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Provider Operations Manager

Date:  Jan 30, 2025
Location: 

Montgomery, AL, US, 36106 Any city, AL, US, 99999

Req ID:  28972

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

 

Summary

Join Gainwell, a cutting-edge product company dedicated to meeting the healthcare needs of our communities. As a manager, you will be critical in delivering exceptional service and achieving account goals and outcomes. You will oversee and guide your team, manage performance and engagement, optimize processes, and maintain the highest quality standards. Your work directly supports our mission, the Account Delivery Manager [ADM], the Regional Leader, and internal business partners in achieving or exceeding contractual obligations and company goals and objectives.

 

This role is part of a new contract with a two-year DDI before heading into Operations. Therefore, we are looking for the right candidate who can support both phases of the contract.

Your role in our mission

During DDI & Certification Phase

  • Participate in all facets of the Provider Management (PM) solution with Gainwell business partners, including planning, execution, and delivery of project milestones.
  • Participate in the Change Advisory Board (CAB) with the client and other stakeholders.
  • Serve as a secondary point of contact for the PM contract during this phase.

Your Role During the Operations Phase

  • Serve as the primary point of contact for the PM Services contract and related plans.
  • Handle contract administration and coordination of basic contractual/invoicing requirements.
  • Engage in formal communication and correspondence with the Agency and serve as the point of contact for Public-facing PM services.
  • Oversee the development and monitoring of tools, processes, and procedures.
  • Collaborate with MES Module Contractors to provide seamless customer service for all Provider Management inquiries.
  • Build, develop, and lead teams of leaders and individual contributors, supporting employees and executing day-to-day operations delivery to meet client service level agreements and driving accountability and efficiency.  
  • Establish and effectively lead routines, including utilizing tools and reporting, to drive team performance; train and provide ongoing coaching to ensure employee engagement while maintaining client satisfaction.
  • Cultivate relationships with account leaders and business partners to proactively identify and implement opportunities to enhance the delivery of operational products, services, and capabilities.
  • Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.

What we're looking for

  • 7+ years of people management experience.
  • 5+ years of experience managing operations of Provider or Major Health Care Payer services. Participation in implementation of new system preferred.
  • 3+ years of experience in Medicaid operations or systems.
  • 3+ years of experience collaborating on multi-vendor projects or similar complex integration efforts.
  • Experience with Outcomes Based Certification, Streamlined Modular Certification, or other Certification efforts preferred.
  • Working knowledge of Medicaid Transformation Initiative, Medicaid Information Technology Architecture (MITA) 3.0, and the CMS Conditions for Enhanced Funding preferred.
  • Bachelor’s degree in computer science, information systems, business, or a related field; or equivalent work experience.
  • Proficiency with Microsoft Office suite and hardware and software applications to manage contact center and back-office operations (Cxone, Verint, Avaya, etc.).
  • Strong written and oral communication and interpersonal skills to work effectively with team members, customers, and clients.
  • Demonstrated strategic initiative implementation and execution, specifically with operating policies and procedures and work process improvements in customer contact operations.

What you should expect in this role

  • Location:
    • Montgomery, AL office OR (Remote, with frequent trips to the Montgomery, AL area to meet with the client, other vendors, team members, and Gainwell business partners.)
    • Anticipate an average of 50% travel, with more being expected during two-year start-up and go-live with less during regular operations.
  • This is a full-time permanent regular salaried (W-2) employee position.
    • Monday through Friday work schedule (40 hours per week).
  • 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.
  • 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.
  • This position is to be filled as soon as possible. This posting will remain up for pipelining.  We will accept applications on an ongoing basis until the position is no longer available.

 

 

 

 

 

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The pay range for this position is $106,500.00 - $152,100.00 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.


Nearest Major Market: Montgomery

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