Senior Manager, Medicaid Systems Operations

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

The Senior Medicaid System Operations Manager will manage a team of 30+ System Operations Managers responsible for overseeing the day-to-day operational support, stability, performance, and continuous improvement of the Medicaid Management Information System (MMIS) and related healthcare technology platforms. This role leads operational governance, production support, incident management, release coordination, vendor management, and service delivery activities to ensure Medicaid systems operate efficiently, securely, and in compliance with federal and state regulations.

Your role in our mission

Operational Leadership

• Manage daily operations for Gainwell’s MMIS and integrated Medicaid systems.
• Ensure system availability, reliability, scalability, and performance meet SLAs and operational targets.
• Lead production support activities including monitoring, triage, issue resolution, and root cause analysis.
• Establish and maintain operational procedures, standards, and governance processes.
• Coordinate operational readiness activities for new releases and system enhancements.
• Develop operational metrics, dashboards, and executive reporting.

Incident, Problem & Change Management

• Lead ITIL-based incident, problem, and change management processes.
• Coordinate resolution of high-severity production incidents and facilitate war-room activities.
• Conduct post-incident reviews and implement corrective/preventive actions.
• Ensure proper documentation of operational issues, problems, workarounds, and resolutions.
• Oversee change control processes and production deployment coordination.

Medicaid System Management

• Support core Medicaid modules including:
  • Claims Processing
  • Provider Management
  • Member Eligibility
  • Prior Authorization
  • Care Management
  • Financial Management
  • Pharmacy Systems
  • Data Warehouse and Reporting
• Ensure compliance with CMS regulations, HIPAA requirements, and Medicaid operational standards.

Vendor & Stakeholder Management

• Monitor vendor performance against contractual SLAs and KPIs.
• Collaborate with Account business operations, PMO, infrastructure, security, and application development teams.

Release & Environment Management

• Coordinate release planning and production deployments.
• Production Gatekeeper. Ensures operational acceptance criteria are met prior to implementation.

Compliance & Audit Support

• Support CMS certification activities and operational readiness reviews.
• Ensure compliance with:
  • HIPAA
  • CMS Medicaid Enterprise Standards
  • State security policies
  • Data retention and audit requirements
• Coordinate operational support for audits and regulatory reviews.

Continuous Improvement

• Identify opportunities to improve operational efficiency and system stability.
• Drive automation initiatives for monitoring, alerting, batch operations, and reporting.
• Implement operational best practices and process improvements.
• Drive Root Cause Analysis (RCA) & permanent correction.

What we're looking for

• 7–10+ years of IT operations or Medicaid systems experience.
• 5+ years managing large-scale healthcare or Medicaid system operations.
• Experience supporting MMIS, Medicaid Enterprise Systems (MES), or healthcare payer platforms.
• Experience with production support and IT service management processes.

Preferred Certifications

• ITIL Foundation or ITIL v4 Certification
• PMP Certification

What you should expect in this role

• United States remote opportunity
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• The Deadline to submit applications for this posting is October 22, 2026

The pay range for this position is $108,400.00 - $154,800.00 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.