Remote Medicaid Provider Enrollment Specialist

Gainwell Technologies; Nevada (IA); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

401(k) match

Healthcare benefits

Educational assistance

Flexible vacation policy

Job summary

Gainwell Technologies is seeking a Provider Enrollment Advisor to support the Nevada Medicaid program. The role serves as a subject matter expert for enrollment processes, analyzes data to inform cost-effective improvements, and ensures compliance with Federal, State, and agency guidelines while meeting service level agreements.

You will collaborate with the enrollment manager and technical teams, manage projects and timelines, build stakeholder relationships, and drive process enhancements that

Qualifications

• Bachelor’s degree in a related field or equivalent experience.
• 5+ years in healthcare operations.
• 3+ years in provider credentialing and enrollment.
• 5+ years in problem solving, research, and process improvement.
• Knowledge of CMS Federal and State enrollment guidelines preferred.
• Knowledge of NV Medicaid guidelines preferred.
• Six Sigma Lean Green or Black Belt certification preferred.

Responsibilities

• Serve as the subject matter expert for provider enrollment requirements, ensuring compliance with regulatory and business standards.
• Analyze business needs, gather client requirements, and recommend process and system improvements to support operational goals.
• Develop business specifications and collaborate with technical teams on system enhancements, testing, and implementation activities.
• Manage project activities, timelines, and deliverables, ensuring deadlines and objectives are met.
• Utilize data analysis to identify trends, root causes, compliance risks, and process improvement opportunities, and provide actionable recommendations.
• Support corrective action plans, resolve complex business application issues, and exercise sound judgment in decision-making.
• Build strong stakeholder relationships, influence positive outcomes, and maintain a high level of accuracy and attention to detail.

Skills

Healthcare ops

Provider enrollment

Data analysis

Problem solving

CMS guidelines

Medicaid knowledge

Six Sigma

Education

Bachelor's degree

Job description

Gainwell Technologies is seeking a Provider Enrollment Advisor to support the Nevada Medicaid program. The role serves as a subject matter expert for enrollment processes, analyzes data to inform cost-effective improvements, and ensures compliance with Federal, State, and agency guidelines while meeting service level agreements.

You will collaborate with the enrollment manager and technical teams, manage projects and timelines, build stakeholder relationships, and drive process enhancements that