Wonderful team that is always willing to assist with issues or concerns. This new platform will drive efficiency and quality, improving our ability to serve our members and providers.. About Gainwell Technologies LLCGainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. Since 2010, Gainwell has achieved 16 Centers for Medicare Build your career with Gainwell, an industry leader. In 2019, the Ohio General Assembly instructed ODM to adopt a single PBM following release of a 2018 Health Data Solutions (HDS) report stating the PBMs were paid $224 million by Medicaid. Medicaid requires two test batches be successfully submitted in order to receive production approval. #LI- Medicaid. Additionally, PNM training is now available for providers in a variety of formats, including virtual, in-person, and self-paced. Put your passion to work at Gainwell. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. WebSummary. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. We are working to process these as quickly as possible. Pharmacy Services. View this and more full-time & part-time jobs in San Francisco, CA on | Source: For insights into what you need to know, visit managedcare.medicaid.ohio.gov/providers. As a Test Engineer - Medicaid Testing at Gainwell, you will be a part of an innovative healthcare technology company with a mission to serve the healthcare needs of our communities. Learn more about Gainwell at our and visit our for all available job role openings. View job listing details and apply now. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. 1 0 obj The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) awards its fiscal intermediary (FI) service contract to Gainwell Technologies, taking another important step forward in delivering a person-centric next generation managed care program to Ohio. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. 4 0 obj Here are the details on this position. Put your passion to work at Gainwell. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Previous We also have a variety of leadership and technical development academies to help build your skills and capabilities. About NASPO and NASPO ValuePointThe National Association of State Procurement Officials (NASPO) is a non-profit association dedicated to advancing public procurement through leadership, excellence and integrity. <> Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Name Changes to Gainwell Technologies Effective October 1, 2020, Veritas Capital purchased the Medicaid Fiscal Agent business from DXC Technology. Supports unit Testing, System Integration Testing, System Testing, and user Acceptance Testing. Mississippi Medicaid has created the following guide on how to enroll:Trading Partner Enrollment and Registration ProcessIf the link above does not work properly, please download the guide from here:medicaid.ms.gov/edi-technical-documents/If you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. 2 0 obj Thepublic facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. Please accessthis job aidfor step-by-step instructions to sign up for a session. WebIf you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. Viewing this training is important for pharmacists and their support staff to learn about the many tools available on both the public facing and secure portal. This single-vendor approach will result in lower total cost for TPL services and fully streamlines the process by filling in gaps that previously required multiple vendors and disparate point solutions. Clipped from: https://www.dice.com/job-detail/eb49bd3b-53cd-43e7-89e4-fbf4c64a1d8c?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. View job listing details and apply now. In addition to HMS benchmark fees, our recoveries and savings for states and MCOs surpassed $1.5 billion in recoveries and an additional $2.5 billion in savings in 2021 providing clients with best-in-class ROI. Gainwell Technologies LLC. The secure portal requires log in credentials that will allow access to specific patient information. Learn more about Gainwell at our and visit our for all available job role openings. Full-Time. https://www.linkedin.com/jobs/view/experienced-business-analyst-medicaid-at-gainwell-technologies-3480611811/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. The PNM Pre-Registration tool is available until Sept. 23 and will ease the transition and prevent disruptions to system access for providers ahead of go-live on Oct. 1. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Before beginning the enrollment or re-enrollment process, gather all information needed to complete an application. My question is, "Why didn't I find out about Claim Shuttle earlier?!?" 3 . WebJoin to apply for the Experienced Business Analyst- Medicaid role at Gainwell Technologies. I am so happy to have found you! Be part of a team that unleashes the power of leading-edge technologies to Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Coordinate workstreams and teams on IT projects to align solutions with client business priorities, Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results, Delegate work across teams, and coach and monitor project team members to plan, design and improve complex business processes and modifications, Streamline workflows across clients and technical personnel to determine, document and oversee carrying out system requirements, Support quality control as you approve and validate test results to verify that all requirements have been met. Joy Home Care <25 <$5M. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). The following process must be followed prior to initiation of electronic claim submission or inquiry. We offer clients scalable and flexible solutions for their most complex challenges. Under WebGainwell Technologies offerings including Medicaid Management Information Systems (MMIS), fiscal agent services, program integrity, care management, immunization registry, and eligibility services. At issue was the lack of transparency. From members and providers to managed care organizations and state agencies, this transformative system empowers stakeholders to get vital services more quickly and efficiently to drive better health outcomes. By Phone: 1-770-325-9590 1-877-261-8785 (toll free) I just wanted to let you know how impressed I am with this service. The newly designed program is targeted for launch in January 2022. I always get the most fabulous service when calling or emailing!!! We are hiring a hardworking Senior Business Analyst - Medicaid to join our exceptional team at Gainwell Technologies LLC in Conway, AR. 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. View similar Healthcare / Careworkers jobs below. Previous experience with a Medicaid Management System or with major operations-related components of an Medicaid Management System or other large healthcare systems and Creates accurate mapping documents according to the mapping process. Clipped from: https://www.linkedin.com/jobs/view/experienced-business-analyst-medicaid-at-gainwell-technologies-3480611811/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. A Happy Friday message from a Satisfied User! The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Gainwell technologies brings a wealth of experience to strengthen ODM's pharmacy benefits delivery. The recorded SPBM Web Portal training is now available for prescribersand prescribersupport staff. The auditor stated, we cannot be content to accept a black box in the delivery of public services. Ohio Medicaid and other state agencies had no means to audit potential steerage or conflicts of interest. endobj Gainwell Technologies. Interface with the technical team to ensure designs are understood and properly implemented. Since 1985, HMS has been the leader in TPL solutions for state Medicaid agencies. Gainwell is experiencing very high call volumes related to prior authorizations. 1 . Please share my thanks with everyone involved. Help the client innovate and formulate business solutions and technology enabled business models to implement CMS mandated or State directed initiatives. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. x\o7n~ Gainwell Technologies brings a wealth of experience to strengthen ODMs pharmacy benefits delivery. WebSummary. If you're asked to log in with an OHID - the state's best-of-breed digital identity - your privacy, data, and personal information are protected by all federal and state digital security guidelines. 2023 Snagajob.com, Inc. All rights reserved. Working at Gainwell carries its rewards. Ohio Medicaid Copyright 2023 Grabjobs Pte.Ltd. If this is a transaction you would like to utilize please make sure to enroll with the payer. Questions may be directed to the EDI Helpdesk at 1 844-807-9449 or via the Contact Us link ODM received six competitive offers in response to the single PBM request for proposal. , Pharmacy Web Portal training recording now available. Neither ODM nor the state auditor could verify or refute the appropriate use of funds. Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. We are proud to be an Equal Please follow the Enrollment Instructions below to become an electronic submitter for Mississippi Medicaid. Summary The Customer Support Center is closed on Thanksgiving Day and Christmas. The pay range for this position is $38,400.00 - $54,900.00 per year, however, the base pay offered may vary depending on geographic ODM is building its next generation managed care program throughout 2021, including preparations to integrate and launch the strategic components of the program: the single PBM, POSV, fiscal intermediary, centralized credentialing, and the OhioRISE specialized managed care program for children with complex needs. Works toward delivering a first draft solution to ETL for coding, by rapidly understanding which details about the mapping can be deferred. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. All Rights Reserved. YKrvrM.-,[=*q}iP)w_y7y1ywIzz|~xI%G)OHL'I$i?O?E&+~|| OgV'8HZ4/=>}|kx? Presents analysis and design recommendations to lead MITA teams, customer and/or vendors into the acceptance of the design. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. The pay range for this position is $63,100.00 $90,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. WebOur CMS-certified Medicaid Management solutions are modular, intelligent and cloud-based, and they cover all your management needs. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 21 0 R 29 0 R 30 0 R 31 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Theresult is a comprehensive platform that is a model for statesseeking to transform their Medicaid programs.. SIC Code 63,632. 10:52B establish the New Jersey County Option Ohio Medicaid is changing the way we do business. All Rights Reserved. The single PBM is part of a larger overhaul of the Medicaid program designed to put the needs of Medicaid members first and bring visibility to the use of state dollars. Show More. 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. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. The business domain includes Healthcare business processes, specifically focused on Medicaid and Medicare and CMS. 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. October 18, 2022 09:30 ET NAICS Code 52,524. As aData Mapping Leadat Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health andwell-being of the members they serve a communitys most vulnerable. Register today for SPBM Web Portal training! We can now process 276/277 requests (claim status). Everything about it (including your team) is great! Learn more atwww.naspo.org. Click here to join our private community of job Doing so meant structuring the program as a specialized managed care health plan that rewards the single PBM for patient wellness and health outcomes. Uses SQL, data models, data element dictionary and schema to perform data and business analysis. Read on if you are looking for information specific to our current programs. Posted: February 07, 2023. Some of the key benefits to Kansas include: A Strategic PartnershipKansas is proud of what we have accomplished through our strategic partnership with Gainwell, said Kansas Medicaid Director Sarah Fertig. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Want to receive job alerts for similar jobs? 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. Please join the Gainwell Ohio SPBM training staff to learn the difference between the public and the secure portals, including how to register for the secure portal. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions tosome of healthcares biggest challenges. That is a direct consequence of your fantastic employees. For training registration instructions,click here.. Here are the details on this position. My phone line was costing 4 TIMES MORE per month than the fee for using ClaimShuttle, and it couldn't have been easier to set up and get going. You have successfully created a new job alert. The groundbreaking, cloud-based platform uses a service-oriented architecture to seamlessly connect all modules in a secure and dynamic environment. A lock or https:// means you've safely connected to the .gov website. We also have a variety of leadership and technical development academies to help build your skills and capabilities. WebAs a Senior Business Analyst Medicaid 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 communitys most vulnerable. With over 50 years of proven experience, Gainwell carries forward a reputation for technological innovation, service excellence, and unparalleled We also have a variety of leadership and technical development academies to help build your skills and capabilities. Working at Gainwell carries its rewards. endobj The Kansas Medicaid platform implementation sets the standard for states adopting modular solutions. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. The changes we make will help you more easily access information, locate health care providers, and receive quality care. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Experience and knowledge with HCPCS and ICD procedure codes and ICD diagnosis code is a plus, Knowledge of Microsoft Excel advanced features such as macros and/or relational database software, Ability to clearly and concisely translate technical requirements to a non-technical audience, Skills working with business processes and re-engineering, Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members, A caring team leader who motivates and coaches less experienced resources, Fully remote, only US location options will be considered. Viewing this training is important for managed care entities to learn about the many tools available on both the public facing and secure portal. SeniorinCare <25 <$5M. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. WebAs a Medicaid Data Analyst SME 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 Reno, NV. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. To access the recording, pleaseclick here. | Source: Our transformed Medicaid platform will provideincredible benefits to our state,our most vulnerable citizens,andourvalued providers. Top Competitors of Gainwell Technologies. Your role in our mission New Extensions for Gainwell Technologies Provider Representatives 12/7/2020 PDF Version TO: All Providers RE: New Extensions for Gainwell Technologies Provider Representatives Effective Wednesday, December 9, 2020, Gainwell Technologies Provider Representatives may be reached by dialing 855-523-9170, then dialing a new 7 Claims and encounters? The recorded SPBM WebPortal training is now available for pharmacies and pharmacy support staff. Please enable Cookies and reload the page. Supports the ETL developers based on the mappings created. To access the recording, pleaseclick here. Refines mapping documents, adding more detail, and filling out deferred material as questions are resolved. CONTACT:Elizabeth Bonet Gainwell Technologies972-556-5082elizabeth.bonet@gainwelltechnologies.com. Log in to the member secure portal to view your: Your guide to Medicaid and other information about your Medicaid benefits can be found in the Member section of the Medicaid Managed Care Plan websites., The Gainwell Notice of Privacy Practices is available. You can deactivate or delete job alerts by clicking the button below. The award moves Ohio closer to realizing greater transparency and accountability in Medicaid's $3 billion pharmacy program. Gainwell has served Kansas for two decades, forming a deep relationship with the state built on trust and transparency. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Provide business solutions, process improvements, business case and change consulting to the external client at functional and senior management level. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Your role in our mission Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. This time it was warranted. The rep and supervisor went out of their way to get the issue resolved. Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. Put your passion to work at Gainwell. 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. ODM expects to award the POSV vendor by summer 2021. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. WebSummary. WebSummaryAs a [ [Medicaid Senior Business 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 communitys most vulnerable. I just transmitted my first batch of electronic claims through Claim Shuttle! We celebrate diversity and are dedicated to creating an inclusive environment for all employees. TennCare, Gainwell Technologies LLC and Axis Direct, Inc. announced today that they have notified approximately 3,300 Medicaid members in the State of Tennessee of a privacy issue that may have impacted their protected health information. We are redesigning our programs and services to focus on you and your family. Working at Gainwell carries its rewards. Reno, NV. As a Senior Business Analyst - Medicaid 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 communitys most vulnerable. If you don't receive your credentials within 2-3 weeks, please call theirTechnology Support Center toll-free at1-800-884-3222. Pharmacy providers and members may contact the Gainwell Customer Support Center by phone 833-491-0344, 24 hours a day, seven daysa week. Mississippi Division of Medicaid (ms.gov)) click on the MOVEit Portal at Mississippi Replacement Project (msxix.net) page. 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. An Ohio.gov website belongs to an official government organization in the State of Ohio. WebWhat you should expect in this role. WebGainwell provides several services to the Indiana Health Coverage Programs, including provider enrollment, customer service, eligibility verification systems, and fee-for-service Full-Time. 3 0 obj Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Gainwell Technologies LLC. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. I was really concerned that this transition was going to be difficult and costly, but I was wrong on both counts. Gainwell is the market leader in providing Medicaid services. PNM will replace MITS provider enrollment and provider data management. San Francisco, CA. Users may find helpful website links and documents within our online portal in the menu bar above. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. LA Dept of Health and Hospitals. Youll have an incredible 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, We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. To access the recording, pleaseclick here. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. Through the SPBM, ODM gains increased accountability and ensures alignment with clinical and policy goals, while also improving transparency. Our billers love the interface that ClaimShuttle provides and I would be happy to be a future reference if needed. Web1-770-325-2331 1-866-211-0950 (toll free) Providers, Trading Partners, or Provider Agents: Problems with registration or logging into the website should be directed to the Gainwell Technologies Company Georgia Medicaid EDI Services group. As a Test Engineer - Medicaid Testing at Gainwell, you will be a part of an innovative healthcare technology company with a mission to serve the healthcare needs You have reached your maximum number of active job alerts. $63,130 to $78,957 Yearly. Welcome to Document requirements for business and system requirements. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information. How can you stand out? As a result, health care providers are subject to meeting unique, time-consuming processes required by each MCO to prescribe important, sometimes life-sustaining medications. P.L. Members will have access to a training video on Oct. 1. Find the best jobs in the US, apply in 1 click and get a job today! It provides access to specific patient information and the ability to reach the SPBM Clinical help desk via web chat. Clinical information that is available includesmember benefit and eligibility, pharmacy prescription claims activity, Rx prior authorizations, and Coordinated Services Program (CSP) status will be distributed to the MCEs, however, the portal will allow quicker access to the most current information. La Med. Thank you for your patience as we continue to enhance the system. TennCare is committed to safeguarding the information of our members. Coordinate workstreams and teams on IT projects to align solutions with client business priorities, Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results, Delegate work across teams, and coach and monitor project team members to plan, design and improve complex business processes and modifications, Streamline workflows across clients and technical personnel to determine, document and oversee carrying out system requirements, Support quality control as you approve and validate test results to verify that all requirements have been met, Nine or more years of experience working as a business analyst or requirements translator between technical and non-technical personnel, with 3 or more years of Medicaid and Medicare experience preferred, Knowledge of Microsoft Excel advanced features such as macros and/or relational database software, Ability to clearly and concisely translate technical requirements to a non-technical audience, Skills working with business processes and re-engineering, Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members, A caring team leader who motivates and coaches less experienced resources, Opportunities to travel through your work (0-10%), Onsite, remote or Hybrid options may be available from US locations, The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.