Advisor Pharmacy Business Process Modeler / Trainer

Summary

As an Advisor Pharmacy Business Process Modeler / Trainer 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.

In this position, you will leverage your expertise in Medicaid and the Medicaid Information Technology Architecture (MITA) framework, with a specialized focus on Pharmacy Benefit Management (PBM) processes. Your role will be centered on optimizing operational efficiency while ensuring compliance with relevant regulations. Additionally, you will be responsible for delivering comprehensive training sessions—both in-person and virtually—applying adult learning principles to facilitate effective knowledge transfer. You will play a key role in developing and presenting complex technical concepts to diverse audiences, ensuring clarity and understanding across various stakeholders. By combining process expertise with strong communication and facilitation skills, you will contribute to the continuous improvement of business operations and regulatory adherence.

Here are the details on this position.

Your role in our mission

Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes. 

• Coordinate workstreams and teams on IT projects to align solutions with client business priorities  
• Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results
• Delegate work across teams, and coach and monitor project team members to plan, design and improve complex business processes and modifications 
• Streamline workflows across clients and technical personnel to determine, document and oversee carrying out system requirements
• Support quality control as you approve and validate test results to verify that all requirements have been met

What we're looking for

• 9 or more years of experience in a relevant Business Analyst position with 3 or more years of Medicaid and Medicare experience preferred
• Medicaid and MITA Expertise: Knowledge of PBM-specific processes, including formulary management, claims adjudication, drug rebate processing, and pricing methodologies. Pharmacy technologist background preferred.
• Business and Technical Skills: Strong business analysis, research, and troubleshooting skills to diagnose and address system issues, paired with technical savvy and familiarity with Visio and process modeling.
• Training and Presentation Skills: Skilled in both in-person and virtual training, with experience in adult learning, classroom facilitation, and delivering technical concepts effectively.
• Content Creation and Documentation: Background in technical writing and documentation, with expertise in video creation and editing (Camtasia, Articulate, Captivate) and 508 compliance for accessibility.
• Communication and Soft Skills: Strong interpersonal and communication abilities, capable of leading presentations, facilitating stakeholder sessions, and maintaining clarity in complex discussions.
• Requirement Management: Proficient in requirements analysis, capturing, and managing requirements throughout the project lifecycle, and familiar with product-based implementations.

What you should expect in this role

• Fully remote options from continental US locations only
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• This posting is intended for pipelining. This is a developing position therefore the job description is subject to change.

• #LI-HC1

• #LI-PBM