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Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. The newly designed program is targeted for launch in January 2022. 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. Supports unit Testing, System Integration Testing, System Testing, and user Acceptance Testing. If this is a transaction you would like to utilize please make sure to enroll with the payer. 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. 4 0 obj Copyright 2023 Grabjobs Pte.Ltd. Have never had any problems and this is the easiest claim site. Every time I call, it feels as if I am talking directly with the owner of the company. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Thanks! Thanks for your honesty and integrity! We celebrate diversity and are dedicated to creating an inclusive environment for all employees. Here are the details on this position.. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Name Changes to Gainwell Technologies Effective October 1, 2020, Veritas Capital purchased the Medicaid Fiscal Agent business from DXC Technology. Through the SPBM, ODM gains increased accountability and ensures alignment with clinical and policy goals, while also improving transparency. %PDF-1.7 Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. The business domain includes Healthcare business processes, specifically focused on Medicaid and Medicare and CMS. Medicaid Posted: February 07, 2023. Gainwell Technologies Creates unit test cases for area of responsibility and updates technical specifications and mappings. Medicaid Gainwell Technologies LLC. Medicaid Management - Gainwell Technologies Here are the details on this position. 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. This website provides information to members, pharmacies, prescribers, Managed Care Entities, and the public. 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. Ohio NAICS Code 52,524. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. TennCare is committed to safeguarding the information of our members. Viewing this training is important for managed care entities to learn about the many tools available on both the public facing and secure portal. Learn more about Ohio's largest state agency and the ways in which we continue to improve wellness and health outcomes for the individuals and families we serve. All Rights Reserved. Medicaid , Ohio SPBM Prescribers, When submitting a prior authorization (PA) request via fax or mail, the prescriber is required to use the prior authorization forms found on the, Welcome to Ohio Medicaid Pharmacy Services Online Portal. Your product is everything you said it was. 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. 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. You can also receive alerts via instant message. 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. Users may find helpful website links and documents within our online portal in the menu bar above. 10:52B establish the New Jersey County Option Please share my thanks with everyone involved. YKrvrM.-,[=*q}iP)w_y7y1ywIzz|~xI%G)OHL'I$i?O?E&+~|| OgV'8HZ4/=>}|kx? Learn more about Gainwell at our and visit our for all available job role openings. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Ohio Medicaid achieves its health care mission with the strong support and collaboration of our stakeholder partners - state health and human services agencies, associations, advocacy groups, and individuals who help us administer the program today and modernize it for the next generation of healthcare. Learn more atwww.naspovaluepoint.org. Medicaid Everything about it (including your team) is great! Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. For decades, HMS has been a leader in providing cost containment solutions to state Medicaid agencies, said Paul Saleh, President and CEO of Gainwell. Our transformed Medicaid platform will provideincredible benefits to our state,our most vulnerable citizens,andourvalued providers. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. The single PBM is part of a larger overhaul of the Medicaid program designed to put the needs of Medicaid members first and bring visibility to the use of state dollars. The groundbreaking, cloud-based platform uses a service-oriented architecture to seamlessly connect all modules in a secure and dynamic environment. 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. Tableau Report Developer Job in San Francisco, CA at Gainwell 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. 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. 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. The following process must be followed prior to initiation of electronic claim submission or inquiry. The POSV will ensure incentives are properly and fairly aligned, self-dealing and steering are prevented, and monetary loopholes are closed. Since 2010, Gainwell has achieved 16 Centers for Medicare and Medicaid Services (CMS) certifications more than all other vendors within the same time period. Summary Here are the details on this position. 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 Gainwell Technologies 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. View job listing details and apply now. Gainwell Technologies LLC Medicaid Data Analyst SME Job in endobj Just as you promised, I was up and running within 20 minutes of our initial conversation. The award moves Ohio closer to realizing greater transparency and accountability in Medicaids $3 billion pharmacy program. P.L. 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. ODM received six competitive offers in response to the single PBM request for proposal. Provider CONTACT:Elizabeth Bonet Gainwell Technologies972-556-5082elizabeth.bonet@gainwelltechnologies.com. LA Dept of Health and Hospitals. I make phone calls a lot and I find few companies as engaged as yours. 3 . If you don't receive your credentials within 2-3 weeks, please call theirTechnology Support Center toll-free at1-800-884-3222. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. WebSummaryAs a [ [Medicaid Senior Business Analyst ]] 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. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Please enable Cookies and reload the page. 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. The recorded SPBM WebPortal training is now available for pharmacies and pharmacy support staff. Managed Care Entity Web Portal training recording now available. The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. I have also been transferred to other staff, who helped me resolve issues in the most professional way. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. TYSONS, Va., June 14, 2022 (GLOBE NEWSWIRE) -- Gainwell announced today that HMS, a Gainwell Technologies company, has been selected to provide We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. , Pharmacy Web Portal training recording now available. Click here to join our private community of job Media ContactLacey Hautzinger, Gainwell Technologies469.284.7240Lacey.hautzinger@gainwelltechnologies.com, Schae Kane, NASPO ValuePointskane@naspovaluepoint.org, The National Association of State Procurement Officials (NASPO), Lacey.hautzinger@gainwelltechnologies.com. NASPO is an organization that helps its members as public procurement leaders by promoting best practices, education, professional development, research and innovative procurement strategies. Gainwell Technologies brings a wealth of experience to strengthen ODMs pharmacy benefits delivery. Copyright 2013 AXIOM Systems, Inc. All Rights Reserved. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. Test Engineer - Healthcare/Medicaid Testing Job in Reno, NV at 2023. Gainwell Technologies LLC. Refines mapping documents, adding more detail, and filling out deferred material as questions are resolved. Put your passion to work at Gainwell. 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. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. WebIf you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. Works toward delivering a first draft solution to ETL for coding, by rapidly understanding which details about the mapping can be deferred. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. Attention All Providers: Nevada Medicaid Fiscal Agent If you have already submitted a prior authorization, please refrain from sending in a duplicate Prior Authorization. At issue was the lack of transparency. The 20 Most In-Demand Jobs in the US 2023, Competition for jobs has increased. LA Medicaid Managed Care Organization. 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. The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Find out what skills and jobs are in high demand. 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 also have a variety of leadership and technical development academies to help build your skills and capabilities. Are you a pharmacy or prescriber having issues registering for the secure SPBM Web Portal? WebSummary. 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. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Gainwell is the market leader in providing Medicaid services. Want to receive job alerts for similar jobs? Put your passion to work at Gainwell. Be the first to receive the latest Nurse Full-Time Jobs in the US. This launch also includes a new requirement to establish an OH|ID to access any of ODM's Ohio Medicaid Enterprise Systems (OMES). GrabJobs is the no1 job portal in the US, connecting you to thousands of jobs fast! It's great to have immediate help and knowledgeable support! 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. Gainwell Technologies LLC Data Mapping Lead in San Francisco, Medicaid Data Analyst SME - Gainwell Technologies Clipped from: 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. Senior Business Analyst Medicaid Gainwell Technologies WebApply for a Gainwell Technologies LLC Data Mapping Lead job in San Francisco, CA. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. SIC Code 63,632. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. By Phone: 1-770-325-9590 1-877-261-8785 (toll free) Your role in our mission 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. Supports the ETL developers based on the mappings created. NASPO ValuePoint delivers high value, reliable and competitively sourced cooperative contracts offering public entities outstanding prices, favorable terms and conditions and value-added services. 2023 Snagajob.com, Inc. All rights reserved. Here are the details on this position.. 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. All Rights Reserved. $61,700 to $99,200 Yearly. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Gainwell has served Kansas for two decades, forming a deep relationship with the state built on trust and transparency. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. <>/Metadata 102 0 R/ViewerPreferences 103 0 R>> Gainwell Technologies. The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. 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. Find the best jobs in the US, apply in 1 click and get a job today! Gainwell Implements Fully Modular, Cloud-Based Medicaid All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Working at Gainwell carries its rewards. Since 1985, HMS has been the leader in TPL solutions for state Medicaid agencies. Please use the same Learning Management System (LMS) credentials set up during your registration to log in. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). 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. Registration for SPBM Web Portal training is now open for all members. Under Ohio Medicaid You have successfully created a new job alert. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Senior Business Analyst - Medicaid - Hiring Urgently at Gainwell Working at Gainwell carries its rewards. Apply online instantly. An official website of the State of Georgia. The configurable, nine-module system will transform how Kansas delivers healthcare solutions. Interface with the technical team to ensure designs are understood and properly implemented. 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. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. Learn more atgainwelltechnologies.com. My work is truly cut in half by using Claim Shuttle. June 14, 2022 08:00 ET Gainwell Technologies Full-Time. 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! Summary 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. Verify solution meets the defined requirements through scenario testing. First name. SPBM Clinical staff can also be reached via phone and email. Read on if you are looking for information specific to our current programs. Reno, NV. A most unexpected experience: Someone who knows and is helpful. Joy Home Care <25 <$5M. In addition to HMS benchmark fees, our recoveries and savings for states and MCOs surpassed $1.5 billion in recoveries and an additional $2.5 billion in savings in 2021 providing clients with best-in-class ROI. Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! Gainwell is the market leader in providing Medicaid services. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. . Learn more at gainwelltechnologies.com. Additionally, CMS cited the companys Step Edits process as a best practice, calling it bulletproof in federal certification review sessions. Experience in Healthcare, such as Medicaid or Medicare required, Distinguished Data Engineer, Card Commercialization (Remote Eligible), Engineering Manager, SkySat Data Pipeline, Do Not Sell or Share My Personal Information. Medicaid Experienced Business Analyst- Medicaid | Gainwell Technologies This contract win further validates the long-standing quality, effectiveness and innovation of our TPL solutions and they are invaluable in continuing to keep our nations healthcare programs protected and strong.. 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. Required Documents for those applying for new Submitter IDs.