Through the SPBM, ODM gains increased accountability and ensures alignment with clinical and policy goals, while also improving transparency. View job listing details and apply now. Your session is about to expire. . 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. Posted: February 07, 2023. First name. View this and more full-time & part-time jobs in San Francisco, CA on Working at Gainwell carries its rewards. Learn more about Gainwell at our. WebGainwell Technologies offerings including Medicaid Management Information Systems (MMIS), fiscal agent services, program integrity, care management, immunization registry, and eligibility services. 2023 Snagajob.com, Inc. All rights reserved. Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. 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. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. 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. Trading Partner Enrollment and Registration Process, https://portal-tpi.msxix.net/ms/provider/Home/tabid/135/Default.aspx, JF Noridian Administrative Services: Alaska Medicare, JF Noridian Administrative Services: Arizona Medicare, JH Novitas Solutions, Inc: Arkansas Medicare, JE Noridian Administrative Services: California Medicare, Blue Shield of California (Anthem Central) via Availity, JH Novitas Solutions, Inc: Colorado Medicare, Colorado Blue Cross Blue Shield (Anthem Central) via Availity, Connecticut Blue Cross Blue Shield (Anthem Central) via Availity, JL Novitas Solutions, Inc: Delaware Medicare, Blue Cross Blue Shield of Washington D.C. (Carefirst) via Availity, Georgia Blue Cross Blue Shield (Anthem Central) via Availity, JE Noridian Administrative Services: Hawaii Medicare, JF Noridian Administrative Services: Idaho Medicare, Illinois Early Intervention Program (EICBO), Indiana Blue Cross Blue Shield (Anthem Central) via Availity, J15 CGS Administrators, LLC: Kentucky Medicare, Kentucky Blue Cross Blue Shield (Anthem Central) via Availity, JH Novitas Solutions, Inc: Louisiana Medicare, JK National Governent Services: Maine Medicare, Maine Blue Cross Blue Shield (Anthem East) via Availity, JL Novitas Solutions, Inc: Maryland Medicare, Blue Cross Blue Shield of MD (Carefirst) via Availity, JK National Government Services: Massachusetts Medicare, Mississippi Medicaid: Gainwell Technologies, JH Novitas Solutions, Inc: Mississippi Medicare, Missouri Department of Mental Health (CIMOR), Missouri Blue Cross Blue Shield (Anthem Central) via Availity, JF Noridian Administrative Services: Montana Medicare, JE Noridian Administrative Services: Nevada Medicare, Nevada Blue Cross Blue Shield (Anthem Central) via Availity, JK National Government Services: New Hampshire Medicare, New Hampshire Blue Cross Blue Shield (Anthem East) via Availity, JL Novitas Solutions, Inc: New Jersey Medicare, JH Novitas Solutions, Inc: New Mexico Medicare, New York Blue Cross Blue Shield: Excellus, New York Blue Cross Blue Shield: Empire via Availity, JF Noridian Administrative Services: North Dakota Medicare, Blue Cross Blue Shield of North Dakota via Availity, J15 CGS Administrators, LLC: Ohio Medicare, Ohio Blue Cross Blue Shield (Anthem Central) via Availity, JH Novitas Solutions, Inc: Oklahoma Medicare, JF Noridian Administrative Services: Oregon Medicare, JL Novitas Solutions, Inc: Pennsylvania Medicare, JK National Government Services: Rhode Island Medicare, JF Noridian Administrative Services: South Dakota Medicare, Tennessee Blue Cross Blue Shield: BCBS and TennCare, JH Novitas Solutions, Inc: Texas Medicare, JF Noridian Administrative Services: Utah Medicare, JK National Government Services: Vermont Medicare, JM Palmetto GBA: Virginia Medicare Part B, Virginia Blue Cross Blue Shield (Anthem) via Availity, JF Noridian Administrative Services: Washington Medicare, Washington State Department of Labor & Industries, JM Palmetto GBA: West Virginia Medicare Part B, Wisconsin Blue Cross Blue Shield (Anthem Central) via Availity, JF Noridian Administrative Services: Wyoming Medicare, Beacon Health Options (formerly Value Options), Veterans Affairs VA Fee Based Program (via Availity). We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Gainwell is the market leader in providing Medicaid services. Medicaid This new platform will drive efficiency and quality, improving our ability to serve our members and providers.. P.L. Gainwell Technologies The Kansas Medicaid platform implementation sets the standard for states adopting modular You have already created a job alert with same filters. % Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Medicaid Build your career with Gainwell, an industry leader. A lock or https:// means you've safely connected to the .gov website. The POSV will ensure incentives are properly and fairly aligned, self-dealing and steering are prevented, and monetary loopholes are closed. Validates test plan results that satisfy the detailed design goals. Newly Formed Gainwell Technologies Named PBM for You can also receive alerts via instant message. Document requirements for business and system requirements. 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. 6+ years of associated work experience in a software development environment, Practical ability with Microsoft Office as well as SQL, Demonstrated ability to independently manage multiple responsibilities, prioritize tasks and meet deadlines, Excellent written and verbal communication, Ability to perform in lead Business Analyst role on projects, Position open to candidates residing in Arkansas, El Paso, TX or Puerto Rico. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. <> Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. | Source: This experience takes the partnership to an entirely new 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. Data Mapping Lead - Gainwell Technologies LLC Gainwell is offering several options available below for your assistance: Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! By Phone: 1-770-325-9590 1-877-261-8785 (toll free) Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! June 14, 2022 08:00 ET Medicaid 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. Required Documents for those applying for new Submitter IDs. 2 . Reno, NV. Gainwell is experiencing very high call volumes related to prior authorizations. The secure portal requires log in credentials. Working at Gainwell carries its rewards. This comprehensive solution gives Kansas Medicaid the agility and interoperability it needs to deliver high-quality healthcare services while reducing costs. Learn more about Gainwell at our and visit our for all available job role openings. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. 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. Ohio Medicaid is changing the way we do business. Works toward delivering a first draft solution to ETL for coding, by rapidly understanding which details about the mapping can be deferred. %PDF-1.7 We also have a variety of leadership and technical development academies to help build your skills and capabilities. <>/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>> Excellent service and I never give anyone "Excellent" scores on surveys. Under Registration for SPBM Web Portal training is now open for all members. Selecting Gainwell as our partner in administering a clinically driven, outcomes-oriented pharmacy program enables us to take advantage of their previous successes.. Working at Gainwell carries its rewards. Medicaid Data Analyst SME - Gainwell Technologies Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. 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 We also have a variety of leadership and technical development academies to help build your skills and capabilities. Click OK to renew your session or Logout of the application. How can you stand out? You have reached your maximum number of active job alerts. Find the best jobs in the US, apply in 1 click and get a job today! Put your passion to work at Gainwell. Learn more about Gainwell at our and visit our for all available job role openings. 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 Pharmacy providers and members may contact the Gainwell Customer Support Center by phone 833-491-0344, 24 hours a day, seven daysa week. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. 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 awards fiscal intermediary contract On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. ODM's goals for the SPBM are to improve management and administration of pharmacy benefits for Ohio Medicaid managed care members. Please use the same Learning Management System (LMS) credentials set up during your registration to log in. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Every time I call, it feels as if I am talking directly with the owner of the company. HMS was selected as a supplier for ValuePoints TPL service offerings, allowing states to gain more efficiency and savings by choosing one sole provider to manage all their data and TPL service needs. As always excellent, professional, knowledgeable customer service. TTY: 711. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Change Healthcare, Express Scripts, Gainwell Technologies, MagellanRx Management, Navitus Health Solutions, and RxAdvance each submitted responses. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions tosome of healthcares biggest challenges. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Gainwell Technologies. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. SPBM Clinical staff can also be reached via phone and email. Here are the details on this position. The recorded SPBM Web Portal training is now available for prescribersand prescribersupport staff. 3 . Gainwell Technologies brings a wealth of experience to strengthen ODMs pharmacy benefits delivery. 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. Copyright 2013 AXIOM Systems, Inc. All Rights Reserved. Be part of a team that unleashes the power of leading-edge Gainwell is the market leader in providing Medicaid services. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. Members will have access to a training video on Oct. 1. The recorded SPBM Web Portal training is now available for Managed Care Entity Portal Administrators and staff. The Customer Support Center is closed on Thanksgiving Day and Christmas. 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. Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. 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. Work as a liaison between the customer and the technical team to provide quality solutions for the customers needs. Please use the same Learning Management System (LMS) credentials set up during your registration to log in. Copyright 2023 Grabjobs Pte.Ltd. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. Name Changes to Gainwell Technologies Effective October 1, 2020, Veritas Capital purchased the Medicaid Fiscal Agent business from DXC Technology. Joy Home Care <25 <$5M. Once implemented, the single PBM will eliminate costly duplicative administrative processes for ODM and providers alike. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. To bolster accountability in the pharmacy program, Ohio Medicaid soon will select a pharmacy operational support vendor (POSV) tasked with auditing the single PBM. Summary Full-Time. Put your passion to work at Gainwell. Mississippi Medicaid has created the following guide on how to enroll: Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. Department of Medicaid logo, return to home page. An Ohio.gov website belongs to an official government organization in the State of Ohio. Uses SQL, data models, data element dictionary and schema to perform data and business analysis. We also have a variety of leadership and technical development academies to help build your skills and capabilities. 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. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Questions may be directed to the EDI Helpdesk at 1 844-807-9449 or via the Contact Us link NASPO ValuePoint is the cooperative purchasing division of the National Association of State Procurement Officials (NASPO), facilitating cooperative public procurement solicitations using a Lead State model. 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. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Welcome to Thank you for your excellence! Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive 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. It's great to have immediate help and knowledgeable support! Managed Care Entity Web Portal training recording now available. LA Dept of Health and Hospitals. Together, as one team, we collaborated on every aspect of this program. 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. Viewing this training is important for managed care entities to learn about the many tools available on both the public facing and secure portal. Before beginning the enrollment or re-enrollment process, gather all information needed to complete an application. Supports the ETL developers based on the mappings created. 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. We can now process 276/277 requests (claim status). Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. 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. Be the first to receive the latest Nurse Full-Time Jobs in the US. Everything about it (including your team) is great! Gainwell technologies brings a wealth of experience to strengthen ODM's pharmacy benefits delivery. It was nice to have a direct contact with the same representative until the problem was resolved. 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. Please open this website in one of the following browsers: Chrome, Edge, Firefox, Safari. 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. SeniorinCare <25 <$5M. Please enter a Name and Password so you can update your Job Alerts in the future. If you don't receive your credentials within 2-3 weeks, please call theirTechnology Support Center toll-free at. 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. The secure portal requires log in credentials that will allow access to specific patient information. The following process must be followed prior to initiation of electronic claim submission or inquiry. We are hiring a hardworking Senior Business Analyst - Medicaid to join our exceptional team at Gainwell Technologies LLC in Conway, AR. Senior Business Analyst - Medicaid - Hiring Urgently at Gainwell Users may find helpful website links and documents within our online portal in the menu bar above. This time it was warranted. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Gainwell Technologies LLC. Since 2010, Gainwell has achieved 16 Centers for Medicare and Medicaid Services (CMS) certifications more than all other vendors within the same time period. Full-Time. 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. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. WebMedicaid Data Analyst SME - Gainwell Technologies - San Francisco CA - data-analyst, san-francisco----ca, gainwell-technologies. Indiana Medicaid: Partners: Gainwell Technologies The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay Claims and encounters? Welcome to New Jersey Medicaid Headlines 3 - NJMMIS We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Build your career with Gainwell, an industry leader. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Last name. Welcome to the new Ohio Medicaid pharmacyservices onlineportal. LA Medicaid Managed Care Organization. WebApply for a Gainwell Technologies LLC Data Mapping Lead job in San Francisco, CA. Top Competitors of Gainwell Technologies. 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. TennCare is committed to safeguarding the information of our members. Click here to join our private community of job 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. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. We are redesigning our programs and services to focus on you and your family. $63,130 to $78,957 Yearly. 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. There simply is no comparison! Share sensitive information only on official, secure websites. To access the recording, pleaseclick here. 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. Gainwell operates as a standalone company with over 7,500 employees who support clients across 42 U.S. states and territories.
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