Logo for Gainwell Technologies LLC

Associate Professional Quality

Role overview

Summary

This role focuses on quality assurance and analysis of Provider Enrollment applications to ensure compliance with policies and guidelines. You will support the delivery of exceptional member and provider experiences by monitoring interactions and collaborating with various teams.

Qualifications

  • Bachelor's degree or equivalent combination of education and experience.
  • Two or more years of quality assurance experience.
  • Minimum of 3 years working in Provider Enrollment and/or Credentialing.
  • Proficiency in Microsoft Office Suite and Sharepoint.
  • Strong written and verbal communication skills.

Responsibilities

  • Monitor and evaluate voice and non-voice interactions for accuracy and compliance.
  • Conduct daily reviews and audits to ensure adherence to standards and policies.
  • Identify and escalate quality issues and process improvement needs.
  • Recommend process and policy improvements using data-driven insights.

Key facts

Hard skills

Other skills

  • Quality Assurance
  • Microsoft Office
  • Communication
  • Collaboration
  • Organizational Skills
  • Time Management
  • Adaptability

About the company

Gainwell Technologies LLC logo

Gainwell Technologies LLC

  • GovTech
  • Large
  • 10,001+
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.

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

 

Summary

The CX Associate Professional Quality is responsible for monitoring and evaluating voice and non-voice interactions (accuracy, compliance, and experience).  This role supports our commitment to delivering exceptional member and provider experience and the assurance of accurate, and compliant work through measurement and analysis of calls, transactions, and related business processes. Responsibilities include conducting daily reviews and audits to ensure adherence to client, company, and regulatory standards, policies and procedures. You may contribute to planning, execution, and delivery of quality initiatives. By partnering with centralized and account teams, your work will enhance employee, member, and client experiences to help achieve organizational goals.

Your role in our mission

  • Provide quality assurance and analysis of Provider Enrollment applications to ensure compliance with Federal and State policies and guidelines.
  • Meet established production and quality standards while processing and supporting complex provider enrollment requirements.
  • Participate in and, when needed, facilitate calibration sessions and stakeholder engagement meetings to ensure consistency and alignment.
  • Identify, escalate, and support the resolution of quality issues, coaching opportunities, and process improvement needs.
  • Use data-driven insights, automation, and industry best practices to recommend process and policy improvements and increase QA efficiency and effectiveness.

What we're looking for

  • Bachelor's degree or equivalent combination of education and experience, including two or more years of quality assurance (QA principles and methodologies, or subject matter expertise of areas to be evaluated).
  • Minimum of 3 years working in Provider Enrollment and/or Credentialing required, 5 years of experience preferred.
  • Demonstrated ability to collaborate with team members across multiple areas.
  • Proficiency in Microsoft Office Suite and Sharepoint, with familiarity in contact center and back-office quality platforms (CXOne, Verint, etc.).
  • Strong written and verbal communication skills, with proven ability to work effectively with diverse teams.

What you should expect in this role

  • Strong organizational and time management skills.
  • Skilled at working independently and collaboratively.
  • Demonstrated adaptability to change and continuous improvement.
  • 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.
  • Remote role – required to have a home office or room with a door to separate from anyone in the house. Hours are 8am-5pm punctuality is a must.

The deadline to submit applications for this posting is 11/30/2026.

#LI-REMOTE

#LI-JT1

 

Related jobs

See all jobs

Other jobs at Gainwell Technologies LLC