Find the best jobs in the US, apply in 1 click and get a job today! Through the SPBM, ODM gains increased accountability and ensures alignment with clinical and policy goals, while also improving transparency. Coordinate workstreams and teams on IT projects to align solutions with client business priorities, Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results, Delegate work across teams, and coach and monitor project team members to plan, design and improve complex business processes and modifications, Streamline workflows across clients and technical personnel to determine, document and oversee carrying out system requirements, Support quality control as you approve and validate test results to verify that all requirements have been met. Managed Care Entities (MCE) including Managed Care Organizations (MCO) and the Prepaid Inpatient Health Plan (PIHP), which is also known as OhioRISE, will be given access to the SPBM online portal to view clinical profile information about members that are actively enrolled in their associated MCE. Users may find helpful website links and documents within our online portal in the menu bar above. Put your passion to work at Gainwell. La Med. Here are the details on this position. YKrvrM.-,[=*q}iP)w_y7y1ywIzz|~xI%G)OHL'I$i?O?E&+~|| OgV'8HZ4/=>}|kx? I make phone calls a lot and I find few companies as engaged as yours. San Francisco, CA. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. ODM received six competitive offers in response to the single PBM request for proposal. From members and providers to managed care organizations and state agencies, this transformative system empowers stakeholders to get vital services more quickly and efficiently to drive better health outcomes. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. % For insights into what you need to know, visit managedcare.medicaid.ohio.gov/providers. Every time I call, it feels as if I am talking directly with the owner of the company. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. The pay range for this position is $63,100.00 $90,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. 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. The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). WebGainwell Technologies LLC is now hiring a Account General Manager - State Medicaid Management Services in Nevada. Gainwell operates as a standalone company with over 7,500 employees who support clients across 42 U.S. states and territories. 5+ more years of experience working as a business analyst or requirements translator between technical and non-technical personnel, with 3 or more years of Medicaid and Medicare experience preferred. Here are the details on this position.. View job listing details and apply now. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Please use the same Learning Management System (LMS) credentials set up during your registration to log in. Working at Gainwell carries its rewards. Creates unit test cases for area of responsibility and updates technical specifications and mappings. Just as you promised, I was up and running within 20 minutes of our initial conversation. WebOnsite, remote or Hybrid options may be available from US locations. https://www.dice.com/job-detail/eb49bd3b-53cd-43e7-89e4-fbf4c64a1d8c?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. Build your career with Gainwell, an industry leader. HIPP Unit, Gainwell Technologies | Georgia Medicaid LA Medicaid Managed Care Organization. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. Interface with the technical team to ensure designs are understood and properly implemented. October 18, 2022 09:30 ET Log in to the member secure portal to view your: Your guide to Medicaid and other information about your Medicaid benefits can be found in the Member section of the Medicaid Managed Care Plan websites., The Gainwell Notice of Privacy Practices is available. Gainwell Technologies LLC Account General Manager - State My work is truly cut in half by using Claim Shuttle. This is a soft launch of the SPBM onlineportal with limited features. Ohio Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health andwell-being of the members they serve a communitys most vulnerable. Registration for SPBM Web Portal training is now open for all members. Gainwell Technologies. It's great to have immediate help and knowledgeable support! Gainwell Technologies We can now process 2018, Chapter 136 and N.J.A.C. Your company feels young and fresh and it is a real pleasure being a client of yours. Neither ODM nor the state auditor could verify or refute the appropriate use of funds. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Find out what skills and jobs are in high demand. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive To bolster accountability in the pharmacy program, Ohio Medicaid soon will select a pharmacy operational support vendor (POSV) tasked with auditing the single PBM. Put your passion to work at Gainwell. 3 . The pay range for this position is $63,100.00 $90,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Click OK to renew your session or Logout of the application. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Theresult is a comprehensive platform that is a model for statesseeking to transform their Medicaid programs.. Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! We celebrate diversity and are dedicated to creating an inclusive environment for all employees. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. In 2019, the Ohio General Assembly instructed ODM to adopt a single PBM following release of a 2018 Health Data Solutions (HDS) report stating the PBMs were paid $224 million by Medicaid. PNM will replace MITS provider enrollment and provider data management. Works closely with configuration team and DBAS to ensure synchronicity of configuration to interfaces and mappings. The recorded SPBM Web Portal training is now available for prescribersand prescribersupport staff. Thank you for your patience as we continue to enhance the system. Other companies could learn from you. Reno, NV. Hope Private In-Home Care <25 <$5M. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Working at Gainwell carries its rewards. Medicaid Gainwell Technologies Copyright 2023 Grabjobs Pte.Ltd. My phone line was costing 4 TIMES MORE per month than the fee for using ClaimShuttle, and it couldn't have been easier to set up and get going. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. At issue was the lack of transparency. First name. Thank you very much for the help. That is a direct consequence of your fantastic employees. Learn more atwww.naspo.org. 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. A lock or https:// means you've safely connected to the .gov website. Be part of a team that unleashes the power of leading-edge technologies to Home page - OH MCD SPBM.Web - Ohio As a Test Engineer - Medicaid Testing at Gainwell, you will be a part of an innovative healthcare technology company with a mission to serve the healthcare needs 2023. View this and more full-time & part-time jobs in San Francisco, CA on Check. WebSummary. Gainwell technologies brings a wealth of experience to strengthen ODM's pharmacy benefits delivery. The recorded SPBM Web Portal training is now available for Managed Care Entity Portal Administrators and staff. The PNM Pre-Registration tool is available until Sept. 23 and will ease the transition and prevent disruptions to system access for providers ahead of go-live on Oct. 1. Please join the Gainwell Ohio SPBM training staff to learn the difference between the public and the secure portals, including how to register for the secure portal. The auditor stated, we cannot be content to accept a black box in the delivery of public services. Ohio Medicaid and other state agencies had no means to audit potential steerage or conflicts of interest. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Medicaid Data Analyst SME - Gainwell Technologies