Experienced Compliance Review - Analytics Support

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

As a Experienced Compliance Review - Analytics Support 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 community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

Assist in tracking, managing, and processing compliance incidents within the Medi-Cal Dental Program. Review and analyze data surrounding the delivery, billing, and utilization of dental services to detect unusual practices, billing anomalies and potential abuse by Medi-Cal dental providers and/or members. Query data reports, summarize and present findings to Gainwell staff and the Department of Health Care Services (DHCS) staff. Create, edit and present results of remediation activities of surveillance and utilization review findings via written report and verbal presentations. Track and support activities surrounding providers and remediation activities. Assist in tracking, managing and processing compliance incidents within the Medi-Cal Dental Program. Query reports and analyze data surrounding the delivery, billing, and utilization of dental services to detect unusual practices, billing anomalies and potential abuse by Medi-Cal dental providers and/or members. Facilitate internal and external department meetings, including establishing calendar invitations and formulating formal agendas. Record, capture, publish and disseminate detailed meeting minutes for Performance Management. Assist in documentation of activities surrounding providers and remediation activities.

What we're looking for

A minimum of three (3) years of experience in a relevant Business Analyst position within healthcare. Proficiency in creating, querying, and analyzing reports. Demonstrated excellent verbal and written communication skills with exceptional attention to detail and organization skills. Knowledge of Medi-Cal Dental criteria and program requirements strongly preferred.

What you should expect in this role

Hybrid work environmen t 3 days a week in t he office as needed for face-to-face and client meetings with the remainder of time remote work. The office is located in the Roseville/Sacramento area. Video cameras must be used during all interviews Cal Dental

The pay range for this position is $74,300.00 - $106,100.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. 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.