Provider Enrollment Lead - Remote US

Summary

As a Provider Enrollment Lead - Remote US at Gainwell Technologies, you will support provider enrollment and provider revalidation operations for the New Jersey Medicaid program. This role is responsible for assisting with workflow coordination, inventory management, escalated issue resolution, and team support activities within a high-volume healthcare operations environment.

The Provider Enrollment Lead serves as a subject matter resource for Provider Enrollment Analysts and supports operational leadership in maintaining productivity, quality, compliance, and service level expectations tied to Medicaid provider enrollment and fraud prevention initiatives.

Your role in our mission

• Support provider enrollment, provider revalidation, maintenance, and renewal activities for the New Jersey Medicaid program while ensuring compliance with CMS, ACA, state, and federal regulatory requirements.
• Monitor inventory, workflow, production metrics, and service level agreements (SLAs) to support operational efficiency and timely processing of provider enrollment activities.
• Serve as a resource for Provider Enrollment Analysts by assisting with training, mentoring, escalated issue resolution, process guidance, and day-to-day operational support.
• Review enrollment applications, provider documentation, audits, and administrative reports to identify deficiencies, inconsistencies, compliance concerns, or opportunities for process improvement.
• Perform both routine and complex provider enrollment tasks with minimal supervision while maintaining productivity, accuracy, quality standards, and confidentiality requirements in a remote production-based environment.

What we're looking for

• High school diploma or GED required; associate degree or additional post-secondary education in healthcare administration, business, or a related field preferred.
• 3+ years of experience in provider enrollment, provider revalidation, provider credentialing, healthcare operations, claims processing, healthcare administration, or healthcare compliance support.
• Prior experience serving as a team lead, mentor, trainer, or subject matter expert in a healthcare operations or production environment preferred.
• Strong written and verbal communication skills, organizational skills, analytical thinking, and problem-solving abilities with attention to detail.
• Experience working with Medicaid, Medicare, healthcare enrollment systems, provider data management, Microsoft Office applications, and operational reporting tools preferred.

What you should expect in this role

• This is a fully remote position open to candidates located anywhere within the United States.
• Employees must be available to work Monday through Friday during Eastern Time business hours, from 8:00 AM ET to 5:30 PM ET, regardless of their local time zone.
• This role supports provider revalidation and healthcare compliance initiatives tied to evolving federal and state fraud prevention requirements.
• Daily productivity, quality, attendance, and service level expectations will be monitored in this fast-paced operational environment.
• Video cameras must be used during interviews and orientation, and employees must maintain a broadband internet connection with minimum speeds of 24 Mbps download and 8 Mbps upload for remote work effectiveness.

*This posting is intended for pipelining. We will accept applications on an ongoing basis.

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