Senior Business Analyst - Medicaid Claims & Eligiblity

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 a Senior Business Analyst - Medicaid Claims & Eligiblity at Gainwell, you will leverage your expertise in Medicaid programs, business analysis, and process improvement to support critical healthcare initiatives that serve our clients and their members. The most successful candidates bring experience supporting Medicaid claims and eligibility operations , combined with strong analytical and business analysis skills. They excel at understanding complex business processes, translating stakeholder needs into clear requirements, identifying opportunities for operational improvement, and collaborating effectively with business and technical teams to deliver successful outcomes. Join a team that harnesses the power of technology to improve healthcare outcomes while providing opportunities for professional growth, flexibility, and career development.

Your role in our mission

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

• Help coordinate a business analyst team’s duties and activities on IT projects and nurture newer team members by providing guidance and support
• Be a knowledgeable bridge between clients, project managers and technical staff to define, document and share business requirements and expected impact
• Work with the client to develop business specs at the start of a technical project
• Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
• Help verify that all requirements have been met by approving and validating test results
• Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work

What we're looking for

• 6 or more years of experience in a relevant Business Analyst position with 3 or more years of Medicaid and Medicare experience preferred.
• Experience in Medicaid claims processing and eligibility business functions strongly preferred.
• Knowledge of computer programming concepts such as configuration, development, and batch processing.
• Advanced knowledge of analytical software such as Microsoft Excel or SQL and requirement-mapping tools such as Application Lifecycle Management (ALM) tools.
• Strong client communication skills translating client needs into actionable objectives.
• Strong analytical, business process re-engineering, and business process modeling skills.
• Demonstrated ability to gather, elicit, analyze, document, and validate business requirements.
• Strong critical thinking and problem-solving capabilities.
• Strong executive presence and communication skills to deliver messages to business leaders, clients, and technical personnel.
• A leader who motivates others to action and communicates key technical ideas in a digestible way.

Key Skills & Domain Expertise

• Proven ability to elicit, analyze, document, and validate business and system requirements.
• Strong verbal and written communication skills, with the ability to effectively collaborate with business stakeholders, clients, and technical teams.
• Experience with Business Process Modeling and process improvement methodologies.
• Demonstrated critical thinking, analytical problem-solving, and decision-making skills.
• Knowledge of Medicaid claims processing, including claims lifecycle workflows and related business processes.
• Experience with Medicaid eligibility and claims operations strongly preferred.

Technical Tools & Applications

• Proficiency with Microsoft Word and Microsoft Excel required on day one.
• Experience using analytical and requirement management tools such as Excel, SQL, ALM, or similar platforms preferred.
• Ability to learn client-specific systems, applications, and business process tools as needed.

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 22, 2026

#LI-HC1

#LI-Medicaid Claims

#LI-Eligibility

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 $69,400.00 - $99,200.00 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.