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.
Summary
Leads the Payment Integrity Client and Provider Services Operations teams to ensure compliance and adherence with key client deliverables and contractual Service Level Agreements. Work with internal teams to ensure revenue forecast projections are met or exceeded. Establish departmental processes and procedures to maximize productivity and performance.
Your role in our mission
- Leader of Payment Integrity operations and call center teams, reporting to the Sr. Director of Operations, ensuring efficiency and service quality
- Understands and provides operational expertise for the breadth of Payment Integrity audit strategies and supporting operations.
- Payment Integrity revenue forecast analysis and operational team oversight to ensure revenue forecast projections are met or exceeded.
- Monitor performance metrics, including client satisfaction, response times, and resolution rates, to ensure targets are met
- Reviews, analyzes, and evaluates business procedures to identify sources of revenue and cost reduction strategies through process improvements, new initiatives, automation, and strategic agendas/oversight
- Implements policies and procedures that will improve day to day operations and maximize company productivity, performance, and service quality
- Ensure compliance and adherence with key client deliverables and contractual Service Level Agreements
- Identifies, performs root cause analysis, and develops immediate action plans impacting operational performance
- Set the vision and direction for the call center to drive performance and ensure a high level of customer satisfaction
- Advanced ability to manage projects with demonstrated knowledge and experience in project management techniques, software, and tools
- Develops and presents reports and other written communication to the client, partnered with Account Management, to ensure client satisfaction and operational excellence
- Interacts with executives and supporting staff
- Supports collaboration and communicates broadly to ensure overall coordination of goals and objectives between internal teams such as Account Management, IT, Implementation, Sales, Product, and other key internal stakeholders.
- Responsibility for overseeing hiring, training, development, and performance management
What we're looking for
- Eight or more years experience in Payment Integrity Audit and Recovery with knowledge of audit strategies such as Data Mining, Clinical Medical Record Review, and Bill Audit
- Eight or more years experience in a senior management capacity for operations and call center, preferably in a Payment Integrity market
- Five or more years experience working collaboratively with multiple organizational departments, including Information Technology
- Ability to present and communicate ideas clearly and persuasively at all levels to both internal and external audience, including executive levels
- Strong leadership, project management, and process optimization skills
What you should expect in this role
- This role is 100% remote, based in the U.S.
The deadline to submit applications for this posting is February 20, 2025.
Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
