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Program Specialist (Remote in CT, MA, NJ, or NY)

Role overview

Qualifications

  • Bachelor's degree required
  • Five (5) or more years relevant work experience in areas such as Health insurance or Government
  • Two (2) or more years of experience in Health Insurance or Government
  • Healthcare or Medicaid recovery experience strongly preferred

Responsibilities

  • Builds and manages client provider relationships to ensure client satisfaction
  • Oversight and management of client provider recoupments
  • Continuous monitoring and timely reporting to management on business goals
  • Supports collaboration between account management team and operations staff

Other skills

  • Customer Service
  • Governance
  • Collaboration
  • Problem Solving
  • Communication

About the company

Gainwell Technologies LLC logo

Gainwell Technologies LLC

Digital Health & Health Tech

For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus. Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies. Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.

Company details

Company typeLarge
IndustryDigital Health & Health Tech
Company size10001

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Job description

 

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

The Program Specialist is responsible for supporting the client and provider relationships. Works closely with account management team and operations team on maintaining provider inquiries on successful delivery of HMS (a Gainwell company) services for our client. Job responsibilities include oversight and management of small projects, analysis of data, customer service, building and maintaining reports along with the potential of creating client deliverables. Only candidates within CT, MA, NJ, and NY will be considered.

Your role in our mission

  • Builds and manages client provider relationships with support from the Program Director or Manager; responsible for ensuring client satisfaction.
  • Builds relationships and collaborates effectively with HMS provider relations to ensure successful delivery of services to client(s). Assist in the creation and/or review of client deliverables
  • Oversight and management of client provider recoupments, specific to disallowance services and provider portal
  • Works with account management and operations team as necessary on applicable client design project(s) approach and develop implementation plans.
  • Continuous monitoring and timely reporting to management progress toward business goals
  • Assist in the development of both internal and external reports to monitor operational and financial performance
  • Monitors and prepares trending analysis and reporting for provider related services for client(s)
  • Supports collaboration between account management team and operations staff.
  • Manage expectations, resolve problems, and develop opportunities.
  • Lead and manage projects.
  • Work proficiently in multiple company databases.
  • Understand the basics of data table structures and report building.
  • Demonstrates exceptional customer service and follow up skills.

What we're looking for

  • Bachelor's degree required.
  • Five (5) or more years relevant work experience required with experience in one of the following areas preferred: Health insurance, Government, Client service/business to business, and Healthcare policy.
  • Two (2) or more years of experience in one of the following areas desired: Health Insurance, Government, Client Service/business to business, Health Policy required.
  • Two (2) or more years of experience in TPL required. Specific hospital provider background preferred.
  • Healthcare or Medicaid recovery experience strongly preferred.

 

What you should expect in this role

  • This is a full-time permanent regular salaried (W-2) employee position.
  • Only candidates within CT, MA, NJ, and NY will be considered.
  • Monday through Friday work schedule (40 hours per week).
  • Upward career advancement is possible and encouraged.
  • Health (medical, dental, vision) benefits start on day 1 of employment.
  • Company match 401K and other benefits available within months of starting.
  • New 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.
  • Company provided computer for work use.
  • 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.
  • The use of AI during interviews is prohibited.
  • This position will accept applications until July 22, 2026.

 

#LI-NB1

#LI-REMOTE

 

The pay range for this position is $15.00 - $21.00 per hour, 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 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

 

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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