1 . Verify solution meets the defined requirements through scenario testing. WebIf you have any questions regarding the enrollment instructions, please call the Mississippi Medicaid EDI Technology Support Center at: 1-800-884-3222. The Kansas Medicaid platform implementation sets the standard for states adopting modular 2 0 obj Click here to join our private community of job WebAs a Senior Business Analyst Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a communitys most vulnerable. 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. Theresult is a comprehensive platform that is a model for statesseeking to transform their Medicaid programs.. Here are the details on this position.. Change Healthcare, Express Scripts, Gainwell Technologies, MagellanRx Management, Navitus Health Solutions, and RxAdvance each submitted responses. stream <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 21 0 R 29 0 R 30 0 R 31 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Creates accurate mapping documents according to the mapping process. It provides services for 29 state Medicaid programs, processes more than 195 million pharmacy claims a year, and answers 6.6 million provider and recipient phone calls annually on behalf of state health care customers. Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. All Rights Reserved. Mississippi Medicaid has created the following guide on how to enroll: Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. Supports the ETL developers based on the mappings created. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Gainwell Technologies. 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 LA Dept of Health and Hospitals. Put your passion to work at Gainwell. Here are the details on this position.. View job listing details and apply now. To access the recording, pleaseclick here. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. All Rights Reserved. CONTACT:Elizabeth Bonet Gainwell Technologies972-556-5082elizabeth.bonet@gainwelltechnologies.com. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Currently, each of Ohio Medicaids six managed care organizations (MCOs) contracts with one or more PBM to manage prescription drug benefits. Youll be joining a company where collaboration, innovation, and inclusion fuel our growth. 3 0 obj WebMedicaid Data Analyst SME - Gainwell Technologies - San Francisco CA - data-analyst, san-francisco----ca, gainwell-technologies. 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. Put your passion to work at Gainwell. 2018, Chapter 136 and N.J.A.C. HMS was selected as a supplier for ValuePoints TPL service offerings, allowing states to gain more efficiency and savings by choosing one sole provider to manage all their data and TPL service needs. This time it was warranted. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. The following process must be followed prior to initiation of electronic claim submission or inquiry. We are proud to be an Equal Please use the same Learning Management System (LMS) credentials set up during your registration to log in. 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. Web1-770-325-2331 1-866-211-0950 (toll free) Providers, Trading Partners, or Provider Agents: Problems with registration or logging into the website should be directed to the Gainwell Technologies Company Georgia Medicaid EDI Services group. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. Working at Gainwell carries its rewards. Selecting Gainwell as our partner in administering a clinically driven, outcomes-oriented pharmacy program enables us to take advantage of their previous successes.. Here are the details on this position. We celebrate diversity and are dedicated to creating an inclusive environment for all employees. The changes we make will help you more easily access information, locate health care providers, and receive quality care. We can now process 276/277 requests (claim status). Works toward delivering a first draft solution to ETL for coding, by rapidly understanding which details about the mapping can be deferred. For training registration instructions,click here.. It provides access to specific patient information and the ability to reach the SPBM Clinical help desk via web chat. Summary As a Senior Business Analyst Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a communitys most vulnerable. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Uses SQL, data models, data element dictionary and schema to perform data and business analysis. P.L. An official website of the State of Georgia. Document requirements for business and system requirements. Thank you for your excellence! Gainwell is the market leader in providing Medicaid services. The Ohio Department of Medicaid (ODM) provides health care coverage to more than 3 million Ohioans through a network of more than 165,000 providers. Working at Gainwell carries its rewards. The ease of use and user-friendly environment is awesome. 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. During the training, you will also learn about many exciting tools available on the SPBM Web Portal such as member eligibility, viewing prior authorization status, the ability to quickly speak with the SPBM help desk, and much more! Clipped from: https://www.dice.com/job-detail/eb49bd3b-53cd-43e7-89e4-fbf4c64a1d8c?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic. New Extensions for Gainwell Technologies Provider Representatives 12/7/2020 PDF Version TO: All Providers RE: New Extensions for Gainwell Technologies Provider Representatives Effective Wednesday, December 9, 2020, Gainwell Technologies Provider Representatives may be reached by dialing 855-523-9170, then dialing a new 7 Additionally, PNM training is now available for providers in a variety of formats, including virtual, in-person, and self-paced. Help the client innovate and formulate business solutions and technology enabled business models to implement CMS mandated or State directed initiatives. Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. TTY: 711. endobj | Source: Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Together, as one team, we collaborated on every aspect of this program. Claims and encounters? Other companies could learn from you. We are redesigning our programs and services to focus on you and your family. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. Working at Gainwell carries its rewards. 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. This is a soft launch of the SPBM onlineportal with limited features. 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. 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. Learn more atgainwelltechnologies.com. Our transformed Medicaid platform will provideincredible benefits to our state,our most vulnerable citizens,andourvalued providers. If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. A lock or https:// means you've safely connected to the .gov website. NAICS Code 52,524. These capabilities make us a trusted partner for organizations seeking reliability, innovation and transformational outcomes. Once the Trading Partner Enrollment process has been completed, you should receive an email with your login and password for their test site. {XOdE$p,Z0Hd(,.#3#LAs3DL~Z R2fX{jm.?VX.B^ `0?gLgpi:#[4d@Sa6 3C[-Z%,i0=z"YF8=kXh*b8\U^&}pm2Z|nL]Cm\ x)n'x2.ozUxil;3AcUf%9M`3pV1%iS&>gBj22W Read on if you are looking for information specific to our current programs. This launch also includes a new requirement to establish an OH|ID to access any of ODM's Ohio Medicaid Enterprise Systems (OMES). $63,130 to $78,957 Yearly. Analyze and document current business processes and determine new processes to solve complex Healthcare initiatives. La Med. You can deactivate or delete job alerts by clicking the button below. Reno, NV. Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. https://pnm-preregistration.omes.maximus.com, OH_MCD_PBM_Network@gainwelltechnologies.com, Myers and Stauffer (PPAC) - Ohio Medicaid Pharmacy, Chapter 5160-26 - Ohio Administrative Code | Ohio Laws, Single Pharmacy Benefit Manager (SPBM) Secure Web Portal Provider Registration FAQ is available, Provider Registration Manual is available, Provider Registration Process training video is available, Check provider enrollment application status, You can also call or visit your local county office for help with benefits at 1-844-640-OHIO (6446). Neither ODM nor the state auditor could verify or refute the appropriate use of funds. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive endobj Full-Time. Put your passion to work at Gainwell. I keep having great experiences every time I call your company, finding a super friendly rep on the phone, helping me with any questions I have. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. As a result, health care providers are subject to meeting unique, time-consuming processes required by each MCO to prescribe important, sometimes life-sustaining medications. I was really concerned that this transition was going to be difficult and costly, but I was wrong on both counts. The portal also gives the user the ability to reach the SPBM Clinical help desk via web chat. Department of Medicaid logo, return to home page. Viewing this training is important for pharmacists and their support staff to learn about the many tools available on both the public facing and secure portal. We offer clients scalable and flexible solutions for their most complex challenges. View this and more full-time & part-time jobs in San Francisco, CA on NASPO ValuePoint delivers high value, reliable and competitively sourced cooperative contracts offering public entities outstanding prices, favorable terms and conditions and value-added services. My work is truly cut in half by using Claim Shuttle. As a Senior Business Analyst - Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a communitys most vulnerable. Gainwell Technologies brings a wealth of experience to strengthen ODMs pharmacy benefits delivery. Mississippi Division of Medicaid (ms.gov)) click on the MOVEit Portal at Mississippi Replacement Project (msxix.net) page. ODM's goals for the SPBM are to improve management and administration of pharmacy benefits for Ohio Medicaid managed care members. The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay | Source: 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. On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. Find out what skills and jobs are in high demand. The following process must be followed prior to initiation of electronic claim submission or inquiry. Put your passion to work at Gainwell. Gainwell Technologies is the leading provider of cloud technology solutions vital to the administration and operations of health and human services programs. The groundbreaking, cloud-based platform uses a service-oriented architecture to seamlessly connect all modules in a secure and dynamic environment. % Learn more about Gainwell at our and visit our for all available job role openings. PrescriberWeb Portal training recording now available. Gainwell has already contracted with more than 2600 pharmacies. Our billers love the interface that ClaimShuttle provides and I would be happy to be a future reference if needed. How can you stand out? Want to receive job alerts for similar jobs? TennCare is committed to safeguarding the information of our members. The award moves Ohio closer to realizing greater transparency and accountability in Medicaids $3 billion pharmacy program. <> Previous Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. I am a very small company, and have actually now reduced my overhead by going with you guys! I just transmitted my first batch of electronic claims through Claim Shuttle! Required Documents for those applying for new Submitter IDs. Thank you very much for the help. WebAs a Senior Business Analyst Medicaid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of The pay range for this position is $86,800.00 $124,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Learn more about Gainwell at our and visit our for all available job role openings. WebAs a Medicaid Data Analyst SME at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the Gainwell Technologies LLC. Working at Gainwell carries its rewards. COLUMBUS, Ohio The Ohio Department of Medicaid (ODM) today announced Gainwell Technologies was selected to be the agencys single pharmacy benefits manager (PBM). Full-Time. It's great to have immediate help and knowledgeable support! Supports unit Testing, System Integration Testing, System Testing, and user Acceptance Testing. The secure portal requires log in credentials that will allow access to specific patient information. 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. Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215, Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516, Gainwell Technologies selected to bring new level of accountability. Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! Be part of a team that unleashes the power of leading-edge WebGainwell Technologies Provider Services 1-800-776-6334: Click here for ICD 10 Resources. Everything about it (including your team) is great! Learn more about Ohio's largest state agency and the ways in which we continue to improve wellness and health outcomes for the individuals and families we serve. SIC Code 63,632. A Happy Friday message from a Satisfied User! Members will have access to a training video on Oct. 1. Build your career with Gainwell, an industry leader. Working at Gainwell carries its rewards. Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. The public facing portal includes access to reference material such as the Unified Preferred Drug List and criteria. I have also been transferred to other staff, who helped me resolve issues in the most professional way. This single-vendor approach will result in lower total cost for TPL services and fully streamlines the process by filling in gaps that previously required multiple vendors and disparate point solutions. Works closely with configuration team and DBAS to ensure synchronicity of configuration to interfaces and mappings. , Pharmacy Web Portal training recording now available. Viewing this training is important for pharmacists and their support staff to learn about the many tools available on both the public facing and secure portal. This new platform will drive efficiency and quality, improving our ability to serve our members and providers.. View job listing details and apply now. 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. NASPO is an organization that helps its members as public procurement leaders by promoting best practices, education, professional development, research and innovative procurement strategies. You should receive an email with that information as well, Step 2: Register as a Trading Partner via the "Register Now" link:https://portal-tpi.msxix.net/ms/provider/Home/tabid/135/Default.aspx, Please make sure to select "Trading Partner" on the first screen, On the following screen you will need to enter the Trading Partner ID you received from Step 1 and enter your zip code, Please write down the User ID and Password you create on the next screen, After completing the rest of the required fields on this page, you will receive an email that contains a secure link to complete registration. PNM will replace MITS provider enrollment and provider data management. Gainwell is offering several options available below for your assistance: Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! The Kansas Medicaid platform implementation sets the standard for states adopting modular solutions. Previous experience with a Medicaid Management System or with major operations-related components of an Medicaid Management System or other large healthcare systems and 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. Welcome to the new Ohio Medicaid pharmacyservices onlineportal. Youll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. <> ODM is building its next generation managed care program throughout 2021, including preparations to integrate and launch the strategic components of the program: the single PBM, POSV, fiscal intermediary, centralized credentialing, and the OhioRISE specialized managed care program for children with complex needs. Your customer support reps are the best!!! Your role in our mission Posted: February 07, 2023. 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. Presents analysis and design recommendations to lead MITA teams, customer and/or vendors into the acceptance of the design. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. Last name. 6+ years of associated work experience in a software development environment, Practical ability with Microsoft Office as well as SQL, Demonstrated ability to independently manage multiple responsibilities, prioritize tasks and meet deadlines, Excellent written and verbal communication, Ability to perform in lead Business Analyst role on projects, Position open to candidates residing in Arkansas, El Paso, TX or Puerto Rico. To access the recording, pleaseclick here. The recorded SPBM Web Portal training is now available for prescribersand prescribersupport staff. As aData Mapping Leadat 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. Once you have received your Submitter ID and Password from Mediciad, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission.

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