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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 $152,000.00 - $217,200.00 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. 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.
