Provider Revalidation Field Representative - Delaware

Provider Revalidation Field Representative - Delaware

Location:

Newark, DE, US, ;
Any city, DE, US, 99999

The Provider Revalidation Field Representative serves as the primary liaison between Gainwell, state Medicaid programs, and the provider community, supporting provider enrollment and revalidation initiatives to ensure healthcare providers remain compliant with CMS, state, and federal participation requirements.

• Conduct proactive outreach to healthcare providers regarding enrollment, revalidation requirements, deadlines, and compliance expectations.
• Serve as the primary point of contact for providers throughout the revalidation process, ensuring timely completion of required documentation and corrective actions.
• Research and resolve provider inquiries related to enrollment, revalidation, credentialing, participation requirements, claims, and billing operations.
• Deliver provider education through individual consultations, webinars, workshops, presentations, and outreach activities designed to improve provider engagement and compliance.
• Monitor provider participation and revalidation progress while collaborating with internal teams to improve completion rates and provider satisfaction.

• Two or more years of experience in provider enrollment, provider relations, credentialing, healthcare operations, medical billing, customer service, Medicaid, Medicare, or a related healthcare environment.
• Experience working with healthcare providers, physician offices, clinics, hospitals, behavioral health providers, long‑term care facilities, or other healthcare organizations.
• Strong verbal and written communication skills with the ability to educate providers, build professional relationships, and deliver excellent customer service.
• Strong organizational, analytical, and problem‑solving skills with the ability to manage multiple priorities and deadlines.
• Proficiency with Microsoft Office applications, including Excel, Outlook, Word, and Teams.

• Support critical provider revalidation initiatives that help ensure continued access to care for Medicaid members.
• Build relationships with healthcare providers and serve as a trusted resource throughout the enrollment and revalidation process.
• Collaborate with Provider Enrollment, Operations, Compliance, Quality Assurance, and Client teams to improve provider participation and compliance outcomes.
• Receive training on state‑specific provider enrollment and revalidation requirements to support provider success and compliance.
• Travel within assigned territories may be required based on project and business needs.

Pay Range: $35,000 - $50,000 per year. Base pay may vary based on geographic region, internal equity, job‑related knowledge, skills, and experience.

Benefits include a generous, flexible vacation policy, 401(k) employer match, comprehensive health benefits, educational assistance, and opportunities for leadership and technical development.

Gainwell Technologies is 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.”