Gainwell Technologies

Security Engineer

• Lead security operational governance activities
• Drive security remediation efforts and SLA/SLO adherence
• Ensure delivery excellence in security tooling and business operations
• Manage relationships with Gainwell Technologies suppliers and the client
• Create and maintain account security plans for selected accounts and products
• Manage and report security incidents from start to finish
• Manage audit preparation, facilitation, and remediation
• Manage security risks and exceptions
• Ensure implementation of security fundamentals, policies, and regulatory and contractual standards
• Escalate and resolve security issues
• Coordinate security metrics and reporting in support of contractual commitments
• Present security information clearly and confidently

Information Security Officer – ISO

Vice President

• Own end-to-end baseline Provider business architecture across enrollment, screening, credentialing, provider data management, portals, interfaces, correspondence, and related capabilities
• Establish reusable process models, capability maps, roles, information flows, business rules, and reference designs for Provider solutions
• Lead application design and configuration standards, ensuring requirements, product capabilities, gaps, extensions, and configuration decisions are traceable and executable
• Govern design decisions and exceptions through stage gates, decision rights, owners, deadlines, and escalation paths
• Ensure business requirements include how-met responses, acceptance and testing criteria, dependencies, architectural alignment, and contractual alignment
• Partner with Solutioning, Product, Engineering, and Implementation to translate proposals, contracts, and statements of work into governed designs
• Provide business-architecture leadership across Provider DDIs, including configuration readiness, product-gap resolution, client decisions, and implementation transition
• Act as a hands-on, servant leader solving complex client solution challenges
• Monitor federal and state regulatory changes and maintain compliant Provider processes, business rules, and application designs
• Coordinate with executives across engineering, product management, solutioning, and implementation to resolve cross-functional problems
• Drive DDI transformation through standardization, reusable assets, automation, AI-enabled design and configuration, and implementation-learning adoption
• Measure and improve design reuse, configuration efficiency, quality, cycle time, and cost; make investment needs and tradeoffs visible
• Manage a growing team of 50+ professionals supporting Provider DDIs

Vice President, Provider Solutions – Business Architecture

Software Engineer

• Design, develop, maintain, and support complex batch processing applications within Linux and Unix environments
• Provide technical leadership by mentoring developers, guiding solution design, conducting code reviews, and supporting all phases of the Software Development Life Cycle in Agile and Waterfall environments
• Collaborate with business analysts, architects, quality assurance teams, and stakeholders to translate business requirements into technical solutions
• Analyze, troubleshoot, and resolve complex application and database issues using SQL Server and/or Oracle
• Perform root cause analysis and implement corrective actions to improve system performance and stability
• Support change management, release planning, production deployments, and continuous improvement initiatives
• Help drive modernization through automation, cloud technologies, and DevOps best practices
• Contribute to the design and support of Medicaid healthcare systems, including claims processing, reference systems, PBM, Drug Rebate, ProdDur, batch processing environments, and other mission-critical healthcare applications
• Develop and maintain technical documentation, process flows, and support materials

Pharmacy Claims/Application Developer

• Serve as a trusted security advisor for assigned accounts
• Align information security practices with client objectives, regulatory requirements, and operational standards
• Lead security governance activities and support delivery excellence across assigned accounts and products
• Maintain account system security plans
• Coordinate security metrics, reporting, audit preparation, and remediation efforts
• Manage and report security incidents, risks, exceptions, threats, and vulnerabilities in alignment with service level agreements
• Partner with Gainwell teams, suppliers, and client stakeholders to promote consistent security standards
• Resolve compliance concerns
• Support multiple accounts, products, or suppliers while balancing operational delivery and compliance expectations
• Collaborate with client and internal leadership, information governance, and IT security stakeholders

Information Security Officer

SDET

• Support the full life cycle of testing
• Review software requirements and prepare test scenarios
• Collaborate with business analysts, developers, and stakeholders to understand requirements and design comprehensive test plans
• Develop detailed test cases, test scripts, and test data based on functional specifications and user stories
• Perform system, integration, regression, and user acceptance testing
• Execute manual test cases to identify defects and ensure software quality
• Log defects, collaborate with development teams to prioritize and resolve them, and retest fixes
• Document test results, prepare test summary reports, and communicate findings to stakeholders
• Maintain accurate records of test cases, test scripts, and test data
• Work with cross-functional teams to align on project goals and requirements
• Adhere to QA processes and enforce quality best practices
• Assist in outlining new product/service business case justification and evaluating proposed client benefits
• Analyze test results for database impacts, errors, bugs, and usability
• Report testing outcomes to design teams

Functional Test Engineer

• Own scope, schedule, cost, quality, contractual commitments, go-live, stabilization, and transition to operations across assigned Provider DDIs
• Maintain an integrated portfolio view of milestones, dependencies, staffing, risks, decisions, financial performance, and recovery actions
• Provide reporting that drives executive decisions and resolution
• Manage relationships with client executives and implementation teams to meet client needs and ensure satisfaction
• Lead integrated governance across Provider DDIs with clear decision rights, participants, outputs, and escalation paths
• Enforce stage gates and approved baselines across solution strategy, architecture, scope, cost, staffing, schedule, product gaps, dependencies, and operational readiness
• Drive transformation of solution delivery practices and ensure compliance across projects and teams
• Align Product, Engineering, Architecture, Solutioning, Implementation, Customer Experience, Systems, Security, Data and Analytics, Finance, Account leadership, and delivery partners
• Pressure-test delivery assumptions and require executable recovery plans with accountable owners, deadlines, dependencies, and measurable exit criteria
• Own delivery economics, including budget, forecast, estimate at completion, labor and non-labor costs, change control, revenue timing, margin, productivity, and resource utilization
• Keep delivery plans, staffing, forecasts, cost models, pricing assumptions, and contractual commitments aligned to an executable baseline
• Drive DDI optimization through standardization, reusable assets, earlier value creation, environment readiness, automation, AI-enabled delivery, and continuous improvement
• Build a scalable Provider delivery organization with clear roles, RACIs, capacity and succession plans, performance expectations, and lessons-learned adoption
• Directly manage project-dedicated senior leaders overseeing individual implementations
• Serve as an executive leader for multiple concurrent Provider DDIs and collaborate across business, product, technology, implementation, client, and supporting functions

Vice President, Provider Solutions – DDI Delivery

• Design, develop, maintain, and support complex batch processing applications in Linux and Unix environments
• Provide technical leadership, mentor developers, guide solution design, conduct code reviews, and support all SDLC phases
• Collaborate with business analysts, architects, quality assurance teams, infrastructure, project management, and stakeholders
• Translate business requirements into scalable technical solutions meeting client, regulatory, and operational needs
• Analyze, troubleshoot, and resolve complex application and database issues using SQL Server and/or Oracle
• Perform root cause analysis and implement corrective actions to improve system performance and stability
• Support change management, release planning, production deployments, and continuous improvement initiatives
• Drive modernization through automation, cloud technologies, and DevOps practices
• Design and support Medicaid healthcare systems, including claims processing, reference systems, PBM, Drug Rebate, ProdDur, and batch processing environments
• Develop and maintain technical documentation, process flows, and support materials

Associate

• Evaluate omni-channel interactions, including calls, emails, chats, and back-office transactions, for accuracy, quality, compliance, and regulatory adherence
• Participate in and facilitate quality calibration sessions when assigned
• Communicate quality insights and trends to operational leaders and key stakeholders
• Escalate unresolved quality concerns, coaching referrals, compliance risks, and process improvement opportunities
• Recommend and support data-driven process, policy, and technology improvements
• Conduct daily reviews and audits to ensure adherence to client, company, and regulatory standards, policies, and procedures
• Contribute to planning, execution, and delivery of quality initiatives
• Partner with centralized and account teams to improve employee, member, and client experiences

Associate Professional Quality CT

• Own scope, schedule, cost, quality, contractual commitments, go-live, stabilization, and transition to operations across assigned Provider DDIs
• Maintain an integrated portfolio view of milestones, dependencies, staffing, risks, decisions, financial performance, and recovery actions
• Provide reporting that drives executive decisions and resolution
• Maintain relationships with client executives and implementation teams to ensure client needs and satisfaction
• Lead integrated governance across Provider DDIs with clear decision rights, participants, outputs, and escalation paths
• Enforce stage gates and approved baselines across solution strategy, architecture, scope, cost, staffing, schedule, product gaps, dependencies, and operational readiness
• Drive transformation of solution delivery practices and ensure compliance across projects and project teams
• Align Product, Engineering, Architecture, Solutioning, Implementation, Customer Experience, Systems, Security, Data and Analytics, Finance, Account leadership, and delivery partners
• Pressure-test delivery assumptions, surface constraints, and require executable recovery plans
• Own delivery economics, including budget, forecast, estimate at completion, labor and non-labor costs, change control, revenue timing, margin, productivity, and resource utilization
• Keep delivery plans, staffing, forecasts, cost models, pricing assumptions, and contractual commitments aligned to an executable baseline
• Drive DDI optimization through standardization, reusable assets, earlier value creation, environment readiness, automation, AI-enabled delivery, and continuous improvement
• Build a scalable Provider delivery organization with clear roles, RACIs, capacity and succession plans, performance expectations, and lessons-learned adoption
• Directly manage project-dedicated senior leaders overseeing individual implementations
• Act as a servant leader, helping teams solve complex solution delivery, project delivery, and client engagement problems

• Evaluate omni-channel interactions, including calls, emails, chats, and back-office transactions, for accuracy, quality, compliance, and adherence to regulatory requirements
• Participate in and, when assigned, facilitate quality calibration sessions
• Communicate quality insights and trends through regular engagement with operational leaders and key stakeholders
• Escalate unresolved quality concerns, coaching referrals, compliance risks, and process improvement opportunities
• Recommend and support data-driven process, policy, and technology improvements
• Monitor and evaluate voice and non-voice interactions for accuracy, compliance, and experience
• Conduct daily reviews and audits to ensure adherence to client, company, and regulatory standards, policies, and procedures
• Contribute to planning, execution, and delivery of quality initiatives
• Partner with centralized and account teams to enhance employee, member, and client experiences

Senior Associate Processor

Manager

• Own the strategic direction and delivery of Medicaid Drug Rebate solutions
• Manage directly or indirectly a team of 5+ members across development, testing, implementation support, and drug rebate operations
• Manage drug rebate tasks, including problem resolution, quality control, performance, and change requests
• Manage client relationships through daily operations, change requests, special projects, and system implementations
• Provide project oversight and management of rebate teams and tasks
• Prepare test documents and oversee testing plans for new development and change requests
• Prepare RFI/RFP bid responses and provide demonstrations and presentations of Gainwell’s Drug Rebate solution
• Oversee and assist with drug rebate Design, Development, and Implementations (DDIs) and system enhancement design
• Contribute to Drug Rebate direction, strategy planning, resourcing, and forecasting
• Oversee staff productivity and performance metrics
• Support new initiatives, federal program changes, and state-specific enhancements
• Drive innovation and continuous improvement across product strategy, operational processes, and delivery capabilities

Senior Manager, Drug Rebate Product

Learning and Development

• Deliver engaging and interactive training sessions to new and existing call center agents and other departments such as field services teams
• Facilitate virtual training programs to enhance employee skills and performance
• Adapt training delivery to various learning styles and needs
• Design visually engaging and interactive training materials and presentations using modern adult learning principles
• Collaborate with the LKI training team, subject matter experts, and account leaders
• Provide post-training support and resources to learners and call center leadership
• Assess training outcomes through surveys, feedback, and performance metrics

Training Specialist

• Establish and document tailored quality plans for assigned projects or tasks
• Develop and maintain standardized quality assurance documentation and quality metrics
• Conduct assessments and evaluations to verify compliance with standards and quality plans
• Determine process and product quality levels
• Report findings and escalate unresolved issues
• Evaluate work products and recommend solutions or approaches
• Gather, use, and independently analyze defect metrics data
• Communicate analysis findings verbally and through periodic written reports
• Participate in special projects, external audits, and process improvements supporting quality assurance initiatives

Associate Professional Quality

• Verify and audit documents for accuracy
• Check numerical data against input or reports
• Prepare document batches for data entry and imaging
• Identify issues and escalate them appropriately
• Research problems and follow up with clients regarding resolution
• Interface with management, clients and customers to resolve issues
• Respond to written inquiries and correspondence
• Photocopy and file reports and documents
• Type forms or labels as necessary
• Analyze and report findings
• Interpret, audit and reconcile reports for accuracy or completeness
• Maintain log records and provide periodic status reports
• Process and track forms, mail and transactions
• Accumulate and verify data to process vouchers and produce billings or documents
• Expedite processing of checks, invoices and other transactions
• Prepare deposits as necessary
• Prioritize and delegate work to the team
• Lead, train and assist team members
• Monitor daily employee activity for policy and procedure compliance
• Coordinate scheduling with managers and employees
• Provide work guidance to less experienced personnel
• Handle confidential company data according to policy
• Review, recommend and implement procedure and workflow modifications

• Evaluate omni-channel interactions, including calls, emails, chats, and back-office transactions, for accuracy, quality, compliance, and adherence to regulatory requirements
• Participate in and, when assigned, facilitate quality calibration sessions to support consistent evaluation practices
• Communicate quality insights and trends through regular engagement with operational leaders and key stakeholders
• Escalate unresolved quality concerns, coaching referrals, compliance risks, and process improvement opportunities
• Recommend and support data-driven process, policy, and technology improvements that strengthen QA efficiency and effectiveness
• Conduct daily reviews and audits to ensure adherence to client, company, and regulatory standards, policies, and procedures
• Contribute to planning, execution, and delivery of quality initiatives
• Partner with centralized and account teams to enhance employee, member, and client experiences