Business Analyst - Medicaid

Date: Apr 22, 2024

Location:

Any city, CT, US, 99999

Req ID: 24392

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 Business Analyst - Medicaid 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. Working directly with Trading Partners (TPs) in setting up their accounts along with the resolution of compliance failures. Monitoring of daily incoming Medicare crossover files, SBHC file failures and TA1 failures. The set up and support of Value-Added Networks (VANs). Maintaining and developing structured user manuals and training. Here are the details on this position.

Your role in our mission

Gainwell empowers you show you’re a pro and help clients deliver better health and human services outcomes using innovative technology and solutions.

Delivering operational excellence within our EDI team supporting our client, the Department of Social Services, and the provider community on the Connecticut Medical Assistance Program account.
Analyze, plan, design, document and make recommendations to improve business processes to support client’s technological aspirations
Be a supportive bridge between clients, project managers and technical personnel to define, track and communicate business requirements and their expected impact by building basic conceptual data and process models
Create, execute or analyze basic test scenarios to verify that client requirements are built into system design
Ensure that “intent of change” is carried out through every project phase by participating in technical reviews and inspections

What we're looking for

Three or more years of experience translating technical goals and requirements into real action for clients
Ability to read, understand and interpret file specifications.
Proven problem solving, troubleshooting and analytical skills are essential.
Ability to determine solutions and resolve issues with minimal supervision.
Excellent communication skills, both verbal and written, with the ability to interact professionally with diverse stakeholders.
Ability to work independently and collaboratively in a fast-paced environment.
An ability to deliver projects and answer inquiries on time with attention to detail and accuracy in work.
Excellent organizational skills and the ability to prioritize workload in a frequently interrupted environment.

Technical Requirements

Proficient with Excel and Word.
Understanding of EDI terminology and file structures.
Proficiency in using software tools and systems for EDI management and customer support.
Manage the execution of user acceptance testing for healthcare EDI transactions (ANSI X12 837, 835, 270/271, 999, 276/277).
Function as Subject Matter Expert (SME) for inbound and outbound EDI transactions.

Background requirements

Bachelor’s degree in a technical or a business disciple or equivalent work experience.
Minimum of 4 years prior experience working preferably in the insurance industry in a role working with EDI files and/or analyzing and testing electronic data files.
Proven experience in EDI operations, customer service, or a related role.
Healthcare experience preferred (Medicaid)

Soft Skills

Customer service focused.
Flexibility to adapt to changing priorities and willingness to learn new technologies and processes.
Ability to work collaboratively with team members and provider community.

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
The deadline to submit applications for this posting is May 15, 2024.
#LI-HC1

The 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.