State hearing analyst - roseville, ca - hybrid

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As a State Hearing Analyst at Gainwell Technologies, you will help support the health and well-being of vulnerable community members by ensuring fair and accurate review of Medi-Cal Dental appeals. Working with innovative technology and a collaborative team, you will play a key role in supporting healthcare programs and delivering positive outcomes for members.

This position is ideal for individuals who are passionate about problem-solving, analytical thinking, and customer service. As part of a team focused on accuracy, compliance, and quality, you will conduct secondary reviews of denied dental treatment authorization requests to determine eligibility for approval. When denials are upheld, you will prepare and process appeal and hearing documentation, ensuring compliance with program requirements while supporting members' appeal rights.

Your role in our mission

• Retrieve and review new Medi-Cal Dental appeals, researching denial information and member records. Compile and maintain all pertinent documentation using ACMS, MEDS, CD-MMIS, EIMS, and imaging vendor systems.
• Prepare radiograph requests and obtain missing information from providers and members. Draft Conditional Withdrawal letters and Position Statements while ensuring HIPAA compliance, case accuracy, and completeness.
• Manage appeals throughout the full case lifecycle by monitoring caseloads, tracking case progression, coordinating required next steps, and preparing cases for State Hearings.
• Maintain accurate case status updates within the State Hearing System (SHS), upload required documentation, route cases to appropriate business areas, and coordinate activities through written correspondence while ensuring compliance with all contractual timeliness and performance requirements.
• Serve as the primary point of contact for members upon receipt of a hearing request and following reevaluation, explaining appeal outcomes, hearing procedures, and addressing questions or concerns in a professional and customer-focused manner.

What we're looking for

• Strong written and verbal communication skills.
• Excellent organization, analytical, and problem-solving abilities.
• Ability to manage multiple tasks and navigate several systems simultaneously.
• Proficiency with Microsoft Word and Excel.
• Knowledge of the Medi-Cal Dental Program required.

What you should expect in this role

Role requires reporting onsite 5 days a week for training, and then will become Hybrid for special training requests, or other business needs. The office is in Roseville, Ca.

The deadline to submit applications for this posting is October 25, 2026.

The pay range for this position is $46,800.00 - $66,900.00 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.