Provider Field Representative Lead - Remote California

Gainwell Technologies; California; Remote; USD 70,000 - 80,000; Full time

Job summary

Gainwell Technologies is seeking a Provider Field Representative Lead to provide functional leadership within California's Medi-Cal provider network. You will guide Provider Field Representatives, address escalated issues, and drive provider education and outreach initiatives.

The role emphasizes mentorship, collaboration across departments, and continuous process improvements, with travel across California to support outreach and events. Remote work is supported while requiring CA residency.

Qualifications

• Three or more years of experience in provider relations, provider services, healthcare operations, claims processing, or a related field.
• Experience supporting healthcare providers with billing inquiries, claims research, reimbursement issues, and provider education.
• Experience serving as a lead, subject matter expert, mentor, trainer, or escalation resource.
• Strong analytical, problem-solving, communication, presentation, and customer service skills.
• Experience developing and delivering training in both virtual and in-person environments.
• Ability to manage multiple priorities and collaborate across teams.
• Medi-Cal, Medicaid experience preferred.
• Willingness and ability to travel throughout California.

Responsibilities

• Provide functional leadership and support to Provider Field Representatives, serving as a resource for escalated provider issues, billing inquiries, and claims-related concerns.
• Assist providers with billing support, claims research, reimbursement questions, and resolution of complex issues.
• Support the planning, development, and delivery of provider education, training events, workshops, webinars, and outreach activities.
• Serve as a liaison between providers, internal departments, and clients to facilitate issue resolution and program success.
• Mentor and support team members through coaching, onboarding, training, and knowledge sharing.
• Monitor provider and operational trends, identify improvement opportunities, and support process enhancements.
• Maintain team procedures, job aids, training materials, and knowledge resources.
• Coordinate operational activities, special projects, and provider support initiatives while ensuring consistent and accurate service delivery.

Skills

Provider relations

Healthcare operations

Billing inquiries

Claims research

Mentor / leadership

Job description

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 Lead provides functional leadership, guidance, and support to Provider Field Representatives serving California's Medi-Cal provider community. This role serves as a subject matter expert and escalation resource for complex provider inquiries, billing support, claims research, provider education, and outreach initiatives. The Lead works collaboratively with providers, internal teams, and clients to ensure exceptional customer service, operational excellence, and compliance with Medi-Cal program requirements.

Your role in our mission

• Provide functional leadership and support to Provider Field Representatives, serving as a resource for escalated provider issues, billing inquiries, and claims-related concerns.
• Assist providers with billing support, claims research, reimbursement questions, and resolution of complex issues.
• Support the planning, development, and delivery of provider education, training events, workshops, webinars, and outreach activities.
• Serve as a liaison between providers, internal departments, and clients to facilitate issue resolution and program success.
• Mentor and support team members through coaching, onboarding, training, and knowledge sharing.
• Monitor provider and operational trends, identify improvement opportunities, and support process enhancements.
• Maintain team procedures, job aids, training materials, and knowledge resources.
• Coordinate operational activities, special projects, and provider support initiatives while ensuring consistent and accurate service delivery.

What We're Looking For

• Three (3) or more years of experience in provider relations, provider services, healthcare operations, claims processing, business process outsourcing, or a related field.
• Experience supporting healthcare providers with billing inquiries, claims research, reimbursement issues, and provider education.
• Experience serving as a lead, subject matter expert, mentor, trainer, or escalation resource.
• Strong analytical, problem-solving, communication, presentation, and customer service skills.
• Experience developing and delivering training in both virtual and in-person environments.
• Ability to manage multiple priorities and collaborate effectively across teams.
• Medi-Cal, Medicaid, experience preferred.
• Willingness and ability to travel throughout California.

What You Should Expect In This Role

• Remote position; candidate must reside in California.
• Travel throughout California to support provider outreach, training, workshops, conferences, and special events.
• Occasional overnight travel may be required.
• Involvement in provider outreach and education activities, operational monitoring, process improvement initiatives, and special projects.
• Collaboration with leadership, internal business partners, and client stakeholders to improve provider service and support Medi-Cal program objectives.
• Reliable high-speed internet connectivity is required.

This is a pipeline requisition designed to build a pool of qualified candidates for current and future opportunities as positions become available. The pay range for this position is $70,000 - $80,000 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.

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.