Before beginning the enrollment or re-enrollment process, gather all information needed to complete an application. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) awards its fiscal intermediary (FI) service contract to Gainwell Technologies, taking another important We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. The POSV will ensure incentives are properly and fairly aligned, self-dealing and steering are prevented, and monetary loopholes are closed. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Learn more about Gainwell at our and visit our for all available job role openings. 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 ODM expects to award the POSV vendor by summer 2021. We are hiring a hardworking Senior Business Analyst - Medicaid to join our exceptional team at Gainwell Technologies LLC in Conway, AR. 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. Gainwell Implements Fully Modular, Cloud-Based Medicaid 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. View this and more full-time & part-time jobs in San Francisco, CA on We also have comprehensive leadership and technical development academies to help build your skills and capabilities. With over 50 years of proven experience, Gainwell carries forward a reputation for technological innovation, service excellence, and unparalleled Full-Time. We offer clients scalable and flexible solutions for their most complex challenges. 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. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. 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. Refines mapping documents, adding more detail, and filling out deferred material as questions are resolved. Please open this website in one of the following browsers: Chrome, Edge, Firefox, Safari. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Experienced Business Analyst- Medicaid | Gainwell Technologies 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. 3 0 obj Medicaid requires two test batches be successfully submitted in order to receive production approval. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) awards its fiscal intermediary (FI) service contract to Gainwell Technologies, taking another important step forward in delivering a person-centric next generation managed care program to Ohio. Department of Medicaid logo, return to home page. Working at Gainwell carries its rewards. Hope Private In-Home Care <25 <$5M. 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. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. 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.Please have 25 test claims ready for testing. #LI- Medicaid. At issue was the lack of transparency. 2 0 obj Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Previous Put your passion to work at Gainwell. Works toward delivering a first draft solution to ETL for coding, by rapidly understanding which details about the mapping can be deferred. WebGainwell Technologies LLC is now hiring a Account General Manager - State Medicaid Management Services in Nevada. Be part of a team that unleashes the power of leading-edge 1 . All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. Gainwell Technologies LLC. The secure portal requires log in credentials. Gainwell Technologies selected to bring new level of WebIf you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. 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 newly designed program is targeted for launch in January 2022. Senior Business Analyst Medicaid Gainwell Technologies With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. The following process must be followed prior to initiation of electronic claim submission or inquiry. $63,130 to $78,957 Yearly. Doing so meant structuring the program as a specialized managed care health plan that rewards the single PBM for patient wellness and health outcomes. Learn more about Gainwell at our and visit our for all available job role openings. We are working to process these as quickly as possible. 2 . My question is, "Why didn't I find out about Claim Shuttle earlier?!?" 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). ODM is building its next generation managed care program throughout 2021, including preparations to integrate and launch the strategic components of the program: the single PBM, POSV, fiscal intermediary, centralized credentialing, and the OhioRISE specialized managed care program for children with complex needs. Gainwell Technologies LLC Medicaid Data Analyst SME Job in Learn more about Gainwell at our and visit our for all available job role openings. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. 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. Gainwell is the market leader in providing Medicaid services. It provides access to specific patient information and the ability to reach the SPBM Clinical help desk via web chat. Through the SPBM, ODM gains increased accountability and ensures alignment with clinical and policy goals, while also improving transparency. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Put your passion to work at Gainwell. https://www.dice.com/job-detail/eb49bd3b-53cd-43e7-89e4-fbf4c64a1d8c?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. 1 0 obj Since 2010, Gainwell has achieved 16 Centers for Medicare and Medicaid Services (CMS) certifications more than all other vendors within the same time period. 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. It was nice to have a direct contact with the same representative until the problem was resolved. WebGainwell Technologies offerings including Medicaid Management Information Systems (MMIS), fiscal agent services, program integrity, care management, immunization registry, and eligibility services. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Full-Time. View similar Healthcare / Careworkers jobs below. Learn more atwww.naspo.org. 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. Ohio Medicaid First name. 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. The pay range for this position is $63,100.00 $90,200.00 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. San Francisco, CA. Your customer support reps are the best!!! Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Log in to the member secure portal to view your: Your guide to Medicaid and other information about your Medicaid benefits can be found in the Member section of the Medicaid Managed Care Plan websites., The Gainwell Notice of Privacy Practices is available. Validates test plan results that satisfy the detailed design goals. Full-Time. Reno, NV. I am a very small company, and have actually now reduced my overhead by going with you guys! 2023 Snagajob.com, Inc. All rights reserved. WebMedicaid Quality Reporting Medicaid State Plan Types of Services X Apply Basic Eligibility Fee-For-Service Hospital Presumptive Eligibility X Programs Adults Elderly Disabled Attention All Providers: Nevada Medicaid Fiscal Agent 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. I keep having great experiences every time I call your company, finding a super friendly rep on the phone, helping me with any questions I have. Managed Care Entity Web Portal training recording now available. A most unexpected experience: Someone who knows and is helpful. The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay We also have a variety of leadership and technical development academies to help build your skills and capabilities. LA Medicaid Managed Care Organization. Since the start of the DeWine administration, ODM has launched several initiatives to drive transparency, reduce pharmacy costs, and simplify provider administration, said Maureen Corcoran, ODM director. Document requirements for business and system requirements. I just wanted to let you know how impressed I am with this service. Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. Users may find helpful website links and documents within our online portal in the menu bar above. LA Dept of Health and Hospitals. I always get the most fabulous service when calling or emailing!!! Excellent service and I never give anyone "Excellent" scores on surveys. WebSummary. Gainwell Technologies hiring Professional PHM Data Sciences 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. Working at Gainwell carries its rewards. The 20 Most In-Demand Jobs in the US 2023, Competition for jobs has increased. It is made up of the directors of the central purchasing offices in each of the 50 states, the District of Columbia and the territories of the United States. Verify solution meets the defined requirements through scenario testing. stream Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. 2018, Chapter 136 and N.J.A.C. SeniorinCare <25 <$5M. Other companies could learn from you. Medicaid Please use the same Learning Management System (LMS) credentials set up during your registration to log in. Medicaid Management - Gainwell Technologies Be part of a team that unleashes the power of leading-edge technologies to As an Experienced 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. This comprehensive solution gives Kansas Medicaid the agility and interoperability it needs to deliver high-quality healthcare services while reducing costs. If this is a transaction you would like to utilize please make sure to enroll with the payer. Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. Learn more atwww.naspovaluepoint.org. CONTACT:Elizabeth Bonet Gainwell Technologies972-556-5082elizabeth.bonet@gainwelltechnologies.com. Your session is about to expire. 4 0 obj The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). medicaid Gainwell empowers you show youre a pro and help clients deliver better health and human services outcomes using innovative technology and solutions. Theresult is a comprehensive platform that is a model for statesseeking to transform their Medicaid programs.. Have never had any problems and this is the easiest claim site. Please enter a Name and Password so you can update your Job Alerts in the future. The secure portal requires log in credentials that will allow access to specific patient information. SPBM Clinical staff can also be reached via phone and email. Managed Care Entities (MCE) including Managed Care Organizations (MCO) and the Prepaid Inpatient Health Plan (PIHP), which is also known as OhioRISE, will be given access to the SPBM online portal to view clinical profile information about members that are actively enrolled in their associated MCE. To access the recording, pleaseclick here. Here are the details on this position. 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. WebJoin to apply for the Experienced Business Analyst- Medicaid role at Gainwell Technologies. 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. Gainwell Technologies LLC Read more, Upgrade to Premium to view the number of applicants for this Job, Upgrade to Premium to start a conversation with Gainwell Technologies Llc. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Selecting Gainwell as our partner in administering a clinically driven, outcomes-oriented pharmacy program enables us to take advantage of their previous successes.. Gainwell is the market leader in providing Medicaid services. Gainwell has already contracted with more than 2600 pharmacies. As always excellent, professional, knowledgeable customer service. How can you stand out? 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 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. 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 Thanks for your honesty and integrity! Gainwell operates as a standalone company with over 7,500 employees who support clients across 42 U.S. states and territories. To allow providers an advanced opportunity to set up their OH|ID and associate their accounts, ODM has launched a PNM pre-registration site at:https://pnm-preregistration.omes.maximus.com. Gainwell Technologies Mississippi Division of Medicaid (ms.gov)) click on the MOVEit Portal at Mississippi Replacement Project (msxix.net) page. The portal also gives the user the ability to reach the SPBM Clinical help desk via web chat. Everything about it (including your team) is great! Once implemented, the single PBM will eliminate costly duplicative administrative processes for ODM and providers alike. 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. You can deactivate or delete job alerts by clicking the button below. Your product is everything you said it was. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. Copyright 2013 AXIOM Systems, Inc. All Rights Reserved. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. . For decades, HMS has been a leader in providing cost containment solutions to state Medicaid agencies, said Paul Saleh, President and CEO of Gainwell. Neither ODM nor the state auditor could verify or refute the appropriate use of funds. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Md]|k >i0NVxC?',X#g*. 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. My work is truly cut in half by using Claim Shuttle. We also have a variety of leadership and technical development academies to help build your skills and capabilities. 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. Working at Gainwell carries its rewards. This website provides information to members, pharmacies, prescribers, Managed Care Entities, and the public. Medicaid 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. Interface with the technical team to ensure designs are understood and properly implemented. All Rights Reserved. Gainwell Technologies hiring Medicaid Data Analyst SME in San Copyright 2023 Grabjobs Pte.Ltd. Working at Gainwell carries its rewards. This new platform will drive efficiency and quality, improving our ability to serve our members and providers.. HIPP Unit, Gainwell Technologies | Georgia Medicaid Build your career with Gainwell, an industry leader. Put your passion to work at Gainwell. 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. A Happy Friday message from a Satisfied User! 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 Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Some of the key benefits to Kansas include: A Strategic PartnershipKansas is proud of what we have accomplished through our strategic partnership with Gainwell, said Kansas Medicaid Director Sarah Fertig. Find the best jobs in the US, apply in 1 click and get a job today! Additionally, CMS cited the companys Step Edits process as a best practice, calling it bulletproof in federal certification review sessions. Gainwell Technologies. Thank you for your excellence! 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 pay range for this position is $63,100.00 - $90,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
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