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 Professional Quality 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. Gainwell empowers you to help clients deliver better health and human services outcomes using innovative technology and solutions, enabling you to design your career for growth, new possibilities, and refinement of your valuable skills. Here are the details on this position.
Your role in our mission
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Identify, analyze, and document defects and inconsistencies in software program functions, outputs, online screens, and content, ensuring effects are corrected in a timely manner.- Utilize quality methodology to optimize delivery value; assess internal and external project successes, change requests and cost of change performance measures.
- Implement and maintain a quality management process, including quality gates, lessons learned and other best practice activities.
- Conduct quality management activities for projects to ensure adherence to quality, cost, and schedule parameters for the projects/programs and ensure project plans include sufficient quality management tasks, resources, and schedule impact.
- Interface with the client, company, and project teams, measuring and communicating quality metrics and recommending changes as needed.
What we're looking for
- Three (3) or more years of business analyst, quality assurance, engineering or audit experience required.
- Experience working with quality metrics and software industry metric data collection and analysis techniques.
- Experience working with quality assurance principles and practices.
- Experience working with standard software development methodology assessments and software test science and tools.
- Healthcare or insurance industry claims experience preferred.
What you should expect in this role
- Must be a resident of the state of California
- Monitor the delivery and utilization of covered services by Medi-Cal providers and members, and utilize pertinent data to detect unusual practices, billing anomalies, and potential abuse.
- Analyze and evaluate the delivery and utilization of services on a case-by-case basis, making recommendations to guard against fraudulent or abusive use of services by either providers or members.
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The pay range for this position is $53,900.00 - $77,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. 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.
