National Association of Medicaid Directors

Demystifying healthcare data: Critical takeaways for unlocking the power of data-driven insights

Fast Healthcare Interoperability Resources for State Agencies

Our FHIR solution helps states comply with the CURES Act & CMS final rule to improve patients' access to their medical data. See how our modular approach can make compliance easy for your state.

Managed Care

Our Managed Care Service helps MCOs be more proactive in everything from managing multiple MCOs to tracking clients as they transition across MCO plans to improving capitation processes.

Pre-payment Solutions - COB Performance Analytics for Government Programs

Our Performance Analytics feature equips clients with transparency into the health of their TPL data by delivering metrics & reports, ensuring data-driven actions are taken for continuous improvement.

Provider Enrollment Screening

Gainwell's Provider Enrollment & Screening solution simplifies clinician enrollment, meets federal requirements and offers cost-saving features for Medicaid agencies.

Provider Management

Streamline provider enrollment, relations and contracting with Gainwell’s integrated commercial-off-the-shelf module.

Rebate Administration

Our Rebate Administration solution allows you to take a seamless approach to maximizing Medicaid Drug Rebate Program advantages. We help you maximize rebate collections & minimize dispute resolution.

Provider Service

Our Provider Service module is an essential component of our Medicaid Management Solutions, a set of services for interoperability that combine automation, standardization, & process maturity.

Pharmacy Solutions

Prior Authorization

Our solution performs reviews of prior authorizations in near real-time, reducing administrative burden, minimizing provider abrasion & improving member satisfaction. See how we can help.

Navigating the future of digital therapeutics: Considerations for Pharmacy Benefit Managers

Business Process Services

Ensure smooth delivery of Medicaid and Health and Human Services programs with our outcome-focused IT solutions. See how we can elevate your program today.

Fraud Capture

Gainwell's cutting-edge technology identifies, addresses, and prevents fraud at all levels - provider, consumer, facility and pharmacy. Learn how our solution empowers government & commercial payers.

Provider Portal

Gainwell’s self-service portal streamlines healthcare operations for providers and administrators, offering access to round-the-clock support.

Claims, Encounters & Financials

Our wide-ranging set of cloud-based Medicaid Management services for interoperability ensure your state meets CMS requirements within budget. Learn how we support management, claims & payments today.

Whole Person Service

With Gainwell's Whole Person Service, you can overcome siloed systems, coordinate across agencies and remove barriers to care. Learn how we can help.

Care Management - Mobile Care Management

Our Mobile Care Management offering brings care coordinators and interdisciplinary teams face-to-face with their patients in any setting, including areas with limited internet connectivity. Learn how.

Gainwell Company Overview

Learn how Gainwell Technologies empower clients everyday through innovative, purpose-built technologies and solutions to deliver great health and human services outcomes.