Provider Enrollment Lead - Remote US (Any city, NJ, US, 99999)

About the Role

The ideal candidate will have a strong understanding of healthcare regulations, excellent analytical and problem-solving skills, and the ability to work independently in a remote environment. The role requires strong communication and interpersonal skills, as the candidate will be working closely with various stakeholders, including provider enrollment analysts, operational leadership, and external partners.

The team at Gainwell Technologies values flexibility, learning, and career development, and this role offers the opportunity to grow professionally while working on challenging and rewarding projects.

What You Will Do

• Support provider enrollment, revalidation, maintenance, and renewal activities for the New Jersey Medicaid program
• Ensure compliance with CMS, ACA, state, and federal regulatory requirements
• Monitor inventory, workflow, production metrics, and service level agreements to support operational efficiency
• Serve as a resource for Provider Enrollment Analysts, providing training, mentoring, and day-to-day operational support
• Review enrollment applications, provider documentation, audits, and administrative reports to identify deficiencies or areas for improvement
• Perform routine and complex provider enrollment tasks with minimal supervision
• Collaborate with operational leadership to maintain productivity, quality, and compliance standards
• Develop and implement process improvements to increase efficiency and effectiveness
• Analyze data and metrics to identify trends and areas for improvement
• Provide guidance and support to junior staff members

What We Are Looking For

• High school diploma or GED required; associate degree or additional post-secondary education in healthcare administration, business, or a related field preferred
• 3+ years of experience in provider enrollment, provider revalidation, provider credentialing, healthcare operations, claims processing, healthcare administration, or healthcare compliance support
• Prior experience serving as a team lead, mentor, trainer, or subject matter expert in a healthcare operations or production environment preferred
• Strong written and verbal communication skills, organizational skills, analytical thinking, and problem-solving abilities with attention to detail
• Experience working with Medicaid, Medicare, healthcare enrollment systems, provider data management, Microsoft Office applications, and operational reporting tools preferred
• Ability to work in a fast-paced environment with multiple priorities and deadlines
• Strong attention to detail and ability to maintain confidentiality

Nice to Have

• Experience with healthcare compliance initiatives and regulatory requirements
• Knowledge of healthcare operations and provider enrollment processes
• Familiarity with remote work environments and virtual collaboration tools
• Certification in healthcare administration or a related field

Benefits and Perks

• Competitive salary range ($45,000 - $55,000 per year)
• Opportunity to work with a dynamic and growing company
• Flexible remote work environment with opportunities for professional growth and development
• Comprehensive benefits package, including health insurance, retirement savings, and paid time off
• Access to cutting-edge technology and tools to support your work
• Collaborative and supportive team environment
• Opportunities for professional development and continuing education
• Recognition and reward programs to acknowledge your contributions and achievements

• Tip: When applying for this role, be sure to highlight your experience with provider enrollment and healthcare compliance, as well as your analytical and problem-solving skills.
• Research Gainwell Technologies and the New Jersey Medicaid program to demonstrate your knowledge and interest in the company and the role.
• Make sure your resume and cover letter are tailored to the position, with a focus on your relevant skills and experience.
• Prepare to discuss your experience with remote work and virtual collaboration, as well as your ability to work independently and manage multiple priorities.
• Consider creating a portfolio or examples of your work to demonstrate your skills and accomplishments in provider enrollment and healthcare operations.
• Be prepared to ask questions during the interview process, such as what a typical day in the role looks like, or what opportunities there are for professional growth and development.
• Research the company culture and values to ensure they align with your own goals and expectations.