[Hiring] Senior Manager, Healthcare Fraud & Program Integrity @Gainwell Technologies LLC

Role Description

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. Gainwell is seeking a customer-focused leader to serve as the primary client advocate and support leader for FraudCapture.

This role is ideal for someone who combines healthcare fraud, waste, and abuse expertise with a passion for user enablement, training, troubleshooting, and client success. You will lead onboarding, training, support operations, and client engagement activities that help investigators, analysts, and supervisors maximize the value of a sophisticated analytics and case management platform.

As the Senior Manager, Customer Support, you will:

• Manage all client‑facing sessions across the lifecycle including new‑client training, implementation workshops, hyper-care meetings, and recurring office‑hours.
• Establish a training curriculum (investigator, analyst, supervisor tracks); deliver live and on-demand sessions.
• Manage client user account setup and ongoing administration, including user onboarding/offboarding, role-based access provisioning, role changes, and periodic user access maintenance.
• Create and manage the Client Communication Plan (cadence, templates, channels) for outages, fixes, feature launches, and policy updates.
• Develop deep functional expertise in FraudCapture and serve as an escalation point for complex user questions, system configuration issues, and workflow troubleshooting.
• Own user defect intake/triage and end‑to‑end defect management, including SLAs, client communication, and resolution tracking; publish regular defect and trend reports.
• Monitor product adoption, training effectiveness, and support trends; recommend improvements to increase client satisfaction and platform utilization.
• Manage the creation and maintenance of all training content and videos (how‑to guides, role‑based job aids, quick starts).
• Own release notes and “What’s New” content; coordinate with Product & Engineering teams to ensure accuracy and clarity for different user audiences.
• Manage, coach, and scale the customer support staff, including hiring, onboarding, scheduling, and performance management.
• Establish, monitor, and continuously improve support processes and SLAs, including response times, resolution targets, escalation procedures, ticket quality, and customer satisfaction metrics.
• Support CMS certification and reporting requirements, including coordinating required documentation, evidence, system information, and recurring reporting needed to demonstrate compliance and support certification activities.
• Work closely with Product Management to relay client issues, validate use cases, and coordinate UAT/hyper-care for new features.
• Partner with Engineering and QA to reproduce defects, provide clear repro steps/data, monitor fixes, and schedule deployments.
• Support Sales and Customer Success with demos, proof‑points, and RFP responses where operational/functional depth is required.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years of direct healthcare fraud and abuse investigation experience, with a strong understanding of how healthcare FWA detection analytics and case management systems are used by investigative teams to identify, investigate, document, and manage potential fraud, waste, and abuse.
• Leadership experience in customer support, customer success, or services for SaaS software solutions.
• Proven success designing and delivering training programs and managing client interactions.
• Strong experience with defect management and communication across technical and non‑technical stakeholders.
• Strong business and analytical problem-solving skills.
• Excellent written and verbal communication skills.
• Strong ability to multi-task and work independently.
• Strong ability to establish priorities and objectives for operation with limited direction.
• Investigative credentials (e.g., CFE or AHFI) & prior PI/MFCU/SIU leadership experience.
• Experience supporting or managing certified coders is a plus.

Requirements

• Serve as the primary client-facing leader for FraudCapture support, training, and user enablement activities.
• Collaborate daily with Product Management, Engineering, Account Management, and program integrity stakeholders.
• Travel approximately 10-25% to support client implementations, training events, conferences, and strategic meetings.

Benefits

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