Experienced Business Analyst - Performance Management

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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 Business Analyst - Performance Management 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 Technologies Performance Management Senior Business Analyst (BA) is responsible for supporting activities to support and monitor providers and members to detect and reduce potential fraud, abuse and quality of care issues within the Medi-Cal Dental Program as a part of Compliance Management.

This role serves to help maintain the integrity of the Medi-Cal Dental Program. You will play a vital role in identifying areas for improvement and assisting in implementing strategies to enhance Program performance.

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.

What we're looking for

• A minimum of five (5) years of experience in a relevant Business Analyst position within healthcare, preferably dental.
• Proficiency in creating, querying, and analyzing reports
• Strong communication skills both in writing and verbal methods, including demonstrated creation and utilization of data visualizations
• Expertise and knowledge of Medi-Cal Dental criteria and program requirements strongly preferred
• Experience with fraud, waste, abuse, and / or surveillance utilization review / SURS.

What you should expect in this role

• Position is hybrid (Roseville, CA) a consistent 2 days per week, to be determined upon hire
• Must reside within commuting distance of Roseville, CA
• Video cameras must be used during all interviews, as well as during the initial week of orientation

The deadline to submit applications for this posting is October 29, 2024

LI-HC1

LI-SURS

LI-Medi-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.