Gainwell Technologies

Auditor

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes.
• Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates.
• Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.

Outpatient Coding Auditor

Communications

• Develop, review, and publish provider-facing materials, including newsletters, bulletins, alerts, policy updates, and educational resources.
• Coordinate with business partners, subject matter experts, compliance teams, and client stakeholders to ensure publication accuracy and consistency.
• Translate complex healthcare policies, operational changes, and regulatory requirements into clear and actionable communications for providers.
• Manage publication schedules, communication calendars, and approval workflows to ensure timely delivery of materials.
• Support provider outreach and education initiatives through written communications, presentations, webinars, and training materials.

Provider Publications, Communications Lead

Backend Engineer

• Code, test, debug, implement, and document moderately complex programs
• Analyze, design, and write specs and requirements from which we develop and code programs
• Evaluate existing systems and programs; assist project manager in assigning tasks and work closely with a team
• Liaise with clients and management to provide technical consulting on complex programming projects, validate program requirements, and resolve issues that arise
• Develop test plans and participate in QA activities such as coding reviews
• Participate as a member of a development team and lead a small sub-team of developers as needed
• Design system components and delegate responsibilities to team members

Senior UI Developer, .NET C#/Oracle

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes.
• Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates.
• Draws on advanced ICD-10 coding expertise to substantiate conclusions.
• Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Consistently achieves productivity and quality performance standards established by management.
• Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs.
• Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Coding Auditor

Business Analyst

• Translate business needs into detailed UI mock-ups and requirements/user stories that guide development efforts
• Proactively identify opportunities for system enhancements or gaps that increase product value and operational efficiency based upon new industry trends/schemes or client need
• Define acceptance criteria and expected system behavior. Apply the test scenarios to execute User Acceptance Testing to verify that systems are functioning properly and business requirements are incorporated into the system design
• Participate in post-deployment testing sessions that occur after normal business hours (Typically one Thursday evening every month)
• Communicate effectively with both technical and non-technical audiences and capable of building and maintaining relationships with key stakeholders
• Create and maintain organized product project plans through integrated management tools to support product development (i.e., Azure DevOps or other tools)
• Utilize product knowledge combined with extensive Payment/Program Integrity subject matter expertise to lead requirement elicitation meetings with clients and stakeholders
• Configure and tailor client system environments (rules, alerts, case workflows, etc.)
• Deliver product demos, walkthroughs, and training as needed
• Develop and maintain internal & client training documents, job aids, and product enhancements/release notes
• Support daily product maintenance and client satisfaction

Experienced Business Analyst – Fraud, Waste & Abuse

• Play a critical part in ensuring Gainwell is meeting our clients’ objectives in pharmacy benefit management (PBM) services
• Support Preferred Drug List (PDL) and supplemental rebate implementations and configurations
• Support PDL and supplemental rebate operations and maintenance on established accounts
• Work with a team of pharmacy clinicians and subject matter experts to configure PDL and rebate systems to deliver services to our state clients
• Apply analytical skills to evaluate and model various rebate scenarios, providing insights for decision-making
• Perform system updates related to PDL and rebate configurations to ensure accuracy and compliance
• Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
• Execute testing for PDL and rebate system changes to ensure functionality and reliability
• Help verify that all requirements have been met by approving and validating test results
• Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work

Business Analyst – Preferred Drug List

Content Writer

• Analyze customer requests for proposal and information.
• Review and interpret key RFP requirements and identify issues or concerns that need resolution prior to submission of response.
• Write compelling proposal responses that accurately describe solutions, strategies, and vision while ensuring the responses embody company win themes and key differentiators.
• Collaborate with senior management, departmental experts, sales/marketing staff, and proposal leadership to implement edits and complete proposals.
• Proofread and perform quality assurance checks on all documents to ensure that proposals meet RFP requirements and accurately convey Gainwell’s strategy.
• Work with the sales organization, SMEs, and team leadership to meet deadlines in both initial submittals and follow-up as needed.
• Demonstrate an understanding of business challenges within customer markets and how company technology-enabled business solutions can address those needs.
• Develop proposal attachments, such as forms, report packages, flowcharts, implementation schedules, and sample communication materials, as required.
• Interface and coordinate with finance to verify pricing for proposal.
• Work with Production Coordinator to produce printed materials and electronic media.
• Share new or modified responses as they are developed and approved to maintain the proposal database.
• Assist other department staff as required based upon business needs.
• Other duties as assigned.

Proposal Writer

Compliance

• Oversight of all contract compliance and audit activities
• Develop and coordinate contract monitoring performance standards
• Produce monthly status reports on contract monitoring conditions
• Work with State and Gainwell Leadership on management areas
• Train and reinforce understanding of contract compliance to new staff and leadership

Contract Compliance Manager

Analyst

• Play a critical role in shaping PCMH program effectiveness measurements and incentive payment strategies to align with client program, policy, and organizational goals
• Serve as a strategic advisor to state stakeholders on PCMH program direction and tradeoffs
• Take a leading role in helping the state document, interpret, develop and enhance PCMH program policies and procedures
• Research national incentive methodologies, PCMH program operations, and the broader healthcare delivery ecosystem to recommend program improvements
• Assess the impact of incentive metric changes, policy updates, and funding options on Arkansas Fee-for-Service (FFS) providers
• Own the translation of business needs into clear data, system, and policy requirements
• Work with and guide the Data Analyst team to apply advanced analytical techniques to analyze large datasets and evaluate costs, trends, and reimbursement outcomes
• Synthesize analytic outputs to help in form program design and identify 2nd and 3rd level analyses
• Help lead Gainwell’s team in the design, development, and implementation of incentive payment methodologies for PCMH providers
• Work with the Gainwell team to ensure the accuracy, completeness, and appropriateness of metrics produced by established analytical models
• Monitor State and Federal PCMH policy changes—with an emphasis on Arkansas Medicaid—and assess their operational and financial impact
• Partner with internal teams, business leaders, and external stakeholders to promote transparency and alignment in PCMH program performance measurement practices
• Prepare high-quality written analyses, presentations, and recommendations for leadership, clients, and technical teams.

Experienced Public Policy Analyst

• Support the full product development life cycle
• Perform complex product design tasks and verify bugs
• Investigate defects and support training course development
• Work with management and cross-functional teams

.Net/C# Developer

Pharmacist

• Perform vital testing, troubleshooting and analysis of application software for complex technical projects
• Design, develop, implement, maintain and monitor critical test processes
• Gather requirements for testing, develop executable test cases and help distribute workload across a team of test engineers
• Coordinate and collaborate with others to analyze requirements to confirm, establish and communicate the defect-causing problem to the right stakeholders
• Assist, as needed, in writing proposals to recommend process and programs
• Help prepare estimates for performing the various activities defined in the test plan

Test Lead, Manual Test, US Healthcare, Medicaid, Pharmacy

• support the design and development of modern, cloud‑native healthcare and public sector products
• design, develop, and maintain scalable Java‑based product platforms supporting healthcare and public sector use cases
• build and evolve cloud‑native applications using modern frameworks and engineering best practices
• translate policy, regulatory, and program requirements into secure, production‑ready software
• develop reusable services, shared components, and platform capabilities to support multiple programs
• design and deploy solutions on AWS, leveraging secure, compliant, and cost‑effective cloud services
• apply microservices, API‑first, and event‑driven architectures to support interoperability and scalability
• support modernization initiatives that move legacy platforms toward cloud‑native architectures
• design and improve CI/CD pipelines with strong controls for quality, security, and compliance
• partner with platform, SRE, and security teams to implement monitoring, logging, and operational readiness
• serve as a technical advisor to product, architecture, and delivery teams
• conduct design and code reviews, mentor engineers, and promote engineering standards and best practices

Senior Java Developer

Manager

• Oversee end-to-end delivery of data integration, interfaces, conversions, reporting, and analytics for Provider+ implementations across all lifecycle phases.
• Own and maintain the integration/interface catalog, including all inbound and outbound data exchanges (e.g., provider enrollment, credentialing, screening, MCOs, state hubs).
• Lead technical design integrity for interfaces, APIs, data mappings, schemas, error handling, and reconciliation, ensuring traceability from requirements through testing.
• Coordinate with engineering and platform teams on build/configuration/localization of integrations, conversions, and analytics pipelines; validate unit and integration test evidence prior to SIT.
• Define and govern provider data conversion and migration strategy, including mapping, cleansing rules, load approach, cutover sequencing, reconciliation, and acceptance criteria.
• Drive analytics and reporting readiness, ensuring datasets, feeds, semantic models, and dashboards are aligned to source-of-truth and ready for UAT and production.
• Ensure non-functional requirements and compliance (security, privacy, auditability, performance) are met in partnership with Architecture and Security teams.
• Serve as the primary technical/data advisor to the Engagement Lead, assessing feasibility of requirements and providing impact analysis and options for scope/schedule trade-offs.
• Lead client facing delivery cadences, including recuring program wide delivery meetings and executive ready status reporting with clear risks and mitigations.
• Drive technical execution quality by setting and enforcing delivery standards, including documentation, coding guidelines, peer reviews, and unit testing expectations.
• Support staffing and financial forecasting inputs, and budget cycle activities needed to keep delivery on track.

Principal Provider Integration, Analytics Delivery Manager

• Support complex healthcare IT initiatives by translating business needs into well-defined, high-quality system solutions
• Contribute to requirements, design, and testing activities while partnering with project teams to ensure solutions are complete, accurate, and aligned with client expectations
• Develop and own structured solution artifacts that define discrete system changes or work products
• Elicit, document, and manage business, functional, and non-functional requirements
• Support development of project deliverables, including requirements, design documentation, and user-facing materials
• Analyze business processes and system impacts across functional areas
• Participate in and support requirements workshops, design sessions, and client walkthroughs
• Ensure adherence to established standards, templates, and naming conventions across deliverables
• Provide guidance and support to junior BAs

Senior Business Analyst – Medicaid

• Take ownership of business analysis leadership on a large, cross-functional system implementation or modernization effort
• Serve as the lead Business Analyst and Project Business Lead (BL)
• Oversee the full lifecycle management of structured solution changes
• Act as a primary liaison to DHS
• Coordinate with the Test Lead and testing team to ensure alignment of test scenarios and test cases
• Enforce quality assurance standards across all BA deliverables