Provider Field Representative - Remote Central California

Summary

Gainwell Technologies provides healthcare technology and business services, including support for California’s Medi-Cal program. The Provider Field Representative serves as the primary contact for healthcare providers in Central California by conducting onsite and virtual visits, delivering education and training, researching claims and billing issues, and resolving operational questions. The role also collaborates with provider organizations, internal teams, and client representatives to improve the provider experience.

Responsibilities

• Build and maintain strong working relationships with healthcare providers and provider organizations throughout an assigned Central 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
• Valid CA driver license
• 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
• valid CA driver license

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
• Leadership and technical development academies to help build your skills and capabilities
• Remote, field-based position
• Work from home when not conducting provider visits, training sessions, meetings, or other field activities