Gainwell Technologies LLC

Gainwell Technologies LLC

17 open positions available

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Gainwell Technologies LLC

Information Security Officer (ISO)

Gainwell Technologies LLCAnywhereFull-time
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Compensation$85K - 130K a year

Manage security risks, compliance, incident response, and act as trusted advisor for healthcare security requirements. | At least 8 years in risk management or security, degree in Computer Science or Information Security, certifications like CISSP, CISM preferred, strong communication skills required. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.  Summary As Information Security Leader (ISO), you will be accountable for all security-related compliance and delivery for the customers assigned. In a typical engagement, you operate as a trusted advisor in the organization, working with senior management and focusing specifically on health care industry regulated security requirements and environments in relation to client business objectives. The ISO works with the leadership team to identity issues, concerns, along with process improvement regarding information security.Your role in our mission Lead Security operational governance activities Compliance and operational focused Dedicated or Shared (Industry) Multi-3rd party services and supplier management Ensuring delivery excellence in security tooling and business operations (Ensuring avoidance of non-performance / non-compliance contractual penalties). Conduct, provide, and report on threat and vulnerability management that aligns to account service level agreements (SLAs) Relationship management with Gainwell Technologies suppliers to clients. Maintain an account system security plan for the selected account(s) and Products Manage and report security incidents Ensure Audit preparation, facilitation and remediation Manage Security Risk and Exception to standards management Ensure knowledge and implementation of security fundamentals, policies and standards (regulatory and contractual) Escalate and resolve Security Incidents with the Security Incident Response team Coordinate delivery of Security Metrics and Reporting in support of contractual commitment What we're looking for At least 8 years’ experience working in a risk management, audit, security or technical delivery role Bachelor or master degree in Computer Science, Computer Studies, Information Security (or equivalent combination of education and experience) Knowledge of the security and auditing regulations Exposure to audit and compliance programs Excellent and effective communication skills Ability to work effectively in diverse, multi-national and virtual environments Self-motivated and tenacious Demonstrate sound judgment and integrity Ability to influence Delivery personnel in the execution of security and compliance requirements     Preferred skills Experience in IT outsourcing business or 8+ years in industry vertical CISSP certification, CISM/CISA or CRISC a plus Experience with HIPAA, NIST/ARC-AMPE, and FedRAMP a plus California SIMM and SAM regulatory compliance (California specific roles) Fluent in English What you should expect in this role Remote-based opportunity within the United States Opportunities to travel through your work (0-10%) 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 7/30/2026  The pay range for this position is $90,900.00 - $129,900.00 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.

Risk Management
Security Auditing
Compliance Management
Threat and Vulnerability Management
Incident Response
Security Governance
Direct Apply
Posted 12 days ago
Gainwell Technologies LLC

Director, Transformation (Testing & Quality Services)

Gainwell Technologies LLCAnywhereFull-time
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Compensation$75K - 120K a year

Define and govern transformation strategy for Testing Services to improve quality and delivery performance. | 15+ years in testing and quality engineering with leadership in large-scale transformation programs and healthcare Medicaid experience preferred. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.  Summary The Transformation Director is a senior leadership role responsible for defining and governing the end-to-end transformation strategy across Testing Services. This role is accountable for establishing the transformation vision, roadmap, standards, and outcomes, while partnering with delivery teams on implementing the transformation initiatives across Maintenance & Operations (M&O) accounts, investment projects and  Design, Development & Implementation (DDI) transformation needs as required.   The Director operates at a strategic and governance level, ensuring alignment across people, process, and technology while driving measurable improvements in quality, efficiency, and delivery performance. This role provides oversight, direction, and governance to ensure transformation activities are executed in accordance with the defined strategy, RACI, and contractual expectations.Your role in our mission Define and own the enterprise transformation strategy, roadmap, milestones, and success criteria across Testing Services.  Hands on delivery experience in driving transformation implementations. Establish transformation priorities aligned to business objectives, service commitments, and continuous improvement goals. Define and implement transformation communication and change adoption strategy across delivery organizations. Define and implement transformation success metrics (e.g., process definition and implementations, quality, productivity, automation AI implementation,, talent refresh, ALM adoption, process compliance, efficiency gains). Drive clarity of roles, responsibilities, and decision rights across transformation and delivery teams.  Define and Drive continuous improvement through metrics, data-driven insights, maturity assessments, and quality audits.  Ensure execution aligns with approved transformation plans, timelines, and quality standards. Define/enhance and maintain the high-level RACI model governing transformation activities across GW and other partner stakeholders Ensure RACI alignment is consistent with agreed contractual responsibilities and governance forums. E2E STLC Processes definition and ensure structured rollout of processes, playbooks, frameworks/accelerators. training, tool adoption, and capability enablement initiatives. Ensure transformation activities are sequenced and integrated with active programs without negatively impacting delivery. Ensure transformation initiatives enable improved efficiency, quality, and measurable outcomes across programs. Establish governance cadence for performance tracking, reporting, and benefits realization. Monitor adoption metrics and address resistance through targeted interventions. Monitor execution progress, risks, and dependencies across multiple programs, ensuring timely resolution and escalation as needed. Partner with TMO, Delivery Leadership, Process and Technology COEs, and vendor partners to align transformation with ongoing delivery commitments. Provide executive-level updates on transformation progress, risks, and outcomes. ALM usage optimization and governance (tracking, reporting, and lifecycle adherence). Automation expansion and maturity uplift (frameworks, coverage, and adoption).Serve as the primary escalation point for transformation-related risks, issues, and dependencies.  What we're looking for 15+ years of experience in testing, quality engineering, technology delivery, including delivering at least 2 large-scale transformation programs. 15+ years of experience in Quality Engineering/Testing Delivery ownership delivering outcomes on productivity, quality and cost. 5+ years in Healthcare with Medicaid programs is preferred. Proven experience defining and governing enterprise transformation strategy. Strong understanding of testing lifecycle (STLC), process definitions, automation, ALM tools, TMMi Model and operating model transformation. Experience working in multi-vendor environments with clearly defined RACI-based delivery models. Demonstrated leadership in driving change management, adoption, and continuous improvement. What you should expect in this role Fully remote position.  Opportunity to travel through your work up to 10% of the time.  The deadline to submit applications for this posting is July 14, 2026.  The pay range for this position is $127,400.00 - $182,000.00 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.

Enterprise Transformation Strategy
Change Management
Automation AI Implementation
Direct Apply
Posted 29 days ago
Gainwell Technologies LLC

Software Developer (.NET, C#, UI Development)

Gainwell Technologies LLCAnywhereFull-time
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Compensation$55K - 90K a year

Develop, test, debug, and document software programs including system design and quality assurance. | 3+ years UI and Web Services development with .NET, C#, JavaScript, HTML, plus SDLC experience. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.  Summary As a Software Developer (.NET, C#, UI Development) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.Your role in our mission Apply your skills to support Gainwell as we help clients deliver better health and human services outcomes.  Code, test, debug, implement, and document low to moderately complex programs. Create appropriate documentation in work assignments such as program code, and technical documentation. Design systems and programs to meet business needs. Prepares detailed specifications from which programs are developed and coded. Ensure programs meet standards and technical specifications; performs technical analysis and component delivery. Gather information from existing systems, analyzes program and time requirements. Assist project manager in preparing time estimates and justification for assigned tasks. Design programs for projects or enhancements to existing programs. Write specifications for programs of low to moderate complexity. Work with client and management to resolve issues and validate programming requirements within their areas of responsibility. Develop test plans to verify logic of new or modified programs. Conduct quality assurance activities such as peer reviews.  What we're looking for 3+ years of UI and Web Services Development (.NET C#, HTML, JavaScript, jQuery). Application development and batch programming with UNIX/C and SQL (Oracle) is also desired. Experience with all phases of the Software Development Life Cycle (SDLC) to include coding, testing, etc. Experience in healthcare systems experience is a plus. What you should expect in this role Fully remote opportunity with the option to work anywhere within the United States. Opportunities to travel through your work (0-10%). Willingness to work a flexible schedule to accommodate business needs and travel as required 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 July 10, 2026.   The pay range for this position is $58,200.00 - $83,200.00 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.

C#
UI Development
JavaScript
HTML
SQL
Direct Apply
Posted about 1 month ago
GT

Healthcare Data Entry Specialist - Remote US

Gainwell Technologies LLCAnywhereFull-time
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Compensation$55K - 70K a year

Accurately enter and validate healthcare claims data while maintaining confidentiality and meeting quality standards. | High school diploma and two years of data entry or healthcare operations experience with proficiency in Microsoft Office and ability to work remotely. | 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 As a Healthcare Data Entry Specialist - Remote US at Gainwell, you will play a critical role in supporting healthcare operations by accurately entering, reviewing, and validating claims-related information. Your attention to detail and commitment to quality will help ensure accurate processing and support services that impact healthcare programs serving millions of members nationwide. This position supports Gainwell's healthcare operations while offering the flexibility of working remotely from anywhere within the United States.Your role in our mission Enter and verify claims information, supporting documentation, and healthcare records with a high degree of accuracy. Review claims forms and related documents to ensure data is complete, accurate, and compliant with established procedures. Maintain confidentiality and security of sensitive healthcare and member information. Meet established productivity, quality, and accuracy standards while managing daily workloads. Utilize multiple systems and Microsoft Office applications to support claims processing and operational objectives. What we're looking for High School Diploma or GED required. Minimum two years of experience in data entry, administrative support, claims processing, healthcare operations, or a related field. Strong typing and data entry skills with a high level of accuracy and attention to detail. Proficiency with Microsoft Office applications, including Outlook, Word, and Excel. Ability to work independently, prioritize tasks, and manage multiple assignments in a remote environment. What you should expect in this role 100% remote position open to candidates located anywhere within the United States. Work schedule will generally align with standard business hours, Monday through Friday. Equipment provided by Gainwell Technologies. Video cameras must be used during virtual interviews and the first week of training. Candidates may be required to complete a skills assessment, including data entry and typing proficiency, as part of the hiring process.   This posting is intended for pipelining. We will accept applications on an ongoing basis. #LI-REMOTE #LI-JT1  The pay range for this position is $35,000 - $50,000 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.   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.

Data Entry
Microsoft Excel
Administrative Support
Direct Apply
Posted about 2 months ago
Gainwell Technologies LLC

Product Experience Owner - Verint Operations Manager

Gainwell Technologies LLCAnywhereFull-time
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Compensation$81K - 115K a year

Manage and optimize the operational roadmap and workflows for Verint Operations Manager platform. | Experience in back-office operational execution, product ownership for workflow platforms, and strong operations-technology collaboration. | 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 Provide operational product experience ownership for the enterprise Verint Operations Manager platform within the Performance Enablement Organization (PEO). This role owns how the business experiences and uses Operations Manager, while the Technology team owns the underlying product and technical delivery. The PXO serves as the primary liaison between Technology Product Owners, operational leadership, and business stakeholders to ensure operational execution needs are clearly translated, platform capabilities are fully understood, and configured solutions support consistent, scalable task and workflow execution. You will define the operational vision and roadmap for optimizing Verint Operations Manager, including task orchestration, workflow standardization, and execution governance across back-office operations. You will ensure consistent, governed use of Operations Manager capabilities across the enterprise, partnering closely with Operational Analysts who execute configuration within defined standards and priorities. Your role in our mission • Own and manage the operational roadmap for Verint Operations Manager, including workflow standardization and optimization initiatives. • Define enterprise standards for task design, workflow structure, prioritization, and execution governance. • Translate operational execution requirements into platform capabilities, configuration standards, and system requirements. • Ensure operational workflows align with performance, compliance, and service-level expectations. • Maintain strong documentation discipline, including operational standards, configuration guidance, and platform runbooks. • Serve as a trusted advisor and subject matter expert to operational leaders and execution teams. • Act as the primary liaison between CX stakeholders and Technology Product Owners, ensuring shared understanding of business needs, performance intent, and platform capabilities. • Partner with Technology Product Owners during sprint planning, backlog grooming, and delivery execution. • Review analyst and vendor deliverables for quality, alignment to standards, and operational feasibility. • Provide guidance and mentorship to Operational Analysts supporting Operations Manager initiatives. • Communicate complex quality and analytics concepts in clear, executive ready language to support leadership decision making. • Operate effectively in an agile, matrix based environment. What we're looking for • Bachelor’s degree in Business Administration, Operations, Information Systems, or related field, or equivalent relevant experience • Extensive experience in back-office operational execution environments • Demonstrated experience providing operational product ownership or business consulting for enterprise workflow or task management platforms • Strong experience working at the intersection of operations and technology across complex, multi-account environments • Deep experience with Verint Operations Manager or comparable workflow orchestration solutions • Proven ability to standardize, optimize and scale operational execution models across multiple lines of business What you should expect in this role • Fully remote position. • Opportunity to travel through your work up to 10% of the time. This posting is intended for pipelining. We will accept applications on an ongoing basis. The pay range for this position is $80,600.00 - $115,200.00 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.

Operational product ownership
Workflow standardization
Task orchestration
Verified Source
Posted about 2 months ago
Gainwell Technologies LLC

Senior UI Developer (.NET C#/Oracle)

Gainwell Technologies LLCAnywhereFull-time
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Compensation$73K - 104K a year

Develop, test, debug, and document UI applications while collaborating with teams and clients. | 6+ years in UI and application development with .NET, C#, Oracle, SQL, HTML, JavaScript, and web services. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary As a UI Developer (.NET C#/Oracle) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission Take a close look at some of the details that contribute to Gainwell’s industry-leading tools and technologies in this challenging position. . • Code, test, debug, implement, and document moderately complex programs • Analyze, design, and write specs and requirements from which we develop and code programs • Evaluate existing systems and programs; assist project manager in assigning tasks and work closely with a team • Liaise with clients and management to provide technical consulting on complex programming projects, validate program requirements, and resolve issues that arise • Develop test plans and participate in QA activities such as coding reviews • Participate as a member of a development team and lead a small sub-team of developers as needed • Design system components and delegate responsibilities to team members What we're looking for • Over six (6) years of experience in application and user interface development, programming with .NET, C#, and Oracle. • More than six (6) years of expertise in application development and support, covering all phases of the Software Development Life Cycle. • Proficient in: • SQL / PLSQL • HTML • JavaScript • jQuery • Web Service Development • Previous experience with interChange MMIS is highly preferred. What you should expect in this role • Fully remote opportunity with the option to work anywhere within the 48-contiguous United States. • Would require working during the central time zone. • Opportunities to travel through your work (0-10%). • Willingness to work a flexible schedule to accommodate business needs and travel as required. • 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 June 17, 2026. #LI-SH1 #LI-REMOTE The pay range for this position is $72,800.00 - $104,000.00 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.

JavaScript
HTML
API Design
Technical Writing
Mentorship
Verified Source
Posted about 2 months ago
Gainwell Technologies LLC

Principal, System Architect - Hybrid Gold River, CA

Gainwell Technologies LLCAnywhereFull-time
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Compensation$127K - 182K a year

Lead design and implementation of AWS infrastructure solutions ensuring security, scalability, and operational excellence. | 10+ years in architecture or software development with deep AWS expertise, certifications, and public-sector experience. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary You will serve as the senior technical authority for AWS‑based infrastructure architecture, guiding the design, implementation, and optimization of secure, scalable, and resilient cloud platforms. This role blends strategic architecture leadership with hands‑on engineering depth, ensuring that mission‑critical systems—particularly large public-sector workloads—are built on a robust AWS foundation aligned with security, compliance, and operational excellence. Your role in our mission • Lead the architecture, design, and implementation of AWS infrastructure solutions, emphasizing security, scalability, and high availability. • Oversee application runtime and platform capabilities using cloud‑native and cloud‑agnostic patterns, with a strong preference for AWS‑managed services. • Architect and deploy multi‑account AWS environments, including VPC design, IAM strategy, network segmentation, encryption, and monitoring. • Partner with platform and product engineering teams to deliver application solutions requiring web applications, integration layers, API platforms, and secure data flows. • Provide advanced technical support and ensure reliable operation of AWS cloud environments, including incident response and root‑cause analysis. • Troubleshoot complex distributed systems, containerized workloads, and integrations across AWS services. • Maintain deep technical knowledge of AWS services, infrastructure platforms, and emerging cloud capabilities. • Develop and enforce technical standards, reference architectures, and best practices for AWS infrastructure, security, and operations. • Evaluate and test vendor technologies, third‑party tools, and cloud‑native services for alignment with enterprise architecture. • Translate business requirements into technical architectures, selecting the right AWS tools and patterns to meet client needs. • Participate in system design reviews, capacity planning, platform governance, and launch readiness assessments. • Collaborate with Site Reliability Engineering teams and stay current on trends such as observability-driven development, chaos engineering, and automated resilience testing. • Apply strong organizational, analytical, and leadership skills to guide teams and influence technical direction. What we're looking for • Ten or more years of experience in architecture, engineering, or software development, with significant focus on cloud infrastructure. • Deep expertise in AWS services, including networking, security, compute, storage, container orchestration, and identity management. • AWS Solutions Architect certification (Professional preferred) and demonstrated hands‑on capability designing and deploying AWS workloads. • Three or more years supporting large public-sector platforms. • Experience with microservices architectures, container runtimes (Docker), and orchestration platforms (Kubernetes, OpenShift, or AWS EKS). • Strong understanding of cloud security, including IAM, KMS, encryption, network security, and compliance frameworks. • Experience working in Agile/Scrum environments and contributing to iterative delivery. • Ability to communicate effectively across cross‑functional teams and up to executive leadership. What you should expect in this role • United States remote opportunity • Video cameras must be used during all interviews, as well as during the initial week of orientation • Collaboration with distributed engineering, product, and security teams. • Opportunity to shape enterprise cloud strategy and influence long‑term platform direction. • The Deadline to submit applications for this posting is March 28, 2026 #LI-GD1 #LI-REMOTE The pay range for this position is $127,100.00 - $181,600.00 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.

API Design
System Architecture
Mentorship
Verified Source
Posted 4 months ago
Gainwell Technologies LLC

Professional Business Analyst

Gainwell Technologies LLCAnywhereFull-time
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Compensation$56K - 79K a year

Analyze and improve business processes, gather and document requirements, and support testing and implementation for healthcare technology solutions. | Requires 3+ years of healthcare business analyst experience, knowledge of claims processing, and SQL skills; your background lacks healthcare industry-specific experience and claims processing knowledge. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary As a Professional Business Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission Gainwell empowers you show you’re a pro and help clients deliver better health and human services outcomes using innovative technology and solutions. • Analyze, plan, design, document and make recommendations to improve business processes to support client’s technological aspirations • Be a supportive bridge between clients, project managers and technical personnel to define, track and communicate business requirements and their expected impact by building basic conceptual data and process models • Gather and document requirements into Business Requirements Document (BRD, or Analysis) for client signoff. • Create test plan and test case scenarios. • Create, execute or analyze test scenarios to verify that client requirements are built into system design. • Prepare test results packet for client signoff. • Ensure that “intent of change” is carried out through every project phase by participating in technical reviews and inspections • Perform research as needed by the customer or internal CX (customer experience) team. • Ability to write and execute basic SQL commands (preferred but not required) What we're looking for • Three or more years of Business Analyst experience in Healthcare industry translating technical goals and requirements into real action for clients • Knowledge of basic computer programming concepts such as configuration, development and batch processing • Advanced knowledge in Microsoft Excel and other software for conducting quantitative analysis • Strong analytical and business process re-engineering skills • Strong written and oral communication and presentation skills to deliver messages to business leaders, clients and technical personnel • An influencer and team player who that motivates others to action and communicates key technical ideas in a digestible way • Experience with Claims processing rules and adjudication preferred What you should expect in this role • Fully remote options from continental US locations only • 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 December 18, 2025 • #LI-HC1 #LI-SQL #LI-BRD #LI- Claims Processing and Adjudication The pay range for this position is $55,600 - $79,400 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.

Data Analysis
Process Improvement
Workflow Mapping
Operational Efficiency
Verified Source
Posted 8 months ago
GT

Advisor Business Analyst - Medicaid

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$93K - 133K a year

Supporting Medicaid workflow operations, requirements gathering, and stakeholder communication. | Extensive experience in healthcare IT business analysis, specifically Medicaid MMIS, with domain knowledge and technical proficiency in relevant tools. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary As an Advisor Business Analyst - Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. We are seeking a highly experienced Medicaid Business Analyst to join our client delivery team supporting the Medicaid Management Information System (MMIS). While supporting operational execution of Medicaid workflow, this role will serve as a critical point of contact for our client and external stakeholders including MCOs, Providers and third parties. You will be the "front line" for triaging complex requirement issues, facilitating high-stakes conversations with state government stakeholders, and translating urgent operational needs into clear, actionable technical specifications for our internal product teams. The role requires active leadership, rapid problem-solving, and deep domain expertise in Medicaid workflows. Your role in our mission Client Liaison & Stakeholder Management • Act as the primary functional liaison between the client, MCOs, and our internal technical teams for all MMIS operations workflows • Lead requirements gathering sessions and "triage" meetings to address any surges in defects, change requests (CRs), and operational gaps. • Manage client expectations regarding system capabilities, timelines for fixes, and regulatory constraints. Requirements Engineering • Analyze and document complex requirement issues namely Claims (FFS & Encounters), Financials, Capitation, Provider Enrollment and others. • Translate high-level policy changes or operational pain points into detailed User Stories, Functional Design Documents (FDDs), and Technical Specifications for developers. • Validate proposed technical solutions solve the business problem before development begins. .... your role continued Requirement issue resolutions • Investigate root causes of systemic issues reported by Providers or MCOs (e.g., mass claim denials, capitation payment errors, EDI rejection loops). • Collaborate with the Operations team to distinguish between "system defects" and "user training gaps," creating workarounds or documentation as needed. Domain Leadership • Serve as the Subject Matter Expert (SME) on Medicaid workflows, ensuring compliance with federal (CMS) and local (District) regulations. • Support the Compliance Manager in assessing the impact of new mandates (e.g., 1095-B reporting, T-MSIS data quality) on current system functionality. • Understanding of MITA 3.0 framework and CMS-64 financial reporting. What we're looking for • 9+ years of Business Analysis experience in Healthcare IT, with at least 4 years dedicated to ‘Medicaid MMIS’ or state-level Eligibility & Enrollment systems. • Domain knowledge • Deep understanding of Core MMIS modules: Claims Adjudication, Encounters Processing, Financial Management, Provider Management, MCO Capitation, 837/835 EDI transactions. • Technical proficiency • * Experience with ALM tools (JIRA, Microfocus ALM, SharePoint) for requirements traceability. • Strong understanding of the SDLC in an Agile/Hybrid environment • Knowledge of Microsoft Excel advanced features such as macros and/or relational database software • PowerPoint and presentation skills • Soft skills • Client-Facing Confidence: Proven ability to lead meetings with government clients and push back diplomatically when necessary. • Crisis Management: Ability to remain calm and structured during "surge" periods of high-volume issues and reporting. • Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members • A caring team leader who motivates and coaches less experienced resources What you should expect in this role • Must be available to work 8a-5p eastern time to support client hours. • Opportunities to travel through your work (0-10%) • Fully remote options from most US locations and territories • 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 December 23, 2025 • #LI-HC1 #LI-Medicaid The pay range for this position is $92,900.00 - $132,700.00 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.

Process Improvement
Data Analytics
Workflow Optimization
Business Intelligence
Verified Source
Posted 8 months ago
Gainwell Technologies LLC

Principal, Program Management

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$109K - 140K a year

Lead complex, multi-stakeholder programs ensuring quality, budget, and timeline adherence while coordinating across teams and executives. | 5+ years project management, 2+ years pharmacy/PBM experience, proficiency in project management methodologies, MS Office, SQL, Tableau, Power BI, and quality management standards. | It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary The Principal, Program Management at Gainwell Technologies leads complex, multi-stakeholder programs by overseeing project planning, documentation, risk management, and client communications. This role ensures deliverables meet quality, budget, and timeline standards while coordinating across teams and executives. It requires strong experience in project management, pharmacy or PBM operations, and proficiency in tools such as MS Office, SQL, Tableau, and Power BI. Basic Qualifications • 5+ years of project management experience. • 2+ years in pharmacy or pharmacy benefit management (PBM). • Proficiency in project management methodologies and assurance practices. • Strong skills in project planning, control, and resource management. • Knowledge of finance and accounting concepts related to project delivery. • Proficient in Microsoft Office Suite (PowerPoint, Word, Excel, Access). • Experience with SQL queries, Tableau, and Power BI. • Familiarity with quality management and delivery assurance standards. • Experience with productivity tools that improve project efficiency and effectiveness. What you should expect in this role • Work Arrangement: Remote within the United States • Travel Requirement: Up to 15% • Position Type: Full-time job Applications for this posting will be accepted until November 25, 2025. #LI-AC1 #LI-REMOTE The pay range for this position is $108,500.00 - $140,000.00 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.

Program Management
Project Planning
Risk Management
Client Communications
MS Office Suite
SQL
Tableau
Power BI
Quality Management
Delivery Assurance
Verified Source
Posted 10 months ago
Gainwell Technologies LLC

Java Full Stack Developer (Java, Angular, Springboot)

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$90K - 130K a year

Develop and maintain full stack web applications including front-end website architecture and back-end RESTful services, ensuring performance, scalability, and cross-platform optimization. | Bachelor's degree, 5+ years full stack development experience, expert SQL skills, knowledge of Linux, DynamoDB, Databricks, AngularJS, Node.js, Java, Python, CSS, JavaScript, HTML, API design, and frontend libraries like log4j, Backbone.js, and jQuery. | Summary We are looking for a Full Stack Developer to code and operate on both front-end and back-end systems. This role is strictly involved in the development of the product and does not involve access to Protected Health Information (PHI) & Personally Identifiable Information (PII) or any secured/confidential client data. The work is limited to application development & demo and does not include handling or processing of sensitive health information. This role is perfectly suited for people that love to learn new technologies, for the simple fact, it requires you to continuously update your skillset and technical abilities. Staying up to date on new development tools, programming techniques, and industry trends is also part of the job. Your role in our mission • Ensure that non-functional requirements such as performance, maintainability, scalability, usability, and reliability are being considered when architecting solutions. • Develop visually appealing front-end website architecture, including translating designer mock-ups and wireframes into front-end code • Develop and design RESTful services and APIs. • Stay current with the latest developments in web applications and programming languages, including cutting edge software approaches, architecture. • Ensure cross-platform optimization. • Strategize organizational direction on emerging technology platforms. What we're looking for • Bachelor’s Degree in Computer Science, Information Technology or other relevant fields. • 5+ years of work experience as a Full Stack developer • 2+ years of expert-level skills in writing and optimizing SQL. • Strong knowledge of Linux, with working understanding of DynamoDB, Databricks AngularJS and Node.js. • Experience working with languages such as Java and Python. • Proficient in CSS (Foundation or Bootstrap), JavaScript and HTML. • Experience in API design and development. • Understanding of libraries including log4j, Backbone.js, and jQuery. • Experience with AJAX. What you should expect in this role • Fast-paced, challenging and rewarding work environment. • Work life balance. • Remote working. • Will required late evening work to overlap US work hours, whenever it is required.

Java
Python
SQL
REST API
JavaScript
HTML
CSS
Linux
Node.js
API design
Verified Source
Posted 10 months ago
GT

Healthcare Operations Analyst - Indiana Medicaid (Remote)

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$31K - 44K a year

Complete provider enrollment tasks including enrollments, updates, revalidations, and related administrative processes. | Proficiency with Windows and Microsoft Office, advanced data entry and communication skills, multitasking, and organizational abilities. | 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 Analysts are responsible for completing all tasks assigned to Provider Enrollment, including enrollments, updates, revalidations, recertifications, changes of ownership, disclosure updates, and other related processes.Your role in our mission Ability to multitask Organization Detail oriented Adapts to change readily Stays on task What we're looking for Proficient with PC and windows environment, including software such as MS Word, Excel, PowerPoint, Outlook, Teams. Advanced data enter and quality entry skills that includes being able to compose clear and concise correspondences and reports. Advanced phone calls skills that include the ability to resolve questions from providers, clients, and vendors. Complete multiple tasks proficiently (i.e. research, analyze, and successfully resolve complex issues) Able to learn and interpret administrative policies and ;Strong planning and organizational skills. What you should expect in this role #LI-REMOTE #LI-LS2   The pay range for this position is $30,500.00 - $43,500.00 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.

PC and Windows environment proficiency
MS Word, Excel, PowerPoint, Outlook, Teams
Advanced data entry and quality entry
Clear and concise correspondence and reporting
Advanced phone communication skills
Research and analysis
Organizational and multitasking skills
Direct Apply
Posted 10 months ago
GT

Manager Customer Support - Remote OH

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$76K - 108K a year

Lead and manage the SPBM call center team to meet SLAs, oversee performance, ensure compliance, and drive continuous improvement. | Bachelor’s degree or equivalent experience, call center leadership experience, preferably with pharmacy/PBM and Medicaid program knowledge. | It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.  Summary Gainwell Technologies is seeking a Senior Manager, Customer Support to lead operations for our Single Pharmacy Benefit Manager (SPBM) Call Center, serving the Ohio Department of Medicaid. In this role, you will provide strategic and operational leadership to ensure timely and accurate resolution of inquiries from members, prescribers, pharmacies, and Managed Care Plans. You’ll oversee call center metrics, drive service-level agreements (SLAs), and foster a culture of excellence, compliance, and continuous employee development.Your role in our mission Lead the SPBM call center team with effective hiring, onboarding, training, coaching, and recognition programs. Manage real-time performance and resource allocation to consistently meet and exceed SLA requirements. Ensure inquiries from members, providers, and partners are accurately researched, documented, and resolved on time. Maintain and update policies, procedures, and work instructions in compliance with state requirements. Partner with Quality Assurance (QA) and Quality Improvement (QI) teams to identify trends and drive continuous improvement. Develop and deliver reporting to leadership and client stakeholders that highlights performance, challenges, and opportunities. What we're looking for Bachelor’s degree in Business, Healthcare, Insurance, or related field preferred (or equivalent work experience). Must-Haves: Previous call center experience and proven leadership experience are required; pharmacy or PBM experience strongly preferred. 1–2 years of managed care, insurance, or PBM call center leadership experience. Demonstrated ability to manage supervisors and staff to meet productivity and performance goals. Experience with Medicaid programs, SPBM UPDL criteria, and/or prior authorization decisioning is a plus. Strong communication and collaboration skills, with the ability to work across teams and with external clients. What you should expect in this role Remote position aligned to Eastern Standard Time (EST) operations: 8:00 AM – 5:00 PM. Reliable home internet required: minimum 24 Mbps download / 8 Mbps upload (higher speeds strongly recommended). Business travel required, including monthly and quarterly trips to the Dublin, Ohio office. Regular meetings with state representatives to review compliance, updates, and performance metrics. Fast-paced environment requiring flexibility, accountability, and a strong customer service mindset. Opportunities to collaborate with cross-functional teams to drive best practices and innovation in customer support.    The pay range for this position is $75,700.00 - $108,100.00 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.

Call center leadership
Customer support management
SLA management
Team hiring and training
Quality assurance collaboration
Reporting and analytics
Medicaid and managed care knowledge (preferred)
Pharmacy Benefit Manager (PBM) experience (preferred)
Direct Apply
Posted 10 months ago
Gainwell Technologies LLC

Medical Claims Specialist - Remote WV

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$29K - 41K a year

Review, evaluate, and process claims accurately and timely while ensuring compliance with policies and regulations and maintaining high customer service. | 2+ years claims processing or insurance experience, knowledge of claims procedures and regulations, proficiency with claims software and Microsoft Office, and strong analytical and communication skills. | 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 Claims Examiner is responsible for reviewing, evaluating, and processing claims in accordance with policy provisions, regulatory requirements, and organizational guidelines. This role ensures timely, accurate, and fair adjudication of claims while maintaining a high level of customer service and compliance. Your role in our mission • Review and analyze claim submissions, supporting documentation, and policy details. • Determine claim eligibility, coverage, and benefits according to company policies and industry regulations. • Request additional documentation or information as needed to finalize claim determinations. • Accurately calculate payment amounts and authorize claim settlements. • Maintain detailed, organized claim files and records in the claims management system. • Communicate claim decisions clearly to policyholders, providers, or other stakeholders. • Collaborate with internal departments (e.g., underwriting, legal, provider relations) for complex claim cases. • Identify potential fraud, waste, or abuse and escalate cases as required. • Ensure all claims are processed within required timelines and service-level agreements. • Stay up to date on industry regulations, policy changes, and best practices. What we're looking for • High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred. • 2+ years of claims processing or insurance industry experience preferred. • Strong knowledge of claims adjudication procedures, policies, and regulatory requirements. • Excellent analytical, problem-solving, and decision-making skills. • Strong attention to detail and accuracy. • Proficient in claims management software and Microsoft Office Suite. • Effective written and verbal communication skills. What you should expect in this role • Analytical thinking • Decision quality • Time management • Compliance awareness • Customer focus • Remote position The pay range for this position is $28,500.00 - $40,700.00 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.

Claims Processing
Insurance Verification
Claims Adjudication Procedures
Regulatory Compliance
Microsoft Office Suite
Claims Management Software
Analytical Thinking
Customer Service
Communication Skills
Verified Source
Posted 10 months ago
Gainwell Technologies LLC

Associate Manager, Data Analytics

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$75K - 107K a year

Manage and mentor an analytics team to deliver actionable healthcare operational insights and projects that improve revenue or reduce costs. | 5+ years healthcare experience with 1+ year people management, proficiency in SQL, Python, Tableau, and experience managing analytics projects in a hybrid/remote setting. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary As an Associate Manager, Data Analytics at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Yor role in our mission • Generate and communicate actionable insights into operational performance in the healthcare analytics sector • Identify, execute, and report performance on actionable projects based on insights obtained through analytics that drive revenue-generating or cost-savings results • Coach team members to build presentation skills and industry knowledge • Develop, enhance, and explain methodologies for evaluating project and operational performance • Ensure on-time, accurate delivery of projects • Provide direct people management and mentorship on the Analytics team What were looking for • 5+ years of healthcare industry experience, preferred 1+ years of experience as a people manager in a hybrid/remote environment • Professional background working in Operations and/or Analytics with experience of managing yield-improving or cost-improvement initiatives • Track record of ability to manage multiple projects to timely completion utilizing both internal analytics team as well as cross-functional collaboration • Team-oriented leader capable of delegating responsibilities and thriving in a culture of continuous feedback • Strong communicator and coach capable of developing team members with authentic and empathetic interactions through primarily remote interactions • Strong Proficiency in SQL, Python, and Tableau with familiarity in AI integration What you should expect in this role • United States remote opportunity • 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 October 30, 2025 The pay range for this position is $74,700.00 - $106,700.00 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.

SQL
Python
Tableau
Data Analytics
People Management
Healthcare Analytics
Verified Source
Posted 10 months ago
Gainwell Technologies LLC

System Operations Manager, Principal

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$101K - 144K a year

Lead and oversee the performance, availability, and modernization of Medicaid Management Information Systems, ensuring operational continuity, compliance, and technical delivery excellence. | Bachelor’s degree plus 10+ years in IT systems engineering or infrastructure leadership, 5+ years in technical service delivery leadership, and expertise in ITIL4, HIPAA, and enterprise compliance frameworks. | Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary The Gainwell Systems Manager is a strategic, technical, and operational leader accountable for the performance, availability, modernization, and delivery of all systems supporting the Medicaid Management Information System (MMIS) and related enterprise services. This role drives IT service management (ITSM) maturity, ensures seamless operations, and enforces governance over system changes, incidents, and escalations. As a core member of the account leadership team, the Systems Manager owns system health, enforces escalation and ownership protocols, and ensures all systems and services are optimized, secure, and aligned with contractual and business outcomes. This role is not a traditional Project Manager or HR People Manager, but is accountable for the systems team’s technical delivery, excellence, and cross-functional coordination. Your role in our mission 1) Operational Oversight & Systems Health - Own end-to-end Gainwell system availability, performance monitoring, and operational continuity. - Enforce defined escalation paths across L1–L5 tiers, ensuring no ownership gaps. - Lead Root Cause Analysis (RCA) and implement permanent corrective actions for all major incidents (P1/P2). -Maximize system updates, patches, and troubleshooting efforts. -Responsible for defect tracking (PROD and non-PROD). - Ensure system observability and lead rapid triage during outages or degradation events. - Maintain operational compliance with HIPAA, state/federal policies, and internal audit controls. 2) Technical Architecture & Modernization - Guide infrastructure modernization initiatives such as cloud-readiness, refactoring, virtualization, and platform reengineering. - Collaborate with architects and engineering teams to align with SOA, DevOps, and enterprise integration best practices. - Implement security best practices, including access controls, data protection, SOC audits, and help with disaster recovery planning and execution. - Coordinate with teams to remediate Security Vulnerabilities across systems. - Champion technical innovation and recommend solutions to increase scalability, security, and automation. 3) ITSM & Service Delivery - Lead the design, implementation, and continuous improvement of ITSM processes, leveraging the ITIL4 framework. - Supervise Incident, Problem, Change, and Service Request Management across all system tiers. -Responsible for MIM reporting and communication. - Own, define and monitor KPIs and SLAs for service quality, proactively driving improvements. - Manage second-level support teams and coordinate with L1 providers for seamless escalation and response workflows. -Promote support to Release team for successful releases to build on project deliverables and compliance to client timelines. -Oversee annual DR exercise. -Support annual SOC audit. 4) Driving Delivery Excellence - Lead technical planning for system initiatives, migrations, upgrades, and risk mitigation efforts. change to reflect partnership with Arch… -Understands Gainwell Technologies Policies and Procedures. -Provide weekly defect reporting and change requests. -Work closely with PMO for weekly/monthly reporting. - Participate in project governance, CAB, and readiness assessments for production deployment approvals. - Ensure successful alignment of technical execution with contractual obligations, security audits, and disaster recovery objectives. 5) Stakeholder & Client Engagement - Act as the primary systems liaison to client leaders (e.g., CDL, DHS, AGM), participating in governance and planning meetings. - Represent systems at weekly status meetings, steering committees, and delivery reviews. - Partner with clients to anticipate future needs, align on solution roadmaps, and maintain strong business relationships. - Provide clear communication and detailed impact reporting during outages, escalations, and planned changes. 6) Influencing Leadership & CSI Development - Lead and coach technical and operations staff across multiple delivery areas. - Set aligned objectives, drive performance feedback, and promote a culture of accountability and learning. - Maintain an Ownership Map—ensuring every service/system has clearly defined primary and secondary owners. - Encourage cross-training, succession planning, and bench strength development. What were looking for - Bachelor’s degree in Computer Science, Information Systems, Engineering, or related field (Master’s or PMP preferred). - 10+ years in IT systems engineering, operations, or infrastructure leadership (Medicare MIS or healthcare platform experience preferred). - 5+ years in technical and service delivery leadership roles. - Deep expertise in ITIL4, ITSM, and technical project execution within complex, regulated environments. - Knowledge of HIPAA, SOC, and enterprise compliance frameworks. What you should expect in this role • United States remote opportunity • 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 August 24, 2025 The pay range for this position is $100,800.00 - $144,000.00 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.

ITIL4
ITSM
Systems Engineering
Technical Project Execution
HIPAA Compliance
SOC Audits
Cloud Modernization
Incident and Change Management
Leadership and Coaching
Verified Source
Posted 11 months ago
GT

Drug Rebate Analyst (Remote US - West Virginia Radius)

Gainwell Technologies LLCAnywhereFull-time
View Job
Compensation$31K - 45K a year

As a Drug Rebate Analyst, you will review Medicaid drug rebate payments, identify disputes, and negotiate resolutions with manufacturers. You will also contact pharmacies and medical providers to verify claims data and maintain productivity reports. | The role requires 1+ years of experience with Medicaid drug rebates or related claims processing. Proficiency with rebate systems and strong analytical and communication skills are essential. | 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 Gainwell Technologies is seeking a Drug Rebate Analyst. In this fully remote role, you’ll review Medicaid drug rebate payments, identify disputes, and negotiate resolutions with manufacturers—helping ensure accurate reimbursements and support critical healthcare funding.Your role in our mission As a Drug Rebate Analyst, you will: Contact pharmacies and medical providers to verify claims data. Liaise with drug manufacturers to gather details on disputed rebates. Research utilization and prepare resolution proposals for rebate disputes. Negotiate fair, accurate settlements and follow up on unpaid invoices. Maintain productivity reports and track dispute-resolution activities daily. Collaborate with internal teams and external partners to meet operational goals. What we're looking for 1 + years of experience with Medicaid drug rebates, pharmacy or medical billing, or related claims processing. Proficiency with rebate or reporting systems (e.g., PRIMS, SSRS, Process Manager) and MS Office (Excel, Word, Outlook). Strong analytical, critical-thinking, and organizational skills. Excellent written and verbal communication. Ability to maintain confidentiality (HIPAA compliance) and operate in a paper-free environment. Self-motivated, reliable attendance, and ability to work independently within agreed schedules. What you should expect in this role Fully remote work—but must live within 50 miles of West Virginia. A dynamic, supportive team environment focused on continuous improvement. Structured onboarding, training on rebate systems, and mentorship from experienced colleagues. Opportunity for career growth through professional development and cross-functional projects. Competitive hourly rate and a comprehensive benefits package, including paid time off, holidays, and 401(k) plan. #LI-REMOTE#LI-JT1#LI-CM1  The pay range for this position is $31,400.00 - $44,800.00 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.

Medicaid Drug Rebates
Pharmacy Billing
Medical Billing
Claims Processing
Analytical Skills
Critical Thinking
Organizational Skills
Communication Skills
HIPAA Compliance
Self-Motivated
Reporting Systems
MS Office
Negotiation Skills
Dispute Resolution
Productivity Tracking
Collaboration
Direct Apply
Posted about 1 year ago

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