Summary

As a Senior Business Analyst - Audit 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 - by supporting Medicaid audit readiness, compliance, and operational transparency. 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.

Your role in our mission

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

• Analyze and research audit components; generate business and/or data specifications in support of evidence requirements for each component
• Help verify that all requirements have been met by confirming that evidentiary documentation meets defined specifications
• Create data extract queries and perform data analysis on Medicaid data sets (e.g., claims, member, provider) to aggregate data, identify trends and validate data results
• Communicate with the customer (internal and external), company and project team, measuring and sharing project metrics/status; recommending changes as needed 
• Exercise your ability to use common analytics, reporting, and relational database tools — such as Excel, SQL, Power BI, SSRS, BusinessObjects, SAS — to quantify the anticipated impact of work 
• Actively support audit projects by quickly escalating any risks and implementing risk mitigation solutions

What we're looking for

• 6+ years of experience in a relevant Business Analyst position with 3 or more years of Medicaid or Medicare experience required
• Knowledge of audit processes including evidentiary documentation, preferably within a Medicaid or Medicare context
• Advanced knowledge in analytical software such as Microsoft Excel and SQL
• Knowledge of requirement-mapping tools such as Application Lifecycle Management (ALM)
• Ability to translate detailed regulatory and compliance (CMS) requirements into actionable objectives, and convey the requirements in a digestible way
• Strong client communication skills translating customer requests to actionable objectives
• Strong executive presence and communication skills to deliver messages to business leaders, clients and technical personnel

• Leadership to train, guide and mentor the work of junior colleagues

Preferred skill and experience

• Advanced Excel capabilities (e.g., ability to create and use pivot tables, create functions to clean and analyze data) - required
• SQL and query building - required
• Familiarity with CMS audit requirements or healthcare regulatory documentation standards ­– required
• Proficiency in PowerPoint, Visio, and platforms like ALM – required
• Experience working with Medicaid or healthcare claims, provider, eligibility, or encounter data – preferred
• Power BI and/or other BI tools – preferred
• Technical writing skills - preferred

What you should expect in this role

• Opportunities to travel through your work (0-10%)
• 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
• The deadline to submit applications for this posting is August 21, 2025

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