Lead Technical Business Analyst - Medicaid FHIR Architecture & Interoperability

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.

Summary

As an Lead Technical Business Analyst - Medicaid FHIR Architecture & Interoperability 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. Here are the details on this position.

Gainwell Technologies is seeking a Technical Business Analyst with deep Medicaid experience and strong FHIR architecture expertise to support large‑scale Medicaid modernization and interoperability initiatives. This role sits at the intersection of state Medicaid policy, enterprise architecture, and modern data exchange standards and plays a key part in translating complex Medicaid data and workflows into scalable, FHIR‑based solutions.

The ideal candidate has hands‑on experience with Provider+, FHIR architecture, profiling, and data translation , and can operate as a trusted advisor to architects, engineers, and state clients—ensuring interoperability solutions are compliant, sustainable, and aligned to CMS and Gainwell standards.

Your role in our mission

Medicaid & Interoperability Architecture

• Serve as a FHIR‑focused technical business analyst supporting Gainwell’s Medicaid interoperability and data exchange solutions.
• Translate state Medicaid business requirements, CMS mandates, and client‑specific policies into FHIR‑aligned technical requirements.
• Support architecture decisions related to FHIR‑based integration patterns , including APIs, canonical data models, and transformation strategies.
• Partner with solution architects to ensure interoperability designs are scalable, reusable, and consistent with Gainwell enterprise standards

Stakeholder & Client Engagement

• Serve as a technical translator between Medicaid business stakeholders, state agencies, and engineering teams.
• Clearly explain FHIR architecture and interoperability concepts to non‑technical audiences.
• Support governance reviews, standards compliance, and documentation required by state Medicaid programs and CMS

FHIR Standards & Data Translation

• Lead analysis and documentation for mapping Medicaid data to and from FHIR (R4) , including:
  • • MMIS data models ↔ FHIR
    • X12 (270/271, 834, 837, 835) ↔ FHIR
    • HL7 v2 ↔ FHIR
• Define and maintain FHIR profiles, extensions, value sets, and implementation guidance appropriate for Medicaid use cases.
• Support FHIR API design by reviewing resource structures, payloads, search parameters, and business rules.
• Ensure FHIR implementations align with:
  • • CMS Interoperability and Prior Authorization rules
    • Patient Access and Provider Directory API requirements
    • Gainwell reusable integration assets and patterns

Technical Analysis & Delivery Support

• Produce clear, detailed technical artifacts, including:
  • FHIR data mapping documents
  • API and integration use cases
  • Sequence diagrams and process flows
  • Acceptance criteria and validation rules
• Actively collaborate with:
  • Integration and platform engineers
  • Enterprise and solution architects
  • State Medicaid SMEs and external vendors
• Review and validate transformation logic, schemas, and API contracts.
• Support SIT and UAT by validating data accuracy, business compliance, and end‑to‑end interoperability.

What we're looking for

• 9+ years experience as a Business Analyst or Technical Business Analyst in healthcare or public sector systems
• Strong Medicaid domain expertise , including MMIS and state Medicaid operations
• Hands‑on experience with FHIR (R4) in production or large‑scale implementations
• Demonstrated experience performing data translation between legacy Medicaid formats and FHIR
• Strong understanding of:
• Proven ability to work effectively in architecture‑driven delivery models

Preferred Qualifications

• Familiarity with Gainwell’s Provider+ Product data and system design
• Experience supporting CMS interoperability initiatives (Patient Access API, Provider Directory API, PA API)
• Familiarity with integration platforms and tools:
  • Postman, Swagger/OpenAPI
  • Interface engines (Mirth, Rhapsody)
  • Cloud‑based integration services
• Experience working on Medicaid transformation or modular MMIS modernization projects
• Agile or hybrid SDLC experience in large enterprise environments

Key Skills & Attributes

• Strong systems thinking and architectural mindset
• Able to balance policy, data, and technology considerations
• Excellent written and verbal communication
• High attention to detail and regulatory compliance
• Comfortable influencing without authority across teams

What you should expect in this role

• Fully remote options from most US locations and territories
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• Photo will be taken during screening for verification in all steps of the recruitment process.

• The deadline to submit applications for this posting is October 19, 2026

  Please ensure you join all screenings, interviews and meetings from a quiet location with a stable internet connection.

  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 $86,800.00 - $124,000.00 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.