Gainwell Technologies

Business Operations

• Analyzes, plans and implements moderately complex operational process improvement needs.
• Supports long-term planning sessions with a single client to improve business processes.
• Identifies process improvement needs and communicates issues to authorized personnel.
• Provides consultation on the use of moderately complex re-engineering techniques.
• Deploys plans from conception through closing on moderately complex aspects of re-engineering projects.
• Develops moderately complex metrics for process management and future improvement opportunities.
• Collects data to identify root cause problems.
• Measures performance against process requirements and aligns improvement projects.

Senior Business Process Consultant

Backend Engineer

• Code, test, debug, implement, and document low to moderately complex programs
• Create appropriate documentation in work assignments such as program code, and technical documentation
• Design systems and programs to meet business needs
• Prepare detailed specifications from which programs are developed and coded
• Gather information from existing systems, analyzes program and time requirements
• Assist project manager in preparing time estimates and justification for assigned tasks
• Write specifications for programs of low to moderate complexity
• Develop test plans to verify logic of new or modified programs
• Conduct quality assurance activities such as peer reviews

Software Developer, .NET, C#, UI Development

Software Engineer

• Working Experience with the following technologies: C, Unix/Linux Systems, Oracle SQL, PL/SQL
• Codes, tests, debugs, implements, and documents programs
• Assists in the modification of company products and/or internal systems to meet the needs
• Gathers information from the system, analyses program and time requirements, and prepares documentation to change existing programs
• Researches and analyses existing systems and program requirements, under periodic supervision
• Designs programs for projects or enhancements to existing programs
• Writes specifications for programs of low to moderate complexity
• Assists in resolving issues & defects
• Develops and suggests alternative approaches to resolving problems
• Develops test plans to verify logic of new or modified programs
• Identifies issues as appropriate
• Creates appropriate documentation in work assignments such as program code, and technical documentation
• Conducts quality assurance activities such as peer reviews
• Expertise in Batch job automation and notification services
• Complex SQL work experience and query tuning expertise
• Experience working with Member, Managed Care, Provider, Financial, Claims domain is a plus
• Experience with technical product configuration, design, and/or integration

C Developer, Batch Developer

Call Center Representative

• Provide knowledgeable responses to basic client questions; elevate more complex cases to appropriate staff as needed
• Put your skills to work to solve client problems, update account history and follow up with clients to confirm their inquiry or request is resolved
• Adhere to the client’s SLAs and consistently meet production targets
• Collaborate with team members, management and clients to resolve client inquiries; cross-train new resources in customer service processes
• Process client inquiries more efficiently and effectively by reviewing and recommending changes to procedures and workflow

Healthcare Contact Center Agent

Business Analyst

• Act as a liaison between business stakeholders (state, pharmacy operations, internal teams) and technical teams
• Support end-to-end delivery by collaborating with cross-functional teams to validate and implement system maintenance requests
• Develop and execute test plans and test cases
• Validate system functionality and perform post-implementation verification to ensure solutions meet business directives
• Identify risks, gaps, and dependencies and proactively work with the team to drive resolution

Business Analyst – Pharmacy

Data Engineer

• Gainwell Technologies is seeking a highly skilled AI and GEN AI Engineer to design, develop, and deploy advanced AI and Generative AI (Gen AI) solutions, across our healthcare technology platforms.
• This role involves building and optimizing AI and GEN AI technologies, integrating them into existing systems, and ensuring their effectiveness in improving healthcare outcomes and operational efficiency while maintaining compliance with industry standards
• Development based on AI/ GEN AI – Design, build, and train machine learning, deep learning, time series models, Gen AI (Multi modal LLMs), predictive analytics, Natural Language Processing, Image Processing solutions for healthcare applications
• Experienced in multiple LLM fine tuning techniques
• Experienced in building GEN AI solutions using RAG architecture
• Skilled in both Lang Chain and Lang Graph
• Experience in Agentic AI Frameworks and Workflow using Lang Chain, Lang Graph or Crew AI or Open AI Swarm
• Experienced in multiple Vector Databases as well as Graph Database Skilled in Agentic AI Framework and has built at least one solution using Agentic AI
• End-to-End AI Solution Deployment – Develop, test, and deploy AI solutions in cloud and on-premises environments, ensuring reliability, scalability, and real-world impact
• Data Processing – Work with large healthcare datasets, performing data preprocessing, feature engineering, and model training while ensuring compliance with HIPAA and other regulatory standards
• System Integration – Skilled in API development and integrations
• Implement and optimize AI models within Gain well’s existing technology stack, collaborating with software engineers to ensure seamless integration
• Experienced in ML Ops and LLM Ops
• Experienced in evaluating models and continuous performance monitoring of both ML/DL and LLMs
• Experienced in applying security measures in GEN AI solutions, implementing guard rails
• Performance Optimization – Continuously monitor, refine, and optimize AI / GEN AI models for accuracy, efficiency, and speed, leveraging ML Ops and LLM Ops best practices
• AI Research & Innovation – Stay updated with the latest AI/ML/ GEN AI advancements, exploring new technologies and methodologies to enhance solution effectiveness
• Compliance & Security – Ensure AI implementations adhere to healthcare industry regulations, ethical AI principles, and data privacy standards
• Automation & Workflow Enhancement – Identify opportunities to automate workflows and optimize business processes using AI-driven solutions
• Front End Development – Stream lit is a must. Good to have React, Angular or Vue.js
• Leadership Skills – Should be able to work as a team lead, interface with team leads of other functions/departments, understand business requirements and translate the same to an appropriate solution that is feasible to develop and deploy.

Data Science AI Engineer

Scheduler

• Develop and maintain a fully integrated master schedule with detailed WBS, dependencies, and critical path
• Use advanced Microsoft Project capabilities (resource loading/leveling, baselining, variance analysis, reporting)
• Coordinate with project managers and stakeholders to validate timelines, assumptions, and constraints
• Analyze schedule performance, identify risks/impacts, and recommend corrective actions to maintain delivery timelines
• Manage schedule updates, change control, and versioning in alignment with PMO standards
• Produce executive-level reporting on milestones, critical path, and schedule health

Master Scheduler

Solutions Engineer

• Seeking an AI Solution Engineer to leverage .NET and Cloud environment AI-assisted delivery: Coding in a Copilot/GenAI driven environment
• Will perform solution architecture, orchestration, and validation versus hands-on coding
• Strengthen GenAI responsibilities: Responsible for LLM, prompt engineering, and MLOps content, positioned as core
• Designing AI-driven workflows, evaluating model outputs, and ensuring reliability and compliance
• Reviewing .NET code for integration layers, APIs, and enterprise patterns
• Accelerating delivery using AI tools (Copilot, code generation, test automation, etc.)
• Defining AI usage patterns, guardrails, security, and compliance
• Writing highly complex design, coding and testing documentation
• Providing technical consulting on highly complex projects
• Leading and mentoring a team of technical professionals

AI Solution Engineer, Healthcare Membership

Account Manager

• Cultivate client relationships and be the voice of Gainwell as a trusted advisor and thought leader
• Manage the operations of your account, including SLAs, security remediation, outage management, resource oversight, staffing, project health, implementations, and quality assurance
• Understand the data and own the outcomes for your client
• Develop a client-centered innovation agenda to proactively engage with client on their business needs and goals
• Harness Gainwell innovative spirit to meet and exceed contractual commitments
• Guide and mentor the delivery and operations team for your account
• Manage the financial quality of the account

Project Manager

• Strengthen the quality and smooth running of important projects as we create innovative, purpose-built technologies and solutions for our company and clients.
• Lead one or more medium-sized project management teams by overseeing smaller aspects of a larger technological program.
• Go all in as you contribute directly to projects, assist in staffing and overseeing assigned staff by providing direction and deadlines to ensure quality and the timely completion of tasks.
• Interface with the client, company and project team leadership, measuring and communicating project metrics and recommending program changes as needed.
• Drive the quality of project deliverables across all phases of the program by creating objectives, schedules, program definitions and budgets.
• Help ensure project timeliness and quality by identifying and mitigating risk through status reporting and project updates.
• Prepare detailed SOW for clients and obtain agreement and approval from stakeholders on the scope of that work.

Senior Project Manager

• Design, develop, and deploy advanced AI and Generative AI (Gen AI) solutions, across healthcare technology platforms
• Build and optimize AI and GEN AI technologies, integrating them into existing systems
• Ensure effectiveness in improving healthcare outcomes and operational efficiency while maintaining compliance with industry standards
• LLM Fine-Tuning: Hands-on with multiple techniques
• Agentic AI: Built solutions using LangChain, LangGraph, CrewAI
• Data Processing: Preprocessing, feature engineering, model training on large healthcare datasets
• System Integration: Skilled in API development, seamless integration with existing stacks
• Performance Optimization: Continuous monitoring, refinement, ML Ops & LLM Ops best practices
• Compliance & Security: Guardrails, ethical AI, HIPAA/CMS adherence
• Automation: Workflow enhancement through AI-driven solutions
• Frontend: Streamlit required; React/Angular/Vue.js preferred
• Leadership: Team lead experience, cross-functional collaboration, translating business needs into deployable solutions

Gen AI Engineer, Data Science

Analyst

• Working under the supervision of the Pharmacy Benefit Manager within the Bureau of Clinical Policy and Pharmacy and serves as an embedded resource on the pharmacy team.
• Collaborate with a team of policy analysts, systems analysts, and clinical staff.
• Assessment, monitoring, and ongoing maintenance of the drug reference file, which includes items covered under the pharmacy benefit and physician-administered drugs.
• Serves primarily as an information and data analyst for the drug reference file and is responsible for the evaluation and ongoing management needed for accurate maintenance of the drug reference file and its functionality within Wisconsin’s Medicaid Management Information System (MMIS).
• Ongoing activities include, but are not limited to, drug file data maintenance, analysis, research, and published data table maintenance.
• Long-term activities include analyzing proposed changes to the drug reference file, developing alternatives, and proposing initiatives to improve the quality and efficiencies of the drug reference file.

Senior Pharmacy Analyst

Producer

• Lead service delivery across multiple clients, overseeing claims configuration, provider setup, and adjudication logic to ensure accurate and efficient execution of business solutions
• Drive standardization and process improvements across the configuration lifecycle (design, build, test, deploy), improving quality, scalability, and operational efficiency
• Partner with account and product teams to forecast demand and align delivery capacity, identifying risks in workload, timelines, and performance and driving mitigation strategies
• Translate regulatory, benefit, and pricing requirements into configuration solutions, advising on impacts to adjudication and downstream processing
• Oversee financial and operational performance, including budgeting, forecasting, and cost optimization while maintaining SLA adherence and delivery quality
• Lead cross-functional collaboration and client relationships, resolving escalations, supporting releases, and driving continuous improvement in configuration accuracy and turnaround times

Manager, Mainframe Production Control & DBA

• Support the planning, coordination, and execution of small to medium-sized projects
• Translate meetings into clear, actionable decisions
• Assist in gathering, analyzing, and documenting business requirements
• Monitor project progress, risks, dependencies, and budgets

Associate Project Manager

• Provide knowledgeable responses to basic client questions; elevate more complex cases to appropriate staff as needed
• Put your skills to work to solve client problems, update account history and follow up with clients
• Adhere to the client’s SLAs and consistently meet production targets
• Collaborate with team members, management and clients to resolve client inquiries