Senior Business Analyst - WI Medicaid Provider & Prior Authorization

Summary

As a Senior Business Analyst - WI Medicaid Provider & Prior Authorization on the Wisconsin Medicaid Systems Team, you’ll apply your expertise in the Provider and Prior Authorization (PA) functional areas to support technology solutions that help improve outcomes for Wisconsin Medicaid members — some of the state’s most vulnerable populations. Connect your passion with purpose by teaming with people who thrive on developing innovative, high‑quality solutions to complex healthcare challenges.

Here are the details on this position.

Your role in our mission

Play a vital part in ensuring Gainwell meets the needs of the Wisconsin Medicaid program across the Provider and Prior Authorization domains.

• Collaborate with Wisconsin Medicaid business partners, project managers, and technical teams to gather, interpret, and document business requirements for Provider and PA system enhancements
• Serve as a knowledgeable liaison who translates business needs into clear, actionable technical specifications
• Support project planning activities and coordinate with fellow business analysts to ensure work is aligned with WI Medicaid objectives
• Participate in requirements sessions, workflow discussions, and design reviews for Provider enrollment/maintenance, Provider file updates, and Prior Authorization processing workflows
• Analyze and document business processes, identifying improvement opportunities that support WI Medicaid operational goals
• Validate test results, support UAT activities, and confirm that system changes meet documented requirements and WI Medicaid compliance expectations
• Use analytical tools such as Excel or SQL to research issues, analyze trends, interpret requirements, and verify the accuracy of Provider and PA data
• Assist in identifying system impacts, dependencies, and risks related to changes in the Provider and PA functional areas
• Provide occasional guidance to junior analysts to support team delivery and knowledge growth

What we're looking for

• 4–6 years of experience as a Business Analyst, with at least 1–2 years supporting Medicaid Provider and/or Prior Authorization functional areas
• Strong ability to translate and communicate technical concepts to business stakeholders — and vice versa
• Proficiency in Microsoft Excel (advanced functions) and familiarity with relational data concepts or SQL tools
• Strong analytical abilities and experience with process evaluation or process improvement
• Clear, concise written and verbal communication skills with the ability to create well‑structured requirements and documentation
• Ability to work collaboratively with clients and internal teams within a large, complex Medicaid systems environment
• A proactive team member who supports collaborative problem‑solving and continuous improvement

What you should expect in this role

• Fully remote position available from most US locations
• Up to 10% travel may be required
• Video cameras must be used during all interviews, during the initial week of orientation, and for all client‑facing interactions
• Collaboration with team members and stakeholders across multiple locations

• The deadline to submit applications for this posting is March 5, 2026

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