Gainwell
  • Madison, WI, United States
06/30/2022  
Gainwell Technologies LLC Summary Job Description The Senior Pharmacy Technician/Analyst is expected to be a subject matter expert in areas of pharmacy knowledge as well as technical call center operations. Responsible for assisting with drug benefit configuration of NDC’s (National Drug Codes) received on the weekly First Databank (FDB) Load Cycle updates.  Responds to complex pharmacy provider phone calls that get elevated via the Apropos phone agent and supports provider relations when they require a Subject Matter Expert on pharmacy issues or concerns. Performs research, analysis and troubleshooting within the Pharmacy arena. Makes recommendations to the client and works closely with pharmacy providers to bring about proper resolutions to a variety of pharmacy claims processing issues. These duties will include, but are not limited to, research and resolution of escalations received at the member, provider, or pharmacy level, and initial and continued training of the...
Gainwell WV, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary The Pharmacy Technician for the PBM clinical and technical call center is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, answering incoming calls and making outgoing calls for members, medical providers, or pharmacy providers, appropriate processing of prior authorization requests, and assisting members and providers with inquiries through other media platforms (fax, web, e-mail)   Job Description Responsibilities: •    Remain compliant with all PHI protocols and requirements including the handling of company confidential data according to policy and guidelines. Adheres to existing security policies and procedures. •    Process submitted prior authorization requests within the required time frame mandated by the State client •    Completion of approval process for prior authorizations where all criteria is met and clinical judgement of a...
Gainwell Dublin, OH, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary The Pharmacy Technician for the PBM clinical and technical call center is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, answering incoming calls and making outgoing calls for members, medical providers, or pharmacy providers, appropriate processing of prior authorization requests, and assisting members and providers with inquiries through other media platforms (fax, web, e-mail)   Job Description Responsibilities: •    Remain compliant with all PHI protocols and requirements including the handling of company confidential data according to policy and guidelines. Adheres to existing security policies and procedures. •    Process submitted prior authorization requests within the required time frame mandated by the State client •    Completion of approval process for prior authorizations where all criteria is met and clinical judgement of a...
Gainwell Ridgeland, MS, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary Gainwell is the leading provider of technology, services and solutions that are vital to the administration and operations of health and human services programs. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. We offer clients scalable and flexible solutions for their most complex challenges. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Job Description Essential Job Functions  Proven software application engineer with numerous experiences in designing and developing internal systems that are secure, available, and fault-tolerant. Skilled in all stages of development, including acquiring and translating business requirements into solutions.  Skilled in modern software tools and infrastructure architecture including on premise and cloud.  Experienced delivery in a multi-vendor...
Gainwell New York, NY, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary Codes, tests, debugs, implements, and documents programs. Analyzes, designs and writes specifications for programs. Assists support personnel in locating and resolving problems of significance with programs. Job Description Essential Job Functions Provides more complex design documents and translates into component-level designs to accelerate development. Assists in developing strategy, design and data gathering approaches. Provides high level design expertise in support of development team efforts to provide flexible reusable components to increase cost effectiveness. Analyzes, designs and reviews design of applications and suites of applications to ensure that customer specifications are satisfied. Assists in overseeing relationships between application architects and development teams to ensure that product development and implementation are coordinated. Works with product development teams and senior designers in developing design...
Gainwell Roseville, CA, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary Designs, develops, installs, tests and documents complex applications software, including server, client, and web components. Contributes to the design and delivery of technical architecture solution components. Provides work guidance to less experienced personnel. May provide technical consulting on complex projects. Job Description Essential Job Functions The position requires working closely with Project management team, Solution advisers, technical and business personnel. Experience in ongoing performance tuning, applying patches, and resource optimization. Creating and maintaining operational, configuration, procedural and other documentation. Ability to develop and execute detailed test plans for future enhancements. Qualifications Work as an administrator for support of Healthcare EDI solution. Strong Experience with ITX 10.0 (IBM Transformation Extender) administration and using Trading partner and Partner manager in...
Gainwell NJ, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary Gainwell Technologies makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare—now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives. At Gainwell Technologies, you will develop new skills and build your career in a dynamic industry while making a difference in the lives of others.  We are seeking a talented individual to lead a team of people supporting B2B MFT applications who is responsible for designing, analyzing, implementing, supporting, and maintaining configurations for partners, endpoints, profiles, parameters, enhancements, and extensions with B2BDX and MFT application interfaces...
Gainwell NC, United States Full Time
06/30/2022  
Gainwell Technologies LLC Summary Location:  remote with one day a week starting 5/9/22 - Roseville, CA, US, 95747-6645 Provides more complex design documents and translates into component-level designs to accelerate development. Assists in developing strategy, design and data gathering approaches. Provides high level design expertise in support of development team efforts to provide flexible reusable components to increase cost effectiveness. Analyzes, designs and reviews design of applications and suites of applications to ensure that customer specifications are satisfied. May provides technical consulting on complex projects. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time and form of desired results. Job Description Essential Job Functions Assists in overseeing relationships between application architects and development teams to ensure that product development and...
Gainwell CA, United States Full Time
06/30/2022  
Gainwell Technologies LLC Job Description: Analyzes pharmacy network claims data applying knowledge of pharmacy policy and data mining techniques to determine details of access, adequacy, retention, performance, fraudulent, erroneous, or abusive billing activity on claims processing systems, geographic access, and various pharmacy network client-specific reporting   Prepare draft and final reports, dashboards, and analytic evaluations   Provides management and client reporting and profiling   Provides performance insights   Communicates report findings and observations   Provides subject matter expertise regarding pharmacy audit   Monitors changes related to data requirements and reporting   Supports and implements process improvement initiatives and documentation   Supports pharmacy network directory work   Supports new business initiatives focused on pharmacy network   Supports pharmacy network inquiries and issues   Supports claims analyst(s)...
Gainwell Dublin, OH, United States Full Time
06/29/2022  
Gainwell Technologies LLC Summary Codes, tests, debugs, implements, and documents programs. Analyzes, designs and writes specifications for programs. Assists support personnel in locating and resolving problems of significance with programs. Job Description Essential Job Functions Provides more complex design documents and translates into component-level designs to accelerate development. Assists in developing strategy, design and data gathering approaches. Provides high level design expertise in support of development team efforts to provide flexible reusable components to increase cost effectiveness. Analyzes, designs and reviews design of applications and suites of applications to ensure that customer specifications are satisfied. Assists in overseeing relationships between application architects and development teams to ensure that product development and implementation are coordinated. Works with product development teams and senior designers in developing design...
Gainwell Roseville, CA, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary Gainwell is the leading provider of technology, services and solutions that are vital to the administration and operations of health and human services programs. With more than 50 years of proven experience, Gainwell has a reputation for service excellence and unparalleled industry expertise. We offer clients scalable and flexible solutions for their most complex challenges. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes.  Job Description We’re looking for someone who wants a chance to work on the technology that supports vital immunization registry work during the COVID-19 pandemic and has the passion to make a difference. We need people who know that focus counts, because we are dealing with the health and wellbeing of our communities, our families, and our selves. As a senior developer, you’ll have opportunities to be part of a team, help set our technical...
Gainwell TX, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary At Gainwell, we are passionate about helping those most vulnerable get access to high-quality, affordable healthcare. We harness the power of technology to help our clients improve the health and well-being of the members they serve. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Join us and build your career with an inclusive team that thrives on finding innovative solutions to some of healthcare’s biggest challenges. Job Description Essential Job Functions: •    Specific knowledge of User account creation with AD authenticated passwords •    Specific knowledge of Access Control Lists and managing them. •    Specific knowledge of Webmin or similar application. •    Possesses analytical and creative problem-solving skills related to users encountering account/connection issues to Unix/Linux servers •    Possesses analytical and creative problem-solving skills...
Gainwell TN, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary The Senior Pharmacy Technician is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, appropriate processing of prior authorization requests, research and resolution of escalations received at the member, provider, or pharmacy level, and initial and continued training of the pharmacy technician team.   Job Description Responsibilities: •    Remain compliant with all PHI protocols and requirements •    Perform administrative procedures for input of submitted prior authorization requests within the required time frame mandated by the Ohio Department of Medicaid •    Completion of approval process for prior authorizations where all criteria is met and clinical judgement of a pharmacist is not required •    Follow processes to complete initial reviews of prior authorizations submitted by providers or pharmacies •    Complete necessary communication...
Gainwell Conway, AR, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary The Senior Pharmacy Technician is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, appropriate processing of prior authorization requests, research and resolution of escalations received at the member, provider, or pharmacy level, and initial and continued training of the pharmacy technician team.   Job Description Responsibilities: •    Remain compliant with all PHI protocols and requirements •    Perform administrative procedures for input of submitted prior authorization requests within the required time frame mandated by the Ohio Department of Medicaid •    Completion of approval process for prior authorizations where all criteria is met and clinical judgement of a pharmacist is not required •    Follow processes to complete initial reviews of prior authorizations submitted by providers or pharmacies •    Complete necessary communication...
Gainwell OH, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary At Gainwell, we are passionate about helping those most vulnerable get access to high-quality, affordable healthcare. We harness the power of technology to help our clients improve the health and well-being of the members they serve. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Join us and build your career with an inclusive team that thrives on finding innovative solutions to some of healthcare’s biggest challenges. Job Description Essential Job Functions: •    Specific and in-depth knowledge of ANSI X12 837 Institutional, Professional, and Dental •    Specific knowledge of WEDI SNIP Edits •    Possesses analytical troubleshooting skills and is comfortable with a Unix/Linux command prompt and basic Unix commands. •    Must possess ability to work within a trouble ticket application for resolving trading partner questions and issues. •    Ability to be...
Gainwell TN, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary Provides more complex design documents and translates into component-level designs to accelerate development. Assists in developing strategy, design and data gathering approaches. Provides high level design expertise in support of development team efforts to provide flexible reusable components to increase cost effectiveness. Analyzes, designs and reviews design of applications and suites of applications to ensure that customer specifications are satisfied. Job Description Essential Job Functions Assists in overseeing business process work sessions, project meetings and joint applications development sessions to ensure that product design decisions are communicated to departmental personnel. Functions as a domain expert and works closely with software developers to explain the application design, and coordinates activities between the two functions to enhance product quality and efficiency. Participates in cost analysis studies to...
Gainwell Roseville, CA, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary Location:  remote with one day a week starting 5/9/22 - Roseville, CA, US, 95747-6645 Provides more complex design documents and translates into component-level designs to accelerate development. Assists in developing strategy, design and data gathering approaches. Provides high level design expertise in support of development team efforts to provide flexible reusable components to increase cost effectiveness. Analyzes, designs and reviews design of applications and suites of applications to ensure that customer specifications are satisfied. May provides technical consulting on complex projects. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time and form of desired results. Job Description Essential Job Functions Assists in overseeing relationships between application architects and development teams to ensure that product development and...
Gainwell CA, United States Full Time
06/27/2022  
Gainwell Technologies LLC Summary Designs, develops, installs, tests and documents complex applications software, including server, client, and web components. Contributes to the design and delivery of technical architecture solution components. Provides work guidance to less experienced personnel. May provide technical consulting on complex projects. Job Description Essential Job Functions The position requires working closely with Project management team, Solution advisers, technical and business personnel. Experience in ongoing performance tuning, applying patches, and resource optimization. Creating and maintaining operational, configuration, procedural and other documentation. Ability to develop and execute detailed test plans for future enhancements. Qualifications Work as an administrator for support of Healthcare EDI solution. Strong Experience with ITX 10.0 (IBM Transformation Extender) administration and using Trading partner and Partner manager in...
Gainwell NJ, United States Full Time
06/26/2022  
Gainwell Technologies LLC Summary Gainwell Technologies continues to transform its identity and access management services to support IT system innovations, business growth, and client solutions. Components such as directory services, single sign-on technologies, multi-factor authentication, and identity federation will remain at the forefront of this transformation for the foreseeable future. Gainwell is seeking an experienced Information Security Professional who can provide technical leadership for identity management and help drive its future.   Job Description Essential Job Functions Support technical issues involving IAM applications and related systems and process within negotiated Service Level Objective (SLOs). Respond quickly and effectively to requests received through the ticketing system Log all incidents and service tasks reported via escalation, meeting requests, email, voice mail or any other supported process\method. Distribute and...
Gainwell TX, United States Full Time
06/26/2022  
Gainwell Technologies LLC Job Description We’re looking for someone who wants a chance to work on the technology that supports vital immunization registry work during the COVID-19 pandemic and has the passion to make a difference. We need people who know that focus counts, because we are dealing with the health and wellbeing of our communities, our families, and our selves. As one of our most senior developers, you’ll have opportunities to be both part of and lead teams, help set our technical direction, develop it, and see projects through to implementation and support. See below for a quick summary of what the role would be and require: Essential Job Functions •    Code, test, debug, implement, and document highly complex programs. •    Design systems and programs to meet highly complex programmatic needs and provide technical advice on complex programming. •    Work with clients and management to resolve issues and exceed the expectations of our customers. •    With...
Gainwell AR, United States Full Time