Senior Manager, Healthcare Fraud & Program Integrity

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

Are you an experienced Program Integrity, SIU, MFCU, payment integrity, or healthcare investigations leader who is passionate about helping teams leverage technology to work more effectively? Gainwell is seeking a customer-focused leader to serve as the primary client advocate and support leader for FraudCapture. This role is ideal for someone who combines healthcare fraud, waste, and abuse expertise with a passion for user enablement, training, troubleshooting, and client success. You will lead onboarding, training, support operations, and client engagement activities that help investigators, analysts, and supervisors maximize the value of a sophisticated analytics and case management platform.

As the Senior Manager, Customer Support , you will lead all client support, training, onboarding, and enablement activities for FraudCapture while partnering closely with Medicaid agencies, managed care organizations, and program integrity teams across the country. You will work directly with Product Management, Engineering, and Account Management to resolve client issues, improve platform usability, develop training content, and ensure a consistently high-quality customer experience. This is a unique opportunity for a leader who enjoys the intersection of technology, operations, and client engagement, and who wants to influence how healthcare organizations leverage advanced analytics and investigative technology to combat fraud, waste, and abuse.

Your role in our mission

• Client Experience & Delivery
  • Manage all client‑facing sessions across the lifecycle including new‑client training, implementation workshops and hyper-care meetings and recurring office‑hours.
  • Establish a training curriculum (investigator, analyst, supervisor tracks); deliver live and on demand sessions.
  • Manage client user account setup and ongoing administration, including user onboarding/offboarding, role-based access provisioning, role changes, and periodic user access maintenance.
  • Create and manage the Client Communication Plan (cadence, templates, channels) for outages, fixes, feature launches, and policy updates.
  • Develop deep functional expertise in FraudCapture and serve as an escalation point for complex user questions, system configuration issues, and workflow troubleshooting.
  • Own user defect intake/triage and end‑to‑end defect management, including SLAs, client communication, and resolution tracking; publish regular defect and trend reports.
  • Monitor product adoption, training effectiveness, and support trends; recommend improvements to increase client satisfaction and platform utilization.
• Content, Documentation & Releases
  • Manage the creation and maintenance of all training content and videos (how‑to guides, role‑based job aids, quick starts).
  • Own release notes and “What’s New” content; coordinate with Product & Engineering teams to ensure accuracy and clarity for different user audiences.
• Support Operations & Team Leadership
  • Manage, coach, and scale the customer support staff, including hiring, onboarding, scheduling, and performance management.
  • Establish, monitor, and continuously improve support processes and SLAs, including response times, resolution targets, escalation procedures, ticket quality, and customer satisfaction metrics.
  • Support CMS certification and reporting requirements, including coordinating required documentation, evidence, system information, and recurring reporting needed to demonstrate compliance and support certification activities.
• Cross‑Functional Collaboration
  • Work closely with Product Management to relay client issues, validate use cases, and coordinate UAT/hyper-care for new features.
  • Partner with Engineering and QA to reproduce defects, provide clear repro steps/data, monitor fixes, and schedule deployments.
  • Support Sales and Customer Success with demos, proof‑points, and RFP responses where operational/functional depth is required.

What we're looking for

• Bachelor's degree or equivalent combination of education and experience
• 5+ years of direct healthcare fraud and abuse investigation experience, with a strong understanding of how healthcare FWA detection analytics and case management systems are used by investigative teams to identify, investigate, document, and manage potential fraud, waste, and abuse.
• Leadership experience in customer support, customer success, or services for SaaS software solutions
• Proven success designing and delivering training programs and managing client interactions
• Strong experience with defect management and communication across technical and non‑technical stakeholders
• Strong business and analytical problem-solving skills
• Excellent written and verbal communication skills
• Strong ability to multi-task and work independently
• Strong ability to establish priorities and objectives for operation with limited direction
• Investigative credentials (e.g., CFE or AHFI) & prior PI/MFCU/SIU leadership experience
• Experience supporting or managing certified coders is a plus.

What you should expect in this role

• Serve as the primary client-facing leader for FraudCapture support, training, and user enablement activities.
• Collaborate daily with Product Management, Engineering, Account Management, and program integrity stakeholders.
• Travel approximately 10-25% to support client implementations, training events, conferences, and strategic meetings.

Applications for this role will be accepted until 11/9/2026.

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The pay range for this position is $109,000.00 - $155,700.00 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.