[Remote] Senior Public Policy / Long-Term Care - Rate Setting Analyst

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