WebGainwell Technologies is committed to a diverse, equitable, and inclusive workplace. The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. stream To access the recording, pleaseclick here. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Ohio Department of Medicaid awards fiscal intermediary contract Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Posted: February 07, 2023. The secure portal requires log in credentials that will allow access to specific patient information. Find the best jobs in the US, apply in 1 click and get a job today! Gainwell Technologies 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 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. La Med. SeniorinCare <25 <$5M. You have reached your maximum number of active job alerts. Working at Gainwell carries its rewards. Gainwell has served Kansas for two decades, forming a deep relationship with the state built on trust and transparency. Additionally, PNM training is now available for providers in a variety of formats, including virtual, in-person, and self-paced. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. WebMedicaid Data Analyst SME - Gainwell Technologies - San Francisco CA - data-analyst, san-francisco----ca, gainwell-technologies. Summary The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. The Kansas Medicaid platform implementation sets the standard for states adopting modular LA Dept of Health and Hospitals. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information. It was nice to have a direct contact with the same representative until the problem was resolved. YKrvrM.-,[=*q}iP)w_y7y1ywIzz|~xI%G)OHL'I$i?O?E&+~|| OgV'8HZ4/=>}|kx? 3 . 5+ 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. Welcome to the new Ohio Medicaid pharmacyservices onlineportal. This website provides information to members, pharmacies, prescribers, Managed Care Entities, and the public. The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay 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. Supports the ETL developers based on the mappings created. endobj 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 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. 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. Ohio Medicaid We are proud to be an Equal Our transformed Medicaid platform will provideincredible benefits to our state,our most vulnerable citizens,andourvalued providers. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) awards its fiscal intermediary (FI) service contract to Gainwell Technologies, taking another important We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Build your career with Gainwell, an industry leader. WebWhat you should expect in this role. Creates accurate mapping documents according to the mapping process. I just wanted to let you know how impressed I am with this service. at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health andwell-being of the members they serve a communitys most vulnerable. Gainwell Technologies We can now process 276/277 requests (claim status). SPBM Clinical staff can also be reached via phone and email. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. 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. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. WebOnsite, remote or Hybrid options may be available from US locations. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. | Source: The auditor stated, we cannot be content to accept a black box in the delivery of public services. Ohio Medicaid and other state agencies had no means to audit potential steerage or conflicts of interest. Home page - OH MCD SPBM.Web - Ohio Gainwell operates as a standalone company with over 7,500 employees who support clients across 42 U.S. states and territories. We can now process I just transmitted my first batch of electronic claims through Claim Shuttle! Gainwell Technologies LLC. 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. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Gainwell Technologies Reno, NV. During the training, you will also learn about many exciting tools available on the SPBM Web Portal such as member eligibility, viewing prior authorization status, the ability to quickly speak with the SPBM help desk, and much more! My question is, "Why didn't I find out about Claim Shuttle earlier?!?" To access the recording, pleaseclick here. October 18, 2022 09:30 ET We also have comprehensive leadership and technical development academies to help build your skills and capabilities. LA Medicaid Managed Care Organization. I make phone calls a lot and I find few companies as engaged as yours. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. Doing so meant structuring the program as a specialized managed care health plan that rewards the single PBM for patient wellness and health outcomes. Copyright 2013 AXIOM Systems, Inc. All Rights Reserved. Senior Business Analyst - Medicaid - Hiring Urgently at Gainwell By Phone: 1-770-325-9590 1-877-261-8785 (toll free) Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. It's great to have immediate help and knowledgeable support! 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. Put your passion to work at Gainwell. Department of Medicaid logo, return to home page. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions tosome of healthcares biggest challenges. WebIf you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. Learn more about Gainwell at our and visit our for all available job role openings. 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). Working at Gainwell carries its rewards. Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. Newly Formed Gainwell Technologies Named PBM for Experienced Business Analyst- Medicaid | Gainwell Technologies WebSummary. Help the client innovate and formulate business solutions and technology enabled business models to implement CMS mandated or State directed initiatives. Ohio Medicaid is changing the way we do business. Working at Gainwell carries its rewards. Please enter a Name and Password so you can update your Job Alerts in the future. TYSONS CORNER, Va., Oct. 18, 2022 (GLOBE NEWSWIRE) -- Gainwell Technologies (Gainwell), a leading innovator in healthcare technology solutions, designed and implemented Kansas new and completely modular Medicaid platform. The secure portal requires log in credentials. The pay range for this position is $61,700.00 - $88,200.00 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 launch also includes a new requirement to establish an OH|ID to access any of ODM's Ohio Medicaid Enterprise Systems (OMES). The recorded SPBM WebPortal training is now available for pharmacies and pharmacy support staff. Build your career with Gainwell, an industry leader. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Here are the details on this position. Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215, Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516, Gainwell Technologies selected to bring new level of accountability. The business domain includes Healthcare business processes, specifically focused on Medicaid and Medicare and CMS. If this is a transaction you would like to utilize please make sure to enroll with the payer. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Interface with the technical team to ensure designs are understood and properly implemented. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Gainwell Technologies selected to bring new level of Your customer support reps are the best!!! Presents analysis and design recommendations to lead MITA teams, customer and/or vendors into the acceptance of the design. 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. Please use the same Learning Management System (LMS) credentials set up during your registration to log in. 2023. 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. 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. Refines mapping documents, adding more detail, and filling out deferred material as questions are resolved. 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. Questions may be directed to the EDI Helpdesk at 1 844-807-9449 or via the Contact Us link My work is truly cut in half by using Claim Shuttle. Read on if you are looking for information specific to our current programs. <> Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Gainwell has already contracted with more than 2600 pharmacies. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. . The Kansas Medicaid platform implementation sets the standard for states adopting modular solutions. You have already created a job alert with same filters. This comprehensive solution gives Kansas Medicaid the agility and interoperability it needs to deliver high-quality healthcare services while reducing costs. Copyright 2023 Grabjobs Pte.Ltd. Senior Business Analyst Medicaid Gainwell Technologies medicaid Posted: December 06, 2022. At issue was the lack of transparency. Please open this website in one of the following browsers: Chrome, Edge, Firefox, Safari. 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. 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. Want to receive job alerts for similar jobs? Thanks! 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. The newly designed program is targeted for launch in January 2022. Gainwell Technologies Selected to Provide Full Suite of Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. Creates unit test cases for area of responsibility and updates technical specifications and mappings. WebGainwell Technologies offerings including Medicaid Management Information Systems (MMIS), fiscal agent services, program integrity, care management, immunization registry, and eligibility services. The changes we make will help you more easily access information, locate health care providers, and receive quality care. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. TennCare is committed to safeguarding the information of our members. The portal also gives the user the ability to reach the SPBM Clinical help desk via web chat. Gainwell Implements Fully Modular, Cloud-Based Medicaid The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). We offer clients scalable and flexible solutions for their most complex challenges. 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. An Ohio.gov website belongs to an official government organization in the State of Ohio. This time it was warranted. endobj WebExperience in Healthcare, such as Medicaid or Medicare required; Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. June 14, 2022 08:00 ET 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. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. endobj 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. 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. 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.