It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
Gainwell Technologies is hiring a Provider Relations Specialist to support Wisconsin’s Bureau of Children’s Services (BCS) within the Division of Medicaid Services. This remote role works under the direction of the Internal Operations and Systems Support Section Manager and focuses on provider compliance, claims processing, and policy support for the Children’s Long-Term Support (CLTS) Waiver Program.
Your role in our mission
As a Provider Relations Specialist, you will:
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Manage outlier rate request protocols and provide oversight on county waiver agency (CWA) authorizations.
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Monitor claims compliance in collaboration with Gainwell Technologies, CWAs, and BCS staff.
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Develop and update procedures for CLTS service rate outlier reviews and service fee schedules.
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Oversee provider integrity concerns and complaints through structured compliance frameworks.
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Draft and manage communications such as webinars, GovDelivery updates, bulletins, and responses to the provider relations inbox.
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Serve as a subject matter expert during user acceptance testing and implementation of provider registry and directory initiatives.
What we're looking for
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Bachelor’s degree in a related field or equivalent experience.
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Minimum of 5 years of experience, ideally within a human services agency.
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Strong knowledge of Medicaid, CMS HCBS waiver programs, and cost allocation methods.
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Demonstrated experience in policy implementation, provider training, and claims resolution.
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Expertise in analyzing financial and operational data to inform business decisions.
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Ability to coordinate multi-agency efforts and interpret regulatory guidance effectively.
What you should expect in this role
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Fully remote position within the United States.
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Occasional travel may be required within Wisconsin or other states.
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Full-time role with strong collaboration between Gainwell, BCS, and state stakeholders.
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Requires active use of Microsoft Office tools (Excel, Word, PowerPoint).
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High-impact role with visibility across provider operations and Medicaid service administration.
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Opportunity to shape and improve provider engagement for vital community-based services.
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The pay range for this position is [[salaryMin]] - [[salaryMid]] per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. 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.
