Provider Field Representative - Remote Northern California

Summary

Gainwell Technologies is seeking an experienced Provider Field Representative to support healthcare providers throughout Northern California as part of California’s Medi-Cal program. The role serves as a primary contact for providers, conducting virtual and onsite visits, delivering training, researching claims and billing issues, and resolving operational concerns.

Responsibilities

• Build and maintain strong working relationships with healthcare providers and provider organizations throughout an assigned Northern California territory
• Conduct virtual and onsite provider visits to provide education, training, operational support, and assistance with Medi-Cal program requirements
• Develop and deliver provider training through workshops, seminars, webinars, one-on-one sessions, and other virtual and in-person educational events
• Provide one-on-one billing support and research healthcare claims, payment, and provider-related issues to help identify and resolve concerns
• Serve as a liaison between healthcare providers, provider associations, internal Gainwell departments, and client representatives
• Apply established Medi-Cal policies, procedures, and program requirements to research and resolve provider questions and operational issues
• Identify provider trends, recurring issues, and opportunities for additional education or process improvement and communicate findings to leadership
• Exercise independent judgment within established guidelines while escalating complex or sensitive issues as appropriate

Skills

• Three or more years of experience in provider relations, provider outreach, provider education, healthcare operations, healthcare claims, Medicaid/Medi-Cal, healthcare consulting, business process outsourcing, or a related healthcare function
• Experience working directly with healthcare providers, provider offices, medical groups, healthcare organizations, or other healthcare stakeholders
• Experience delivering training, presentations, workshops, webinars, or educational sessions in both virtual and in-person environments
• Experience researching and resolving healthcare claims, billing, payment, provider enrollment, or other provider-related operational issues
• Strong communication, presentation, facilitation, relationship-management, and customer service skills
• Strong analytical, organizational, and time-management skills with the ability to independently manage an assigned geographic territory
• Willingness and ability to travel throughout an assigned Northern California territory, including limited overnight travel as business needs require
• Medi-Cal or Medicaid experience is preferred

Qualifications

Must Haves

• Three or more years of experience in provider relations, provider outreach, provider education, healthcare operations, healthcare claims, Medicaid/Medi-Cal, healthcare consulting, business process outsourcing, or a related healthcare function
• Experience working directly with healthcare providers, provider offices, medical groups, healthcare organizations, or other healthcare stakeholders
• Experience delivering training, presentations, workshops, webinars, or educational sessions in both virtual and in-person environments
• Experience researching and resolving healthcare claims, billing, payment, provider enrollment, or other provider-related operational issues
• Strong communication, presentation, facilitation, relationship-management, and customer service skills
• Strong analytical, organizational, and time-management skills with the ability to independently manage an assigned geographic territory
• Willingness and ability to travel throughout an assigned Northern California territory, including limited overnight travel as business needs require

Nice to Haves

• Medi-Cal or Medicaid experience is preferred

Benefits

• Work flexibility
• Learning and career development
• All salaried, full-time candidates are eligible for our generous, flexible vacation policy
• A 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• A variety of leadership and technical development academies to help build your skills and capabilities