Provider Relations Representative Hybrid Williston, VT

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

The Provider Relations Representative serves as the primary liaison between Vermont Medicaid providers and Gainwell Technologies. This role is responsible for building and maintaining positive provider relationships, delivering provider education, resolving complex provider inquiries, supporting claims and billing issue resolution, and ensuring providers have the tools and knowledge needed to successfully participate in the Vermont Medicaid program. The position works closely with State partners, Provider Enrollment, Claims, Prior Authorization, EDI, Member Services, and other operational teams to improve the provider experience and support program objectives.

Your role in our mission

• Serve as the primary point of contact for providers within assigned provider type designations.

• Respond to provider inquiries regarding Vermont Medicaid billing, policies, procedures, and system navigation.

• Conduct outreach to onboard and engage new providers, communicate known issues, and support provider education.

• Review high-denial claims weekly, analyze returned claims, and coordinate follow-up to support resolution.

• Conduct virtual or on-site provider visits as requested and facilitate monthly educational webinars for the provider community.

What we're looking for

• Collaborate with State of Vermont agencies on provider-related tasks, initiatives, and operational needs.

• Manage escalations from other Gainwell departments, ensuring timely and effective resolution.

• Monitor and manage the shared provider inbox on a rotating basis, maintaining accurate documentation of interactions and resolutions.

• Partner with cross-functional teams to improve provider experiences, operational efficiency, and service delivery.

• Identify trends, recommend process improvements, and perform additional duties to support Provider Relations team objectives.

• Perform other duties as assigned to support the Provider Relations team and organizational goals.

What you should expect in this role

Hybrid position. You will be required to be onsite for some trainings and meetings but the majority of the time will be remote.

Provider Representative - Williston, VT (Hybrid)

8:30-5:00 Monday through Friday

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“The deadline to submit applications for this posting is11/15/2026.”

The pay range for this position is $43,800.00 - $62,500.00 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 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.