Senior Business Analyst - Medicaid

Summary

As a Senior Business Analyst - Medicaid at Gainwell, you will apply your analytical expertise to help harness the power of data and technology in support of our mission: improving the health and well‑being of the vulnerable populations our clients serve. Bring your passion and purpose to a team that thrives on solving some of healthcare’s most complex challenges. You will serve as a partner and thought leader in transforming data into actionable insights that enhance operational efficiency and effectiveness. While grounded in quantitative analysis, you will also understand the operational realities and complexities that shape how data is applied.

Your role in our mission

You will play a critical role in ensuring Gainwell meets key client objectives across essential operational areas.

• Serve as a lead analyst for complex, multi‑system claims and financial processing activities within Gainwell’s DC Medicaid program.
• Develop a deep understanding of end‑to‑end medical claims and financial processes, including daily, weekly, and monthly operational cycles. Use this knowledge to evaluate data, confirm systems are performing within expected parameters, and identify processing issues when they arise.
• Understand contact center workflows, tools, performance metrics, and SLA requirements. Analyze data to identify adverse trends, anomalies, and opportunities for improvement.
• Partner closely with supervisors and managers to support operational data analysis, including querying datasets to assist with performance improvement initiatives and special projects.
• Analyze, design, document, and recommend enhancements to business processes that support operational effectiveness.
• Apply analytical and relational database tools — such as Excel, Access, and SQL — to quantify trends, assess impacts, and uncover anomalies.
• Collaborate with other Business Analysts across multiple functional areas and solution components.
• Engage directly with state client stakeholders (DHCF) on data‑related issues when needed.

What we're looking for

• 6+ years of experience as a Business Analyst in the Healthcare Industry; 3+ years of Medicaid or Medicare experience preferred.
• Understanding of computer programming concepts, including configuration, development, and batch processing.
• Advanced proficiency with analytical tools such as Microsoft Excel, Access, SQL, and requirement‑mapping tools such as ALM platforms.
• Strong client‑facing communication skills with the ability to translate client needs into actionable objectives.
• Strong analytical and business process re‑engineering capabilities.
• Executive presence and the ability to communicate effectively with business leaders, clients, and technical teams.

What you should expect in this role

• Remote work environment with occasional travel to Washington, DC or other Gainwell locations as needed.
• Residency and work location must be within the contiguous United States (48 states).
• Video cameras are required to be on for all interviews and meetings, both internal and client‑facing.
• Standard working hours are 8:00 AM – 5:00 PM EST.
• Flexibility to work outside normal business hours when necessary to support critical processes or remediation efforts.

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

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