Senior Business Analyst - Provider+

Role Description

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. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges.

• Support business, policy, and technical execution across one or more functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment.
• Translate state and federal Medicaid policy and program requirements into product features, system configuration, and design artifacts.
• Work closely with the Domain Lead, Technical Analysts, and cross-functional teams as a domain and policy subject-matter expert (SME).

Qualifications

• Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field.
• 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.
• Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes.
• Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts.
• Strong knowledge of SQL, particularly for data analysis and validation.
• Strong client communication skills, with experience interacting directly with business stakeholders.
• Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions.
• Strong documentation, facilitation, and analytical skills.
• Experience working in SDLC and Agile delivery environments.

Requirements

• Serves as the primary Domain SME and trusted advisor to the Engagement Lead (EL) on business processes, including regulatory and operational impacts.
• Ensures solutions align with CMS guidance, state policy, and documented business rules.
• Leads and participates in requirements and design sessions with clients and internal teams.
• Develops and maintains domain design documentation, including a comprehensive Design Document.
• Supports configuration and implementation activities across Design, Development, and Implementation (DDI).
• Reviews test cases to ensure alignment with requirements, policies, and acceptance criteria.
• Supports operational readiness across environments, data, processes, and staffing.
• Partners closely with Domain Leads and Technical Analysts as a key domain and policy SME.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to help build your skills and capabilities.