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Gainwell Technologies logo
Gainwell Technologies

Gainwell Technologies is an award-winning digital health technology company that supports the administration of healthcare and human services programs. In past

Senior Public Policy / Long-Term Care - Rate Setting Analyst

Location

United States

Posted

94 days ago

Salary

$69.4K - $99.2K / year

Seniority

Senior

PA

Job Description

Senior Public Policy / Long-Term Care - Rate Setting Analyst

Gainwell Technologies

Role Description As a Senior Public Policy / Long-Term Care - Rate Setting Analyst at Gainwell, you will take a lead role in developing and maintaining rate‑setting methodologies that support a large, complex Medicaid long‑term care program. You will apply deep data expertise, interpret policy impacts — particularly within Wisconsin Medicaid — and understand how rate decisions affect Managed Care Organizations (MCOs) and the broader long‑term care ecosystem. Bring your analytical strengths and passion for public service to a team committed to improving program transparency, efficiency, and outcomes for the communities we serve. - Play a critical part in ensuring rate‑setting and reimbursement strategies meet program, policy, and organizational goals. - 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 their 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. Qualifications - 6+ years of experience in business analysis, financial modeling, or health policy analysis. - Master's degree in Public Administration or Public Policy. - 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 analytical tools such as R, SAS, STATA, or SPSS. - Strong communication skills to translate complex analytical work into clear, actionable insights. - Ability to work independently, manage timelines, and support multiple projects at once. Requirements - Work History in State Policy or with a Managed Care Organization. - Experience evaluating government, business, or healthcare policies that affect internal and external partners. - Experience working 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. Benefits - Fully remote options from Contiguous US locations only. - 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 has been extended until a suitable candidate is selected. - Generous, flexible vacation policy. - 401(k) employer match. - Comprehensive health benefits. - Educational assistance. - Leadership and technical development academies to help build your skills and capabilities.

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