Job Description
About The Company
Gainwell Technologies is a leading provider of innovative healthcare technology solutions dedicated to improving the efficiency and effectiveness of health and human services agencies. With a strong focus on leveraging advanced IT systems, Gainwell supports government programs and healthcare organizations in delivering better outcomes for vulnerable populations. The company prides itself on fostering a collaborative, inclusive environment that values diversity, continuous learning, and professional growth. By integrating cutting-edge technology with industry expertise, Gainwell strives to enhance healthcare delivery, streamline operations, and ensure compliance across various healthcare domains.
About The Role
The Senior Business Analyst - Claims at Gainwell Technologies plays a pivotal role in bridging the gap between client needs, technical teams, and project management. This position involves leading efforts to analyze, document, and optimize claims processing workflows within Medicaid and other health insurance programs. The ideal candidate will utilize their extensive healthcare and claims processing knowledge to support the development and implementation of technology solutions that meet client objectives. This role requires a strategic thinker capable of coordinating cross-functional teams, conducting detailed requirements gathering, and ensuring the delivery of high-quality, compliant solutions. Working remotely within the continental US, the Senior Business Analyst will be integral to supporting Gainwell’s mission of transforming healthcare through innovative technology and process improvements.
Qualifications
- Minimum of 6 years of experience as a Business Analyst, specifically within the healthcare or health insurance sectors
- Deep understanding of Medicaid claim processing, including Institutional and Physician claim forms
- Knowledge of Prior Authorization, Member, Provider, Long-Term Care, Inpatient/Outpatient concepts
- Experience with project and change management tools such as ALM, iTrace, or rTrace
- Proficiency with Software Development Life Cycle (SDLC), particularly waterfall methodology
- Experience creating detailed documentation, user manuals, and training materials
- Hands-on experience with benefit plan configuration updates in Medicaid Management Information System (MMIS)
- Strong analytical skills with proficiency in relational database software such as Excel and SQL
- Excellent communication and stakeholder management skills
- Bachelor’s degree in Healthcare Administration, Information Technology, Business Administration, or related field preferred
Responsibilities
- Coordinate and oversee the duties of the business analyst team on various IT projects, providing mentorship and guidance to junior team members
- Facilitate client meetings to gather, analyze, and document business requirements and explore potential solutions
- Develop comprehensive test scenarios and plans to validate that client requirements are correctly incorporated into system designs
- Analyze testing results throughout project phases, ensuring requirements are met and issues are addressed promptly
- Provide accurate time estimates for project-related tasks to support planning and resource allocation
- Document lessons learned and recommend process improvements to enhance team efficiency and project outcomes
- Act as a liaison between clients, project managers, and technical teams to define, document, and communicate business needs and impacts
- Collaborate with clients to develop detailed business specifications at the start of technical projects
- Analyze, design, and recommend process improvements aligned with client technology goals
- Verify that all project requirements are met by reviewing and approving test results and system validations
- Utilize analytical tools such as Excel and SQL to quantify the impact of proposed changes and solutions
Benefits
- Competitive salary range of $69,400 to $99,200 annually, commensurate with experience and location
- Flexible, fully remote work options within the continental United States
- Generous vacation policy and paid time off
- Comprehensive health benefits including medical, dental, and vision coverage
- 401(k) employer matching program to support your retirement savings
- Educational assistance and professional development opportunities through leadership and technical academies
- Supportive work environment that emphasizes collaboration, innovation, and inclusion
Equal Opportunity
Gainwell Technologies is an Equal Opportunity Employer. We are committed to creating an inclusive environment where all qualified applicants receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), age, sexual orientation, disability, veteran status, or any other legally protected characteristics.