C Net Lead US Healthcare Provider Enrollment

Summary

As C# .Net Lead (US Healthcare Provider Enrollment) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. The role does not involve direct access to Protected Health Information (PHI), Personally Identifiable Information (PII), or any secured or confidential client data. The work is limited to management of a variety of projects; it will not include handling or processing of sensitive health or personal information.

Here are the details on this position.

The Technical Functional Area Lead (TFAL) provides hands-on technical expertise and technical leadership for assigned application areas, functional modules, batch processes, interfaces, and delivery workstreams. The TFAL partners with business, technical, delivery, testing, operations, and client-facing stakeholders to translate business needs into supportable technical solutions and to ensure quality execution through design, development, testing, implementation, defect resolution, and production support.

Functional area requirement. The candidate should have experience in one or more Medicaid or healthcare technology functional areas. Relevant functional experience may include Claims, Provider, Member, or closely related functional areas such as Business Process Analysis (BPA), Reference Data / Configuration, Finance, Reporting, Pharmacy, Interfaces, or Operations.

Your role in our mission

• Serve as the technical lead for assigned functional areas, applications, batch processes, interfaces, or workstreams.
• Lead and support technical analysis, design, development, unit testing, implementation, defect resolution, and production support activities.
• Translate functional and business requirements into technical designs, development tasks, implementation plans, and supportable system changes.
• Partner with architects, business analysts, developers, QA teams, operations teams, project managers, and client-facing stakeholders to ensure technical solutions meet business and system requirements.
• Review technical designs, code, test evidence, implementation documentation, and production-readiness materials for quality, maintainability, reusability, and standards alignment.
• Provide technical guidance, mentoring, and day-to-day direction to developers and application team members.
• Act as a subject matter expert for assigned applications, data flows, interfaces, batch jobs, functional modules, and system dependencies.
• Support issue triage, root cause analysis, defect resolution, system maintenance, and production incident response.
• Identify opportunities to improve code quality, batch performance, process efficiency, automation, documentation, and overall system stability.
• Communicate technical risks, dependencies, progress, tradeoffs, and recommendations clearly to project leadership, business stakeholders, and client-facing teams.

What were looking for

Functional Area Experience
The candidate needs to be able to demonstrate expertise in the following areas.
Provider Functional Area Experience
Functional focus: Experience supporting provider enrollment, credentialing, screening, provider maintenance, provider data management, provider workflows, provider portal functionality, and provider-related integrations.
Relevant experience may include:
•    Technical design and delivery for provider enrollment, maintenance, credentialing, screening, provider-data updates, and provider workflow changes.
•    Impact analysis for provider portals, workflow tools, provider master data, provider interfaces, reporting, correspondence, and downstream systems.
•    Support for provider data quality, duplicate resolution, validation rules, provider-related production defects, and root cause analysis.
•    Coordination with Provider SMEs, Provider Operations, BAs, developers, testing teams, integration teams, and client-facing stakeholders.
Desired knowledge areas:
•    Provider enrollment, credentialing, screening, provider maintenance, provider lifecycle, provider status, taxonomy, specialty, affiliations, service locations, and provider data concepts.
•    Provider portal, workflow queues, document intake, provider correspondence, provider interfaces, and operational reporting.
•    Downstream impacts to claims, reporting, directories, finance, data warehouse, and client systems.

Technical Expertise:
Work Experience with the following technologies: 
o    . NET MVC
o    Entity Framework -Object-Relational Mapping (ORM) tools
o    WEB API
o    LINQ, jQuery
o    Web Services
o    MS-SQL / Oracle
o    ASP .NET
o    IIS Configuration
o    Visual Studio Editor
o    VS Code
o    GitHub

What you should expect in this role

• Remote work environment
• Shift timing: 11:30 AM to 8:30 PM IST