Senior Business Analyst - Care & Case Management

Summary

As a Senior Business Analyst - Care & Case Management 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.

Your role in our mission

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

• Understand new Case and Care Management Policies provided to Gainwell by our Customer. Generate business and/or data specifications in support of evidence requirements for each component.
• Apply knowledge of CMS policies and regulatory requirements associated with Case and Care Management and Population Health Management when partnering with our Customer to develop functional requirements for system changes; keep abreast of CMS policy and regulatory changes.
• Facilitate design sessions with our Customer, our developers and third-party vendors, and generate design specification documents.
• Enter approved requirements into ALM.
• Partner with development team and clarify requirements as needed.
• Help verify that all requirements have been met by running ALM requirements traceability (RTM) reports.
• Partner with test team and support generation of user stories/test scenarios and supporting test cases, for system testing, system integration testing and end-to-end testing, that align to each requirement and to generate test data needed to perform testing.
• Help develop test scenarios and cases as needed for Model Office and End-to-End Testing. This will include building the necessary data sets.
• Support development of user training collateral designed to support Policy and functional requirements and participate in end-user training activities as needed.

Other role expectations

• Support UAT activities performed by our Customer.
• Participate in end-to-end functional testing as needed.
• Communicate with the Customer (internal and external) and project team, measuring and sharing project metrics/statuses, identifying and documenting risks, and recommending changes as needed.
• Assist with Operational Readiness activities including any operational change management activities.
• Serve as the subject matter expert for end-to-end work and data flow for the Care and Case Management application ecosystem
• Build strong working relationships with the Gainwell team and Client stakeholders
• Assist with the overall maintenance of the RTM for each project

What we're looking for

• 5+ years of experience as a Business Analyst, including 3+ years in Medicaid programs and 3+ years in multi-vendor environments.
• Proven ability to interpret high-level requirements and translate them into detailed functional and technical specifications.
• Strong client communication skills, with the ability to translate customer requests into actionable objectives and present effectively to business leaders, clients, and technical teams.
• Leadership experience in mentoring and guiding junior colleagues.
• Hands-on experience with requirements traceability management (RTM), test scenario creation, and test case execution.
• Advanced proficiency in Excel (including pivot tables), and working knowledge of Word, PowerPoint, ALM, and AI tools.
• Strong technical writing skills for documentation, reporting, and communication across stakeholders.

Preferred skills and experience

• 2+ years of experience supporting or working within Healthcare Case Management
• Experience writing/executing SQL queries
• Proficiency in Visio

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

• Virtual work, video presence in all meetings (external and internal)
• Opportunities to travel through your work (0-10%)

• This posting is intended for pipelining. This is a developing position therefore the job description is subject to change.

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