Lead Business Analyst - BPM/Training

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. The Lead Business Analyst - BPM/Training at Gainwell, is responsible for leading business analyses that align information technology solutions with the strategic goals and objectives of multiple, complex accounts. Acting as a subject matter expert and liaison between technical and non-technical personnel, the Senior Business Analyst ensures seamless collaboration across teams and drives effective solution delivery. This role oversees requirements validation, business process modeling, and documentation while providing mentorship and guidance to less experienced team members. The position applies Medicaid pharmacy and care management expertise to translate clinical and operational policies into clear requirements, process models, use cases, and role-based training content that support solution adoption and operational readiness. Lead the analysis, design, documentation, and optimization of business processes to support organizational and project objectives. Facilitate stakeholder workshops and client meetings to gather, validate, and document business requirements, identify gaps, and recommend effective solutions. Develop and maintain business process models, workflows, use cases, and supporting documentation using BPMN 2.0 and other industry-standard methodologies. Ensure requirements, design artifacts, and project documentation align with business needs, operational goals, and stakeholder expectations. Lead and coordinate business analysis activities across multiple projects, providing guidance and mentorship to junior team members. Develop project estimates and support planning efforts for business analysis, process modeling, and training-related activities. Partner with business, operational, technical, clinical, and vendor stakeholders to evaluate impacts, define business rules, and support end-to-end solution delivery. Maintain documentation standards, perform quality reviews, and manage the publication of process models and other knowledge assets. Assess training needs and oversee the development and delivery of training programs, eLearning content, job aids, procedures, and operational readiness materials. Support Learning Management System (LMS) administration activities, including learning paths, training surveys, content deployment, and instructor-led training coordination. Pharmacy Business Analysis & Training Expertise Apply Medicaid pharmacy and care management expertise to analyze, document, and optimize workflows related to utilization management, prior authorization, appeals, formularies, drug utilization review, clinical edits, member lock-in programs, and care coordination. Collaborate with pharmacists, clinicians, care management teams, policy staff, operations, product, configuration, and technical teams to elicit requirements and validate pharmacy-related business processes. Translate pharmacy policies, clinical criteria, system configurations, and operational procedures into business requirements, process models, training materials, user guides, and job aids. Develop scenario-based training, demonstrations, and validation materials for pharmacy and care management users, including state agencies, providers, prescribers, pharmacists, operational teams, and support staff. Bachelor’s degree or equivalent combination of education and experience.

• 9+ years of business analysis experience, including healthcare or government healthcare system implementations.
• Experience analyzing and designing business processes, workflows, use cases, and functional requirements using BPMN 2.0 or similar methodologies.
• Strong understanding of CMS, MITA, Medicaid operations, compliance requirements, data management, and customer service delivery processes.
• Expertise in relational databases, system integrations, technical documentation, and translating complex healthcare concepts into business and training solutions.
• Experience developing and delivering training programs, including LMS administration, eLearning content, learning paths, surveys, and instructor-led training.

Advanced leadership and project coordination skills. Willingness to travel based on project needs. Fully remote options from most US locations, Alaska, Pacific and Mountain Time zones

• Office Hours: 8a-5p Alaska time as need to be available to support Alaska time zone
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• Video is required for screenings and interviews, so please test your camera and microphone in advance.

Do not use AI tools, virtual backgrounds/filters, or visual enhancements during the interview. The pay range for this position is $86,800 - $124,000 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. We also have a variety of leadership and technical development academies to help build your skills and capabilities. 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.