requirements, deadlines, corrective actions, and other Virginia Medicaid initiatives.
• Perform in-state site visits for moderate- and high-risk provider enrollments in accordance with CMS, federal, state, and Virginia Medicaid screening requirements.
• Complete site visit documentation, identify potential compliance concerns, and communicate findings in accordance with program policies and established procedures.
• Research, investigate, and resolve provider inquiries related to enrollment, participation requirements, claims, billing, site visits, and Virginia Medicaid provider operations.
• Deliver provider education through webinars, workshops, provider forums, conferences, presentations, and one-on-one consultations.
• Build and maintain productive relationships with healthcare providers, provider associations, community stakeholders, and state partners throughout Virginia.
• Monitor provider participation and outreach activities, identify barriers to enrollment and revalidation completion, and recommend opportunities for process improvement.
• Collaborate with Provider Enrollment, Operations, Quality Assurance, Compliance, Program Integrity, and Client teams to support provider satisfaction and operational excellence.
• Document provider interactions, outreach activities, site visits, and issue resolutions in accordance with contract requirements and established procedures.
• Support special projects and provider engagement initiatives designed to improve provider participation, compliance, data quality, and enrollment outcomes.
• Serve as a trusted resource to Virginia Medicaid providers throughout the enrollment and participation lifecycle.
• Collaborate with operational, compliance, quality, program integrity, and client teams to improve provider engagement and operational performance.
• Participate in provider-focused meetings, conferences, training events, and stakeholder engagement activities.

What we're looking for

• Two (2) or more years of experience in provider enrollment, provider relations, revalidation, Medicaid operations, healthcare administration, credentialing, medical billing, compliance, customer service, or a related healthcare environment.
• Experience working directly with physicians, healthcare facilities,behavioral health providers, long-term care providers, or other healthcare organizations withknowledge ofprovider screening requirements and participation standards.
• Experience conducting provider education, outreach, training, audits, inspections, site visits, or other provider-facing activities is preferred.
• Strong presentation, communication, and relationship-building skills with an ability to analyze provider issues, identify solutions, and communicate complex information in a clear and professional manner
• Strong organizational skills with the ability to manage multiple priorities and deadlines.
• Proficiency with Microsoft Office applications including Outlook, Excel, Word, Teams, and PowerPoint.

What you should expect in this role

Thisis a hybrid position for Richmond, VA. Candidates must reside in the state of Virginia.

• Conduct travel throughout Virginia to perform provider site visits and support provider outreach activities.
• Hybrid work environment with regular travel throughout the Commonwealth of Virginia based on business and program needs.
• Assessment Requirement: Candidates will be required to complete a skills and competency assessment before advancing to the next stage of the selection process
• The work schedule is Monday through Friday, 8:00 AM to 5:00 PM CST.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.

The deadline to submit applications for this posting is November 2, 2026.

#LI-HYBRID#LI-PP1 #LI-CM1

The pay range for this position is$56,300.00-$80,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.