Provider Enrollment Advisor- Nevada (Remote)

Gainwell Technologies LLC•Any city, OH

8d•$70,400 - $85,000•Remote

About The Position

The Provider Enrollment Advisor will support the Provider Enrollment Manager and team for Nevada Medicaid. This person will act as a subject matter expert for business applications and team processes. This role requires analysis of data to make recommendations that are cost effective and high-quality. This person supports the business meeting Federal, State and Agency guidelines and service level agreements with the client.

Requirements

Bachelor’s degree in a related field or an equivalent combination of education, training, and experience.
Five or more years of experience in healthcare operations (managed care, provider, or member services).
Three or more years of experience in provider credentialing and enrollment.
Five or more years of experience in problem-solving, research, and process improvement.

Nice To Haves

Knowledge of provider enrollment processes and requirements for CMS Federal and State Guidelines related to enrollment and reenrollment policies, preferred.
Knowledge of NV Medicaid Guidelines, preferred.
Six Sigma Lean Green or Black Belt certification, preferred.

Responsibilities

Serve as the subject matter expert for provider enrollment requirements, ensuring compliance with regulatory and business standards.
Analyze business needs, gather client requirements, and recommend process and system improvements to support operational goals.
Develop business specifications and collaborate with technical teams on system enhancements, testing, and implementation activities.
Manage project activities, timelines, and deliverables, ensuring deadlines and objectives are met.
Utilize data analysis to identify trends, root causes, compliance risks, and process improvement opportunities, and provide actionable recommendations.
Support corrective action plans, resolve complex business application issues, and exercise sound judgment in decision-making.
Build strong stakeholder relationships, influence positive outcomes, and maintain a high level of accuracy and attention to detail.