Provider Field Representative Lead - Remote California

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 Provider Field Representative Lead provides functional leadership and support to Provider Field Representatives serving California’s Medi-Cal provider community.

This role supports team escalations, provider outreach, claims research, provider billing support, and the development and delivery of virtual and in-person training. The Lead also serves as a liaison between providers, provider associations, internal departments, and the client to help ensure consistent service delivery and compliance with Medi-Cal program requirements.

Your role in our mission

• Provide functional leadership and direction to Provider Field Representatives, serving as a resource for team escalations, complex provider inquiries, billing questions, claims issues, and program requirements.
• Support provider billing activities, including one-on-one billing assistance, claims research and analysis, reimbursement questions, and resolution of provider billing issues.
• Support and help direct provider education and outreach, including workshops, seminars, program-specific events, one-on-one training, and provider association activities.
• Serve as a liaison between providers, internal departments, and the client to resolve issues and support Medi-Cal programs and initiatives.
• Apply established policies and procedures while exercising independent judgment to resolve complex provider issues, identify areas of concern, and recommend appropriate solutions or escalation.
• Contribute to shared knowledge resources, document complex issue resolution, and help ensure consistent and accurate information is provided across the team.
• Support the development and mentoring of Provider Field Representatives while identifying opportunities to improve provider service, team processes, and overall operational effectiveness.

What we're looking for

• Three or more years of business process outsourcing, consulting, systems implementation, provider relations, provider services, or related healthcare operations experience.
• Experience supporting healthcare providers with billing, claims research, billing issues, and reimbursement-related questions.
• Experience serving as a functional lead, subject matter expert, mentor, trainer, or escalation point for a team.
• Experience developing and/or delivering training to healthcare providers virtually and in person.
• Strong provider relations, analytical, problem-solving, communication, presentation, facilitation, and functional leadership skills.
• Experience working with business processes, assessing provider or client needs, and identifying opportunities for improvement.
• Medi-Cal or Medicaid experience preferred.
• Willingness and ability to travel throughout California.

What you should expect in this role

• Remote position; must reside in California.
• Travel throughout California is required to support provider training, outreach, events, and other business needs.
• Occasional overnight travel and onsite attendance may be required.
• Reliable high-speed internet connectivity is required.

This is a pipeline requisition designed to build a pool of qualified candidates for current and future opportunities as positions become available.

#LI-REMOTE

#LI-MA1

The pay range for this position is $70,000 - $80,000 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 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.