Provider Revalidation Field Representative - Colorado

Provider Revalidation Field Representative - Colorado

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 Revalidation Field Representative serves as the primary liaison between Gainwell, state Medicaid programs, and the provider community. This role supports provider enrollment and revalidation initiatives to ensure healthcare providers remain compliant with CMS, state, and federal participation requirements. The Provider Revalidation Field Representative partners directly with healthcare providers to drive successful completion of provider enrollment and revalidation activities. This role serves as a trusted resource, helping providers navigate Medicaid participation requirements, maintain regulatory compliance, and avoid disruptions in reimbursement or network participation.

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 (2) 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.

The pay range for this position is $35,000 - $50,000 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 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.