Medical Reviewer; Podiatrist; Remote CA

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours.

Gainwell Technologies is seeking a Medical Reviewer (Podiatrist) to provide professional podiatric expertise supporting Medical Review Services for California healthcare programs.

• Review podiatry-related medical records, claims, Treatment Authorization Requests (TARs), and supporting clinical documentation.
• Evaluate requested podiatric services against applicable coverage requirements, medical policies, and clinical standards.
• Apply professional podiatric expertise and clinical judgment when reviewing medical necessity and appropriateness of services.
• Document clinical findings, review decisions, and supporting rationale accurately and timely.
• Refer cases requiring additional clinical review to appropriate medical professionals when needed.
• Collaborate with physicians, nurses, other clinical specialists, operations teams, and business partners to resolve review questions.
• Maintain knowledge of applicable podiatric standards, medical policies, coverage requirements, and regulatory guidelines.
• Meet established quality, accuracy, productivity, and turnaround-time expectations.

• One (1) year of experience working in a variety of clinical settings, ranging from general podiatry services to working with a multi-professional team, is preferred.
• Doctorate or Diploma in Podiatric Medicine, or Diploma in Chiropody.
• Current California State license to practice Podiatry, in good standing.
• Strong clinical judgment and ability to interpret medical records, treatment plans, and supporting clinical documentation.
• Ability to work effectively with multidisciplinary healthcare teams.

• Full-time position.
• Remote work environment.
• Monday through Friday work schedule.
• Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
• Spend the majority of your day reviewing podiatry-related medical, clinical, claim, authorization, treatment plan, and supporting documentation.
• Work independently while collaborating with physicians, nurses, other clinical specialists, operations teams, and business partners.
• Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
• Maintain knowledge of applicable medical policies, coverage requirements, podiatric standards, and regulatory guidelines.
• Meet established quality, accuracy, productivity, and turnaround-time expectations.
• Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.

The pay range for this position is $110,000 - $130,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , 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. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth.

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.