• Support students throughout their learning journey • Foster and energize the student community • Manage WhatsApp groups and other community spaces • Assist students with their questions and needs • Plan and run community initiatives and events • Contribute to the continuous improvement of processes and the student experience • Monitor the student journey in Pipedrive

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment

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 The Gainwell Systems Manager is a strategic, technical, and operational leader accountable for the performance, availability, modernization, and delivery of all systems supporting the Medicaid Management Information System (MMIS) and related enterprise services. This role drives IT service management (ITSM) maturity, ensures seamless operations, and enforces governance over system changes, incidents, and escalations. As a core member of the account leadership team, the Systems Manager owns system health, enforces escalation and ownership protocols, and ensures all systems and services are optimized, secure, and aligned with contractual and business outcomes. This role is not a traditional Project Manager or HR People Manager, but is accountable for the systems team’s technical delivery, excellence, and cross-functional coordination. Your role in our mission 1) Operational Oversight & Systems Health - Own end-to-end Gainwell system availability, performance monitoring, and operational continuity. - Enforce defined escalation paths across L1–L5 tiers, ensuring no ownership gaps. - Lead Root Cause Analysis (RCA) and implement permanent corrective actions for all major incidents (P1/P2). -Maximize system updates, patches, and troubleshooting efforts. -Responsible for defect tracking (PROD and non-PROD). - Ensure system observability and lead rapid triage during outages or degradation events. - Maintain operational compliance with HIPAA, state/federal policies, and internal audit controls. 2) Technical Architecture & Modernization - Guide infrastructure modernization initiatives such as cloud-readiness, refactoring, virtualization, and platform reengineering. - Collaborate with architects and engineering teams to align with SOA, DevOps, and enterprise integration best practices. - Implement security best practices, including access controls, data protection, SOC audits, and help with disaster recovery planning and execution. - Coordinate with teams to remediate Security Vulnerabilities across systems. - Champion technical innovation and recommend solutions to increase scalability, security, and automation. 3) ITSM & Service Delivery - Lead the design, implementation, and continuous improvement of ITSM processes, leveraging the ITIL4 framework. - Supervise Incident, Problem, Change, and Service Request Management across all system tiers. -Responsible for MIM reporting and communication. - Own, define and monitor KPIs and SLAs for service quality, proactively driving improvements. - Manage second-level support teams and coordinate with L1 providers for seamless escalation and response workflows. -Promote support to Release team for successful releases to build on project deliverables and compliance to client timelines. -Oversee annual DR exercise. -Support annual SOC audit. 4) Driving Delivery Excellence - Lead technical planning for system initiatives, migrations, upgrades, and risk mitigation efforts. change to reflect partnership with Arch… -Understands Gainwell Technologies Policies and Procedures. -Provide weekly defect reporting and change requests. -Work closely with PMO for weekly/monthly reporting. - Participate in project governance, CAB, and readiness assessments for production deployment approvals. - Ensure successful alignment of technical execution with contractual obligations, security audits, and disaster recovery objectives. 5) Stakeholder & Client Engagement - Act as the primary systems liaison to client leaders (e.g., CDL, DHS, AGM), participating in governance and planning meetings. - Represent systems at weekly status meetings, steering committees, and delivery reviews. - Partner with clients to anticipate future needs, align on solution roadmaps, and maintain strong business relationships. - Provide clear communication and detailed impact reporting during outages, escalations, and planned changes. 6) Influencing Leadership & CSI Development - Lead and coach technical and operations staff across multiple delivery areas. - Set aligned objectives, drive performance feedback, and promote a culture of accountability and learning. - Maintain an Ownership Map—ensuring every service/system has clearly defined primary and secondary owners. - Encourage cross-training, succession planning, and bench strength development. What were looking for - Bachelor’s degree in Computer Science, Information Systems, Engineering, or related field (Master’s or PMP preferred). - 10+ years in IT systems engineering, operations, or infrastructure leadership (Medicare MIS or healthcare platform experience preferred). - 5+ years in technical and service delivery leadership roles. - Deep expertise in ITIL4, ITSM, and technical project execution within complex, regulated environments. - Knowledge of HIPAA, SOC, and enterprise compliance frameworks. What you should expect in this role - United States remote opportunity - Video cameras must be used during all interviews, as well as during the initial week of orientation - The Deadline to submit applications for this posting is March 24, 2026 The pay range for this position is $99,000.00 - $141,400.00 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.

The job profile for this position is Operations Advisor, which is a Band 4 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. The Operations Advisor is responsible for providing operational management of work requests to drive satisfactory results for the Client Service Team (CST), Sales and Account Management Operations (SAMO) leadership, Sales and clients. Position requires strong client account and PBM operational knowledge. Position is accountable for assigned work with a focus on client satisfaction, quality, timeliness, performance guarantees and the effective use of cross-functional partnerships. Position requires strong analytical skills to drive resolution of complex issues. Role may be client facing, requiring strong communication, presentation and business relationship skills. Role is empowered to identify and drive solutions and improvements for client and ESI processes. Role participates in peer mentoring and special projects as assigned. Position requires proactive approach to ensure workload remains at full capacity based on accomplished cross-training. Responsibilities - Manages assigned service and operational deliverables, including but not limited to: analysis, capture of client intent, cross-functional project management, management of complex and escalated assignments, and handling of member service and client operational initiatives. Assignments may fall across various SAMO work streams. Supports designated clients as assigned. Meets all defined service standards to ensure CST and client satisfaction - Independently determines direction for resolution of any service or escalated issue. Appropriately escalates as needed. - Participates on cross-functional teams to identify opportunities to address global client issues, presenting recommendations to leadership. - Leads special projects as assigned. Shares best practices and knowledge of the business with peers to improve service levels. Assists with peer training and support. Qualifications - Bachelors degree preferred - 3+ years of professional experience - Experience in healthcare or PBM industry preferred - Strong focus on quality, effective communication, and customer service - Demonstrated ability managing projects utilizing proven project management processes - Ability to work and build partnerships cross- functionally to proactively communicate and to resolve issues with the highest sense of urgency - Ability to handle analysis from issue identification to solution delivery - Demonstrated initiative with commitment and ability to work under pressure and meet tight deadlines - Client facing experience preferred If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 82,400 - 137,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.