Provider Enrollment Quality Analyst - Jackson, MS (Onsite)

Summary

As a Provider Enrollment Quality 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.

The Provider Enrollment Quality Analyst is responsible for ensuring the accuracy, quality, and compliance of provider enrollment, credentialing, and maintenance activities. This role performs detailed quality reviews, audits enrollment transactions, and identifies process improvement opportunities to ensure adherence to regulatory, contractual, and organizational requirements. The analyst serves as a subject matter expert in provider enrollment processes and supports continuous improvement initiatives to enhance operational performance and provider experience.

Your role in our mission

• Conduct quality audits of provider enrollment, recredentialing, demographic maintenance, and provider data management transactions.
• Review enrollment documentation for completeness, accuracy, and compliance with state, federal, client, and organizational requirements.
• Monitor adherence to service level agreements (SLAs), quality standards, and operational procedures.
• Identify trends, defects, and process gaps, and provide actionable recommendations for improvement.
• Perform root cause analysis on quality issues and partner with leadership to implement corrective actions.
• Prepare and distribute audit findings to leadership.
• Track and trend audit results to identify refresher training, as needed.
• Assist in developing quality assurance methodologies, audit tools, and monitoring processes.
• Collaborate with Provider Enrollment Specialists, Credentialing teams, Operations leadership, and Compliance partners to improve overall quality performance.
• Support internal audits by providing documentation, reports, and quality metrics.
• Participate in training initiatives and provide coaching based on audit findings and performance trends.
• Maintain expertise in provider enrollment regulations, credentialing requirements, payer guidelines, CMS requirements, and state-specific policies.

What we're looking for

• Associates degree in Healthcare Administration, Business Administration, or related field preferred; equivalent experience may be considered.
• 2 or more years of experience in provider enrollment, credentialing, provider data management, healthcare operations, quality assurance, auditing, or compliance-related functions preferred.
• Experience working with Medicaid, Medicare, managed care organizations, or healthcare payers preferred.
• Advanced analytical, problem-solving, and organizational skills.
• Proficiency with Microsoft Office Suite, reporting tools, and provider management systems.
• Strong written and verbal communication skills.

What you should expect in this role

On-site position based in Jackson, MS, with potential for hybrid work after 90 to 120 days

Work schedule is Monday – Friday, 8:00 AM to 5:00 PM CST

Video cameras must be used during all interviews, as well as during the initial week of orientation.

Assessment Requirement: As part of our interview process, all candidates must successfully complete a skills and competency assessment before advancing in the hiring process.

Employee Benefits & Perks:

Health benefits (medical, dental, and vision) begin on Day 1 of employment.

401(k) with company match and additional benefits become available within the first few months.

Employees can take advantage of the flexible vacation policy after 90 days of employment. Any exceptions require manager approval before the employee's start date at Gainwell.

Career growth and advancement opportunities are encouraged and supported.

A company-provided computer is supplied for work use.

The deadline to submit applications for this posting is November 2, 2026.  

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