Senior Business Analyst

Summary

As a Senior Business Analyst 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.

The Senior Professional Business Analyst will play a key role on the Advancing Interoperability and Improving Prior Authorization Processes project, serving as a bridge between the systems project team, operational leadership, and the client. This role focuses heavily on operational readiness, including evaluating, designing, and documenting staffing models and operational processes needed to support the transition to and long‑term maintenance of new prior authorization workflows.

This position requires strong analytical capabilities, excellent communication skills, and experience working in environments where new technology, federal regulations, and operational processes intersect.

Your role in our mission

Operational Process & Readiness

• Analyzes current operational workflows and designs future-state processes
• Develops detailed operational staffing models, workload forecasts, and support structures to maintain new prior authorization capabilities.
• Recommends changes to organizational procedures and staffing.

Business Analysis & Requirements

• Works closely with operations, technical teams, policy, and business owners to elicit, document, and validate requirements for process changes, system updates, and user needs.
• Constructs conceptual business and data models (including process flows, volume estimates, and operational metrics) reflecting current and future operational realities.
• Facilitates requirements workshops and working sessions with operational stakeholders to explore potential solutions and ensure alignment with business goals.

.... your role continued

Testing & Validation

• Develops operationally focused test scenarios and acceptance criteria to ensure new solutions align with real-world workflows.
• Participates in system and operational readiness testing; analyzes results and coordinates resolution of issues impacting business operations.
• Ensures “intent of change” for operational processes is fully realized through development, testing, and implementation.

Project Delivery & Support

• Serves as a liaison between operations leadership and the systems team to ensure operational needs are understood and incorporated.
• Provides input into system modifications needed to support operational process changes.
• Supports development of transition-to-operations plans, training materials, standard operating procedures, and performance monitoring structures.
• Assists in estimating effort and timelines for analysis, process design, and operational readiness activities.
• Conducts or assists in Trainings for Operational Staff impacted by the project solution.

What we're looking for

• Six or more years of business analysis experience, including work on operations‑heavy or regulatory projects.
• Bachelor’s degree or equivalent combination of education and experience. Degree in business administration, health administration, information systems, or related field preferred.
• Experience with business process design and re-engineering.
• Experience collaborating with operational teams, technical teams, and cross-functional project teams.
• Familiarity with healthcare operations or federal regulatory implementations preferred.

Other Qualifications

• Strong interpersonal and facilitation skills for collaborating with operational leaders and project teams.
• Excellent written and verbal communication abilities, including documentation of complex business processes.
• Strong analytical, problem‑solving, and critical‑thinking skills.
• Ability to present findings and recommendations to management and stakeholders.
• Proficiency with business analysis tools, process modeling tools, and standard productivity software.
• Ability to work effectively in a collaborative team environment.
• Willingness to travel as needed.

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
• The deadline to submit applications for this posting is February 20, 2026

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