It provides services for 29 state Medicaid programs, processes more than 195 million pharmacy claims a year, and answers 6.6 million provider and recipient phone calls annually on behalf of state health care customers. Find the best jobs in the US, apply in 1 click and get a job today! COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). WebGainwell Technologies LLC is now hiring a Account General Manager - State Medicaid Management Services in Nevada. Learn more at gainwelltechnologies.com. If you don't receive your credentials within 2-3 weeks, please call theirTechnology Support Center toll-free at. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. 2 . If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) awards its fiscal intermediary (FI) service contract to Gainwell Technologies, taking another important Gainwell Technologies LLC. % 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. View job listing details and apply now. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. 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. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. 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 The ease of use and user-friendly environment is awesome. 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. Since 2010, Gainwell has achieved 16 Centers for Medicare and Medicaid Services (CMS) certifications more than all other vendors within the same time period. How can you stand out? 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. 2023. Provide business solutions, process improvements, business case and change consulting to the external client at functional and senior management level. 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. Put your passion to work at Gainwell. Doing so meant structuring the program as a specialized managed care health plan that rewards the single PBM for patient wellness and health outcomes. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Copyright 2023 Grabjobs Pte.Ltd. A pioneer in protecting the integrity of Medicaid programs through comprehensive TPL solutions and services, HMS has been awarded contracts for all five categories: Commercial Recoupment, Recovery, Hospital-Physician, MCO Come-Behind Billing and TPL Systems Module. LA Dept of Health and Hospitals. The groundbreaking, cloud-based platform uses a service-oriented architecture to seamlessly connect all modules in a secure and dynamic environment. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Ohio Medicaid 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. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. 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. If you have already submitted a prior authorization, please refrain from sending in a duplicate Prior Authorization. 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 POSV will ensure incentives are properly and fairly aligned, self-dealing and steering are prevented, and monetary loopholes are closed. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. Build your career with Gainwell, an industry leader. Step 1: Enrollment via the "Trading Partner Enrollment" link on their website:https://portal-tpi.msxix.net/ms/provider/Home/tabid/135/Default.aspx, Please make sure your information matches what's in Medicaid's system, Please make sure the signature belongs to the authorized representative Medicaid has in their system for your company, Once you've completed enrollment, please write down the Trading Partner ID and password listed on that screen. Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215, Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516, Gainwell Technologies selected to bring new level of accountability. Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. Working at Gainwell carries its rewards. Please enter a Name and Password so you can update your Job Alerts in the future. 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. The Kansas Medicaid platform implementation sets the standard for states adopting modular solutions. Work as a liaison between the customer and the technical team to provide quality solutions for the customers needs. Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. 1 0 obj The Customer Support Center is closed on Thanksgiving Day and Christmas. Working at Gainwell carries its rewards. Summary 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. Working at Gainwell carries its rewards. Build your career with Gainwell, an industry leader. <> Pharmacy providers and members may contact the Gainwell Customer Support Center by phone 833-491-0344, 24 hours a day, seven daysa week. Learn more about Gainwell at our and visit our for all available job role openings. If this is a transaction you would like to utilize please make sure to enroll with the payer. 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 Pharmacy Services. P.L. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. 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. 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. As always excellent, professional, knowledgeable customer service. Learn more atwww.naspo.org. ODM's goals for the SPBM are to improve management and administration of pharmacy benefits for Ohio Medicaid managed care members. Learn more atwww.naspovaluepoint.org. 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. PrescriberWeb Portal training recording now available. Reno, NV. The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. x\o7n~ Once implemented, the single PBM will eliminate costly duplicative administrative processes for ODM and providers alike. Apply online instantly. Other companies could learn from you. Since 2010, Gainwell has achieved 16 Centers for Medicare Verify solution meets the defined requirements through scenario testing. . 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. This contract win further validates the long-standing quality, effectiveness and innovation of our TPL solutions and they are invaluable in continuing to keep our nations healthcare programs protected and strong.. Additionally, PNM training is now available for providers in a variety of formats, including virtual, in-person, and self-paced. The Ohio Department of Medicaid (ODM) provides health care coverage to more than 3 million Ohioans through a network of more than 165,000 providers. Md]|k >i0NVxC?',X#g*. 10:52B establish the New Jersey County Option 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. Refines mapping documents, adding more detail, and filling out deferred material as questions are resolved. WebApply for a Gainwell Technologies LLC Data Mapping Lead job in San Francisco, CA. Put your passion to work at Gainwell. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. 3 0 obj Our billers love the interface that ClaimShuttle provides and I would be happy to be a future reference if needed. Gainwell Technologies. WebJoin to apply for the Experienced Business Analyst- Medicaid role at Gainwell Technologies. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. We can now process Want to receive job alerts for similar jobs? The following process must be followed prior to initiation of electronic claim submission or inquiry. You can also receive alerts via instant message. Our transformed Medicaid platform will provideincredible benefits to our state,our most vulnerable citizens,andourvalued providers. You can deactivate or delete job alerts by clicking the button below. Once you have received your Submitter ID and Password from Mediciad, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. For decades, HMS has been a leader in providing cost containment solutions to state Medicaid agencies, said Paul Saleh, President and CEO of Gainwell. 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. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. 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. We are proud to be an Equal It provides access to specific patient information and the ability to reach the SPBM Clinical help desk via web chat. NASPO is an organization that helps its members as public procurement leaders by promoting best practices, education, professional development, research and innovative procurement strategies. TYSONS, Va., June 14, 2022 (GLOBE NEWSWIRE) -- Gainwell announced today that HMS, a Gainwell Technologies company, has been selected to provide Medicaid Third Party Liability (TPL) services and solutions to state Medicaid agencies through the National Association of State Procurement Officials (NASPO) ValuePoint TPL Services contract. During the training, you will also learn about many exciting tools available on the SPBM Web Portal such as member eligibility, viewing prior authorization status, the ability to quickly speak with the SPBM help desk, and much more! Members will have access to a training video on Oct. 1. 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. Put your passion to work at Gainwell. Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. We are hiring a hardworking Senior Business Analyst - Medicaid to join our exceptional team at Gainwell Technologies LLC in Conway, AR. TYSONS, Va., June 14, 2022 (GLOBE NEWSWIRE) -- Gainwell announced today that HMS, a Gainwell Technologies company, has been selected to provide Presents analysis and design recommendations to lead MITA teams, customer and/or vendors into the acceptance of the design. PNM will replace MITS provider enrollment and provider data management. Neither ODM nor the state auditor could verify or refute the appropriate use of funds. A Happy Friday message from a Satisfied User! Gainwell Technologies LLC. Learn more about Gainwell at our. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. TYSONS CORNER, Va., Oct. 18, 2022 (GLOBE NEWSWIRE) -- Gainwell Technologies (Gainwell), a leading innovator in healthcare technology solutions, designed and implemented Kansas new and completely modular Medicaid platform. 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. 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 secure portal requires log in credentials. Questions may be directed to the EDI Helpdesk at 1 844-807-9449 or via the Contact Us link Learn more about Gainwell at our and visit our for all available job role openings. 2 0 obj Ohio Medicaid is changing the way we do business. 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. Document requirements for business and system requirements. 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. Learn more about Gainwell at our and visit our for all available job role openings. Summary Your session is about to expire. 5+ 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. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. The portal also gives the user the ability to reach the SPBM Clinical help desk via web chat. 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. Gainwell Technologies brings a wealth of experience to strengthen ODMs pharmacy benefits delivery. LA Medicaid Managed Care Organization. A most unexpected experience: Someone who knows and is helpful. WebSummary. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions tosome of healthcares biggest challenges. Here are the details on this position.. Please use the same Learning Management System (LMS) credentials set up during your registration to log in.. 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. The award moves Ohio closer to realizing greater transparency and accountability in Medicaids $3 billion pharmacy program. Provider The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. Selecting Gainwell as our partner in administering a clinically driven, outcomes-oriented pharmacy program enables us to take advantage of their previous successes.. To access the recording, pleaseclick here. We also have a variety of leadership and technical development academies to help build your skills and capabilities. This is a soft launch of the SPBM onlineportal with limited features. 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. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Joy Home Care <25 <$5M.