Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is a company focused on solving business challenges and enhancing operations. The Senior Public Policy / Long-Term Care - Rate Setting Analyst will lead the development and maintenance of rate-setting methodologies for Medicaid long-term care programs, utilizing data expertise to interpret policy impacts and improve program outcomes.
Responsibilities
- 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
Skills
- 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 (MCO's)
- 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
- 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
- All salaried, full-time candidates are eligible for our generous, flexible vacation policy
- A [401(k) employer match, comprehensive health benefits](https://jobs.gainwelltechnologies.com/content/benefits/?locale=en_US)
- Educational assistance
- A variety of leadership and technical development academies to help build your skills and capabilities
- Fully remote options from Contiguous US locations only
Company Overview
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital. It was founded in 2009, and is headquartered in Irving, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.gainwelltechnologies.com/.