[Hiring] Provider Field Representative Lead @Gainwell Technologies LLC

Role Description

The Provider Field Representative Lead provides functional leadership and support to Provider Field Representatives serving California’s Medi-Cal provider community. This role supports team escalations, provider outreach, claims research, provider billing support, and the development and delivery of virtual and in-person training. The Lead also serves as a liaison between providers, provider associations, internal departments, and the client to help ensure consistent service delivery and compliance with Medi-Cal program requirements.

• Provide functional leadership and direction to Provider Field Representatives.
• Support provider billing activities, including:
  • One-on-one billing assistance
  • Claims research and analysis
  • Reimbursement questions
  • Resolution of provider billing issues
• Support and help direct provider education and outreach, including:
  • Workshops
  • Seminars
  • Program-specific events
  • One-on-one training
  • Provider association activities
• Serve as a liaison between providers, internal departments, and the client to resolve issues and support Medi-Cal programs and initiatives.
• Apply established policies and procedures while exercising independent judgment to resolve complex provider issues.
• Contribute to shared knowledge resources and document complex issue resolution.
• Support the development and mentoring of Provider Field Representatives.

Qualifications

• Three or more years of business process outsourcing, consulting, systems implementation, provider relations, provider services, or related healthcare operations experience.
• Experience supporting healthcare providers with:
  • Billing
  • Claims research
  • Billing issues
  • Reimbursement-related questions
• Experience serving as a functional lead, subject matter expert, mentor, trainer, or escalation point for a team.
• Experience developing and/or delivering training to healthcare providers virtually and in person.
• Strong provider relations, analytical, problem-solving, communication, presentation, facilitation, and functional leadership skills.
• Experience working with business processes, assessing provider or client needs, and identifying opportunities for improvement.
• Medi-Cal or Medicaid experience preferred.
• Willingness and ability to travel throughout California.

Requirements

• Remote position; must reside in California.
• Travel throughout California is required to support provider training, outreach, events, and other business needs.
• Occasional overnight travel and onsite attendance may be required.
• Reliable high-speed internet connectivity is required.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Variety of leadership and technical development academies to help build skills and capabilities.