Pediatrician (Part-Time, Hybrid) - California

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 Board-certified or board-eligible physician specializing in pediatrics with three or more years of direct patient care experience to perform online reviews of medical documentation requiring the clinical expertise of a pediatric general practitioner. In this role at Gainwell, you will 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—particularly in communities most vulnerable—while working alongside teams focused on innovative, purpose-driven solutions. Your role in our mission This position is a part-time (20 hours), contractual-required role for the Medi-Cal MMIS account for the Department of Health Care Services (DHCS).
As a member of the Medical Review team, you will use your clinical knowledge and acumen to respond to medical claims, referrals, and inquiries from DHCS that require the expertise of a qualified pediatrician with a strong clinical background. What we're looking for Minimum of three (3) years of clinical experience as a pediatrician
A current California medical license
Strong communication skills, as well as strong interpersonal and analytical skills
Must reside within 35 miles of the Sacramento State Capitol, California
Comfortable using the following applications: Word, Excel, and Outlook What you should expect in this role The Medical Review Pediatrician is responsible for responding to referrals from DHCS within four (4) hours of notification
Reviewing policy and attending meetings with DHCS
Processing suspended claims requiring expertise from a medical specialist and responding to referrals from internal departments
Hybrid work environment. This is primarily a remote position. Occasionally, upon client request, the consultant will travel to the Medicaid Operations Center (MOC) located in West Sacramento
Expected to cross-train to help provide coverage for other consultants when required Applications for this posting will be accepted until April 10, 2026. The pay range for this position is $115,000.00 - $129,000.00 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. 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.