Program Manager- Payment Integrity Solutions

Date: Apr 9, 2025

Location:

Any city, TX, US, 99999

Req ID: 30336

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 Program Manager- Payment Integrity Solutions 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

Position will support our healthcare Cost Containment – Payment Integrity product management team.
Serves as the liaison between product personnel and Service delivery business areas that serve Medicaid, managed care, Medicare Advantage and commercial insurance carriers.
Advisor will use their knowledge of health insurance benefits, payment accuracy and audit skills to solve complex client challenges, create client messaging, assist in product roadmap development, and add value to proposals.
Engages in proposal efforts and sales calls to align offerings with client specifications.
Participates in meetings with clients to gather and document requirements and explore potential solutions.
Analyzes client feedback and integrates improvements into future programs.
Coordinates with product and marketing teams to generate product collateral.
Lead projects from requirements definition through deployment, identifying schedules, scopes, budget estimations (as needed), and project implementation plans, including risk mitigation.
Collaborate with internal and external resources to product, ensuring projects remain within scope, and schedule, in collaboration with project staff from various functional departments such as sales, markets, operations, and proposals.

What we're looking for

9+ years of program management experience, with a focus on overseeing multiple projects, scope management, and cross-functional team coordination.
5+ years of experience in healthcare payment/program integrity is required
Strong client management experience, with a proven ability to work directly with clients to understand their unique challenges and collaborate on tailored solutions, ideally within the healthcare sector.
Experience assisting in proposal development, gap analysis, and aligning product offerings with client requirements.
Proven ability to collaborate with internal teams and external clients to ensure the effective delivery of solutions and client messaging.

What you should expect in this role

Fully Remote Opportunity
Opportunities to travel through your work (0-10%)
Interesting and challenging work that would contribute to helping those that are most vulnerable in the healthcare (State Medicaid members) industry

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 5/30/2025.

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The pay range for this position is $82,700.00 - $118,100.00 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 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.