Provider Enrollment Specialist Hybrid Warwick, R

Provider Enrollment Specialist Hybrid Warwick, RI

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.

The Provider Enrollment Specialist is responsible for supporting provider enrollment and screening activities for the Rhode Island Medicaid Program. This role ensures the accurate and timely processing of provider enrollment applications in compliance with Rhode Island Medicaid policies, Affordable Care Act (ACA) requirements, and applicable federal regulations. The specialist maintains provider records, responds to enrollment-related inquiries, and collaborates closely with Gainwell Technologies and State Medicaid representatives to ensure program integrity and operational excellence.

Review, validate, and process Medicaid provider enrollment applications in compliance with Rhode Island Medicaid guidelines, ACA requirements, and federal regulations. Maintain and update provider records, conduct enrollment screenings, and ensure documentation is accurate, complete, and compliant. Research, analyze, and resolve provider enrollment issues while responding to provider inquiries regarding enrollment status and requirements. Collaborate with Gainwell Technologies teams and State Medicaid representatives to support enrollment operations and meet productivity, quality, and compliance standards.

Utilize enrollment systems and Microsoft Office applications to perform daily responsibilities while identifying opportunities for process improvements and operational efficiencies.

Excellent customer service, interpersonal, and computer proficiency skills. Strong attention to detail with the ability to accurately manage sensitive provider information. Strong analytical and problem-solving skills, including the ability to research, evaluate information, and apply policies and regulations. Excellent organizational, time management, and prioritization skills, with the ability to adapt in a fast-paced environment. Proficiency with Microsoft Office and Windows-based applications, with the ability to work independently while maintaining confidentiality.

High school diploma or equivalent required;
Associate's or Bachelor's degree preferred. Previous experience in healthcare administration, provider enrollment, data processing, customer service, or a related field preferred. Ability to read, write, and communicate effectively in English with strong written and verbal communication skills. Position is hybrid following training; during the training period, employees are expected to work primarily onsite. Schedule is Monday through Friday, 8:30 AM to 5:00 PM.

Office location is in Warwick, Rhode Island.

The deadline to submit applications for this posting is 8/1/26. The pay range for this position is $35,000.00 - $50,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. 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.

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."