Payment Integrity Operations Advisor

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 Payment Integrity Operations Advisor 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

• As a member of the PI Operations team, coordinates operational aspects of pre-pay data mining and other solution development. Interfaces with product managers, business developers, account managers, and executive management on operationalization of new products.
• Oversees implementation of prepay data mining and other new products to ensure operational needs are met. Advises on staffing and resource needs, implementation timelines, and creates operational workflows.
• Assists management in researching existing business environment including trends and best practices to ensure that company services match business trends.
• Facilitates special projects to drive incremental revenue growth within current PI contracts.
• Interfaces and participates in business development discussions across cross-functional teams and internal and external executive managements to ensure consistency in solution development and implementation.
• Identifies business requirements; evaluates concepts such as market timing, compelling event and problem identification to ensure that delivered solutions meet both short and long term company and client business performance expectations.

What we're looking for

• 7+ years of payment integrity experience with 5 or more years of experience in data mining.
• Experience managing, analyzing, and presenting complex healthcare data. Experience with SQL is a plus.
• Strong communication skills. Experience communicating with clients, peers, and executive management. Experience coordinating products with cross-functional teams.
• Experience working with company products and services, business processes and project management
• Experience working with office productivity tools; delivery assurance and/or industry standards on deliverables

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%)

Please Note: 

• 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 12/31/2024

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The pay range for this position is $88,800.00 - $126,900.00 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.