Senior Long-Term Care – Rate Setting Analyst

Gainwell Technologies

. Lead the development, enhancement, and documentation of rate-setting models for long-term care programs .

Posted 9/22/2026full-timeRemote • Wisconsin • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in financial modeling, Medicaid policy analysis, and long-term care reimbursement methodologies, with strong capabilities in data analysis and communication to translate complex insights into actionable recommendations.

Highest-signal resume keywords

Financial ModelingMedicaid Policy AnalysisStatistical AnalysisData InterpretationLong-Term Care Ecosystem

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quantitative ModelingRate-Setting MethodologiesData AnalysisExcelRSASSTATASPSSSQLStatistical Models

Soft Skills

Strong Communication SkillsProblem-Solving SkillsAbility to Work IndependentlyProject Management

Tools & Technologies

Data Warehouse Tools

Industry Keywords

Managed Care OrganizationsHealthcare ReimbursementPublic PolicyCapitated Payment ModelsWisconsin MedicaidState/Federal RegulationsLong-Term Care Programs

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Lead the development, enhancement, and documentation of rate-setting models for long-term care programs
Use advanced analytical techniques and large datasets to evaluate costs, trends, and reimbursement outcomes
Assess how rate changes, policy updates, and cost drivers affect Managed Care Organizations (MCOs)
Translate business needs into clear data, system, and policy requirements
Research reimbursement methodologies, program operations, and the long-term care ecosystem to recommend improvements
Support the development and implementation of capitated rate-setting methodologies for contracted MCOs
Validate the accuracy and sufficiency of rates produced by established models
Monitor State and Federal policy changes, with emphasis on Wisconsin Medicaid, and assess operational and financial impact
Partner with internal teams, business leaders, and external stakeholders to promote transparency and alignment in rate-setting practices
Prepare written analyses, presentations, and recommendations for leadership, clients, and technical teams

Requirements

What you’ll need

6+ years of experience in business analysis, financial modeling, health policy analysis, Medicaid policy analysis, public administration, or public sector program evaluation
Strong data expertise, including understanding how rate-setting decisions impact Managed Care Organizations (MCOs)
Experience interpreting public policy, preferably within healthcare and/or Wisconsin Medicaid
Understanding of the Long-Term Care (LTC) ecosystem, including program structures and reimbursement models
Advanced skills in Excel and/or R, SAS, STATA, or SPSS
Strong statistical analysis, quantitative modeling, and data interpretation skills
Strong communication skills to translate complex analytical work into clear, actionable insights
Ability to work independently, manage timelines, and support multiple projects at once
Bachelor's degree in Public Administration, Public Policy, Economics, Statistical Analysis, Healthcare Administration, Finance, or a related field
Experience evaluating government, business, or healthcare policies that affect internal and external partners
Experience with Medicaid programs, rate-setting methodologies, or capitated payment models
Experience analyzing large datasets and developing quantitative or statistical models
Ability to write and present comprehensive reports, analyses, and policy summaries
Strong problem-solving skills and a track record of recommending improvements to business or technical processes
Experience with SQL or data warehouse tools
Familiarity with State/Federal regulations influencing long-term care and Medicaid operations
Professional experience working within a state Medicaid agency, state policy office, healthcare policy organization, or government-funded healthcare program
Experience working for or directly supporting Managed Care Organizations (MCOs), including an understanding of managed care financing and oversight
Knowledge of Medicaid policy, healthcare reimbursement methodologies, actuarial concepts, and capitation rate development
Experience evaluating the financial and operational impacts of capitation rates, rate adjustments, and value-based payment arrangements
Must join screenings, interviews, and meetings from a quiet location with a stable internet connection
Video camera required during interviews and the initial week of orientation
Photo required during screening for verification throughout recruitment

Benefits

Comp & perks

Work flexibility
Learning and career development
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies
Base pay may vary based on geographic region, internal equity, job-related knowledge, skills, and experience