It takes great medical minds to create powerful solutions that solve some of
healthcare’s most complex challenges. Join us and put your expertise to work in
ways you never imagined possible. We know you’ve honed your career in a
fast-moving medical environment. While Gainwell operates with a sense of
urgency, you’ll have the opportunity to work more flexible hours. And working at
Gainwell carries its rewards. You’ll have an incredible opportunity to grow your
career in a company that values work-life balance, continuous learning, and
career development.
SUMMARY
As a Genetic Testing Physician at Gainwell, you will provide senior-level
clinical expertise and oversight for genetics and genetic testing programs. This
role supports medical necessity determinations, provider engagement, clinical
policy development, and quality improvement initiatives related to hereditary
conditions, genomic testing, pharmacogenomics, and precision medicine services.
The Advisor Medical Expert serves as a trusted clinical advisor to clients,
providers, and internal teams to promote high-quality, evidence-based, and
cost-effective healthcare outcomes.
YOUR ROLE IN OUR MISSION
When joining Gainwell, you will:
* Serve as the physician subject matter expert for genetics, genomics,
hereditary disorders, and genetic testing services.
* Review complex authorization requests, appeals, and medical necessity
determinations related to molecular diagnostics, genomic testing,
pharmacogenomics, and hereditary disease evaluations.
* Conduct peer-to-peer consultations with providers and apply evidence-based
clinical criteria to support appropriate testing and treatment decisions.
* Provide clinical guidance to utilization management, quality, case
management, and operational teams.
* Interpret and apply Medicaid regulations, medical policies, and national
genetic testing guidelines to support program compliance.
* Collaborate with clients and internal stakeholders to improve healthcare
outcomes, quality initiatives, and appropriate utilization of genetic testing
services.
WHAT WE'RE LOOKING FOR
* Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with an
active, unrestricted U.S. medical license.
* Active, unrestricted license to practice medicine in the State of California
required.
* Board Certification in Medical Genetics and Genomics, Clinical Genetics, or a
related specialty.
* Minimum of 5+ years of post-residency clinical experience in genetics,
genomics, hereditary diseases, or genetic testing programs.
* Strong knowledge of molecular diagnostics, genomic testing, hereditary cancer
syndromes, rare diseases, pharmacogenomics, and evidence-based clinical
guidelines.
* Experience with Medicaid programs, utilization management, prior
authorization, appeals, or medical review activities, with strong analytical,
communication, and decision-making skills.
WHAT YOU SHOULD EXPECT IN THIS ROLE
* Remote position supporting Medicaid healthcare programs. Candidates must
perform work while located within the United States.
* Full-time temporary assignment expected to last 9-12 months, with potential
for extension based on business needs. Standard schedule: Monday-Friday, 8:00
AM-5:00 PM; flexibility required as needed.
* Collaborate closely with providers, genetic counselors, laboratories,
clients, and multidisciplinary healthcare teams.
* Participate in peer-to-peer reviews, complex case consultations, and medical
necessity determinations related to genetic testing and precision medicine
services.
* Contribute to clinical policy development, quality outcomes, and program
effectiveness through the review of clinical documentation and evidence-based
decision-making.
This is a pipeline requisition. Applications will be reviewed on an ongoing
basis.
The pay range for this position is $193,500.00 - $276,400.00 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
[https://jobs.gainwelltechnologies.com/content/benefits/?locale=en_US], 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 [https://www.gainwelltechnologies.com/] and visit our Careers
site [https://jobs.gainwelltechnologies.com/] 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.