Provider Field Representative Lead - Remote California

About the role

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

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.

Responsibilities

• Provide functional leadership and direction to Provider Field Representatives, serving as a resource for team escalations, complex provider inquiries, billing questions, claims issues, and program requirements.
• Support provider billing activities, including one-on-one billing assistance, claims research and analysis, reimbursement questions, and resolution of provider billing issues.
• Support and help direct provider education and outreach, including workshops, seminars, program-specific events, one-on-one training, and 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, identify areas of concern, and recommend appropriate solutions or escalation.
• Contribute to shared knowledge resources, document complex issue resolution, and help ensure consistent and accurate information is provided across the team.
• Support the development and mentoring of Provider Field Representatives while identifying opportunities to improve provider service, team processes, and overall operational effectiveness.

Requirements

• 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, and 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.

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies

Pay

The pay range for this position is $70,000 - $80,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Schedule

• 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.