Program Specialist (Remote in CT, MA, NJ, or NY)

Summary

The Program Specialist is responsible for supporting the client and provider relationships. Works closely with account management team and operations team on maintaining provider inquiries on successful delivery of HMS (a Gainwell company) services for our client. Job responsibilities include oversight and management of small projects, analysis of data, customer service, building and maintaining reports along with the potential of creating client deliverables. Only candidates within CT, MA, NJ, and NY will be considered.

Your role in our mission

• Builds and manages client provider relationships with support from the Program Director or Manager; responsible for ensuring client satisfaction.
• Builds relationships and collaborates effectively with HMS provider relations to ensure successful delivery of services to client(s). Assist in the creation and/or review of client deliverables
• Oversight and management of client provider recoupments, specific to disallowance services and provider portal
• Works with account management and operations team as necessary on applicable client design project(s) approach and develop implementation plans.
• Continuous monitoring and timely reporting to management progress toward business goals
• Assist in the development of both internal and external reports to monitor operational and financial performance
• Monitors and prepares trending analysis and reporting for provider related services for client(s)
• Supports collaboration between account management team and operations staff.
• Manage expectations, resolve problems, and develop opportunities.
• Lead and manage projects.
• Work proficiently in multiple company databases.
• Understand the basics of data table structures and report building.
• Demonstrates exceptional customer service and follow up skills.

What we're looking for

• Bachelor's degree required.
• Five (5) or more years relevant work experience required with experience in one of the following areas preferred: Health insurance, Government, Client service/business to business, and Healthcare policy.
• Two (2) or more years of experience in one of the following areas desired: Health Insurance, Government, Client Service/business to business, Health Policy required.
• Two (2) or more years of experience in TPL required. Specific hospital provider background preferred.
• Healthcare or Medicaid recovery experience strongly preferred.

What you should expect in this role

• This is a full-time permanent regular salaried (W-2) employee position.
• Only candidates within CT, MA, NJ, and NY will be considered.
• Monday through Friday work schedule (40 hours per week).
• Upward career advancement is possible and encouraged.
• Health (medical, dental, vision) benefits start on day 1 of employment.
• Company match 401K and other benefits available within months of starting.
• New employees are eligible to take advantage of flexible vacation policy after ninety (90) calendar days of employment. Any exception requires manager approval prior to employee's Gainwell start date.
• Company provided computer for work use.
• For all hybrid and remote positions employees' Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload.  Greater speeds will of course provide better performance.
• Video cameras must be used during all interviews, as well as during the initial week of orientation if hired.
• The use of AI during interviews is prohibited.
• This position will accept applications until July 13, 2026.

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