Professional Quality - PBM Technician

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

As a Professional Quality - PBM Technician at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

Essential Job Function

• Conducts assessments and evaluations of prior authorization through analysis and interpretation of objective and subjective evidence to verify compliance to the established standards, policies and procedures, best practices and/or applicable quality plan.

• Develops and maintains quality assurance documentation for projects and tasks to include quality metrics. Assists in the development and maintenance of written reports of audits; escalates unresolved issues or findings to appropriate level.

• Evaluates work products to independently assess quality and reports findings. Researches alternative solutions to problems, determines proper approaches and makes verbal and/or written recommendations to appropriate parties. Assists in implementing recommendations as approved.
• Participates in special projects, external audits and process improvements in support of quality assurance initiatives.

What you should expect in this role

• Remote position
• Opportunities to travel through your work (0-10%)
• 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 10/24/2025

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The pay range for this position is $50,400.00 - $72,000.00 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.