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Senior Professional Business Analyst

Date:  Jul 6, 2024
Location: 

Bangalore, KA, IN, 560100 Chennai, TN, IN, 600032

Req ID:  25446

Summary

As 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.

  • Help coordinate a business analyst team’s duties and activities on IT projects and nurture newer team members by providing guidance and support
  • Be a knowledgeable bridge between clients, project managers and technical staff to define, document and share business requirements and expected impact 
  • Work with the client to develop business specs at the start of a technical project
  • Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
  • Help verify that all requirements have been met by approving and validating test results    
  • Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work 

What we're looking for

Qualifications

 

  • Bachelor's degree or equivalent combination of education and experience. 
  • Six or more years of business analysis experience.
  • Openly and actively communicates information and takes initiative to communicate extensively.
  • Four or more years’ experience configuring in QNXT or FACETS:
  •            Contracts/benefits.
  •            System data points needed for successful X12 transactions, Claim Adjustment Reason Codes and Remittance Advice Code.
  • Contracts for provider services, benefits for member coverage, fee schedules, capitation, and claim editing enforcement.
  • Understands Medicaid Program structure in carriers, programs, benefit plans, policy, policy plans, sponsor, and or policies.
  • Understands Provider (Contract and Pricing) data including but not limited to provider type, specialty, taxonomy, enrolment impacts, service locations, certifications and licensing, affiliations, and reimbursement impacts.
  • Understands Member data including but not limited to aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers.
  • Experience with Configuration Implementation Build & Maintenance.
  • Experience working with complex systems at a detailed level.
  • Experience working in a virtual team environment performing self-directed tasks.
  • Understands relational database concepts and schemas.
  • Experience writing SQL queries for data analysis.
  • Experience working with Medicaid/MMIS systems.
  • Preferred experience includes DDI (Design, Development, and Implementation) and operations phases.
  • Experience processing Medicaid claims and ability to troubleshoot adjudication results.
  • Demonstrated aptitude for learning new technologies and keeping current with industry best practices.
  • Experience with Requirement Traceability Matrices.
  • Ability to multi-task and maintain organization in a fast-paced environment.
  • Ability to create and maintain highest levels of confidentiality when dealing with proprietary or private information.
  • Ability to exercise sound judgment and make decisions in a manner consistent with the essential job function.
  • Preferred experience working with HP Application Lifecycle Management (ALM).

What you should expect in this role


Fast-paced,challenging and rewarding work environment.
Work life balance.    
Hybrid Office environment.
Will require late evening work to overlap US work hours.
 
#LI-DNI
 

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