Business Analyst - Medicaid Buy-In Operations

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. SummaryAs a Business Analyst - Medicaid Buy-In Operations at Gainwell, you will support Medicare Buy-In operations. This subject matter expert will help Medicare-eligible members with coverage, eligibility, enrollment, and Buy-In questions.The ideal candidate has Medicare and Medicaid experience, strong analytical skills, and the ability to explain complex healthcare information clearly and compassionately. Responsibilities include answering Buy-In calls, researching eligibility and coverage issues, and coordinating resolutions with internal and external partners.Your role in our missionAnswer Buy-In calls about coverage, benefits, enrollment, and eligibility.Clearly explain Medicare Parts A and B, Medicare Savings Programs, and Medicaid Buy-In benefits.Research and resolve coordination-of-benefits, eligibility, coverage, and enrollment issues.Document inquiries, findings, and resolutions according to procedures.Coordinate with members, state agencies, CMS, health plans, and internal teams.Interpret Medicare and Medicaid policies to resolve inquiries.Identify trends and process improvement opportunities.Help develop requirements, procedures, and training materials.Comply with HIPAA, CMS regulations, and Gainwell policies.What we're looking forThe ideal candidate has 3–5+ years of Medicare and Medicaid experience , is comfortable assisting beneficiaries by phone, understands coverage and eligibility rules, and independently resolves complex inquiries with excellent service.Skills & CompetenciesMedicare and Medicaid expertiseMember supportEligibility and enrollment analysisCritical thinking and problem-solvingClear verbal and written communicationAttention to detailEmpathy and professionalismConfidential handling of sensitive healthcare informationThis role helps Medicare beneficiaries access and understand coverage while supporting essential state healthcare programs.Build your career with Gainwell, where collaboration, innovation, and inclusion help make healthcare work better for everyone.Required QualificationsBachelor's degree or equivalent experience.At least 3 years of experience in Medicare, Medicaid, healthcare eligibility, enrollment, member services, or operations.Experience discussing healthcare coverage with members, beneficiaries, providers, or customers.Strong knowledge of Medicare Parts A and B, Medicare Savings Programs, and Medicaid.Excellent communication, customer service, analytical, and problem-solving skills.Ability to explain complex healthcare information clearly and professionally.Proficiency in Microsoft Office and healthcare systems.Preferred QualificationsMedicare Buy-In program experience.Knowledge of CMS regulations, Medicare eligibility, and Medicare Savings Programs (QMB, SLMB, QI, QDWI).Experience with state Medicaid agencies or government healthcare programs.Call center, member services, or beneficiary support experience.What you should expect in this roleFully remote options from most US locations and territoriesVideo cameras must be used during all interviews, as well as during the initial week of orientationPhoto will be taken during screening for verification in all steps of the recruitment process.The deadline to submit applications for this posting is November 5, 2026The pay range for this position is $55,600.00 - $79,400.00 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.J-18808-Ljbffr Gainwell Technologies LLC