Senior Provider Enrollment Specialist Hybrid Warwick, RI

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 Senior 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.

Your role in our mission

• Review, validate, and process Medicaid provider enrollment applications in accordance with Rhode Island Medicaid guidelines, ACA requirements, and federal regulations, ensuring compliance with established standards.

• Conduct provider screening, maintain accurate provider records, verify enrollment documentation, and safeguard confidential information, including licensing, tax identification, and credentialing data.

• Research and resolve enrollment issues, respond to provider inquiries, and collaborate with Gainwell Technologies personnel and State Medicaid liaisons to support enrollment operations.

• Develop and maintain reports for tracking, compliance, productivity, and quality monitoring while utilizing enrollment systems and Windows-based applications.

• Monitor federal and state policy and regulatory changes, advise leadership on process implications and required actions, and recommend improvements to operational efficiency.

What we're looking for

• Excellent customer service, interpersonal, written communication, and computer skills, with proficiency in Microsoft Office and Windows-based systems.

• Strong attention to detail and ability to maintain accuracy, confidentiality, and sound judgment when handling sensitive provider information.

• Ability to conduct independent research, evaluate information, interpret and apply policies, procedures, government regulations, and healthcare guidelines, and make informed decisions.

• Strong organizational, time management, and prioritization skills, with the ability to adapt to changing priorities in a fast-paced environment.

• Self-motivated and able to work independently and collaboratively while maintaining productivity and supporting team goals.

What you should expect in this role

• High School Diploma or equivalent required, Associate degree or Bachelor’s degree preferred.
• Previous experience in healthcare administration, provider enrollment, data processing, customer service, or a related field is preferred.
• Ability to read, write, and communicate effectively in English.
• Strong written and verbal communication skills.
• Hours: Monday through Friday, 8:30 AM to 5:00 PM
• Work Arrangement: Onsite during training, then hybrid after training (approximately 4 weeks) in Warwick, RI

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"The deadline to submit applications for this posting is November 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.