Senior Business Analyst - Provider+

Job Overview

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.

Job Description

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.

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.

Key Responsibilities

• 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.
• We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
• Will be supporting business, policy, and technical execution across one or more functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment.
• Supported domains may include Member, Provider, Claims (Medicaid, Dental and/or Pharmacy), Finance, Plan and Care Management, and Business Relationship Management.
• This role supports end‑to‑end domain delivery by translating state and federal Medicaid policy and program requirements into product features, system configuration, and design artifacts.
• The Business Analyst works closely with the Domain Lead , Technical Analysts , and cross‑functional teams and acts as a domain and policy subject ‑ matter expert (SME) to ensure successful implementation and operational readiness.
• Your role in our mission Requirements & Design Serves as the primary Domain SME and trusted advisor to the Engagement Lead (EL) on business processes, including regulatory and operational impacts.
• Supports the EL with scope negotiations and change control by assessing trade‑offs and evaluating functional, regulatory, and operational impacts of requested changes.

Required Skills and Qualifications

• We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
• Summary As a Senior Business Analyst - Provider+ 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.
• Supports documentation, knowledge transfer, and ongoing operational support.
• 5 to 8 years of hands ‑ on experience supporting healthcare system implementations , including MMIS solutions and Medicaid Pharmacy platforms.
• Experience with QNXT or similar healthcare claims/encounter management systems.
• Strong knowledge of state and federal Medicaid policy, regulations, and program rules (required).
• Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts.
• Strong knowledge of SQL is required , particularly for data analysis and validation.

Benefits and Perks

• You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance.
• Responsible for domain-specific configuration, including: Claims: edits, pricing, benefit limits, adjudication logic Plan: contracts, benefits, programs, fee schedules Provider: types, specialties, contracts, enrollment, credentialing Member: eligibility, benefits, plans, demographics Pharmacy: RX benefits and claims processing Testing Reviews test cases to ensure alignment with requirements, policies, and acceptance criteria.
• The pay range for this position is $69,400.00 - $99,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
• All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance.
• 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.

Work Location and Schedule

This role is listed as Remote USA with location information shown as Remote USA. The employment type is Full Time.

About the Company

Gainwell Technologies is the organization connected with this listing. USA Jobs Today displays this opportunity for job discovery only, so applicants should verify company details, application instructions, and eligibility on the official employer website.