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Senior Reference Business Analyst

Date:  Jul 3, 2024
Location: 

Chennai, TN, IN, 600032

Req ID:  24757

Summary

 

As a Senior Reference 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.

Your role in our mission

 

• Adheres to and supports configuration team approach and other configuration principles, methodologies, and practices
• Supports configuration team with solution development, proof of concept testing, and the development of audit reports and data validation checkpoints
• Completes configuration/data loads within schedule timelines and configuration best practices
• Experience with coordinating and managing incoming referential data, validating & obtaining approvals, and investigate data variances
• Reference Data Management - support and trouble shoot data variances in conversion and other phases of the DDI
 

What we're looking for

The primary responsibility of a Sr. Business Analyst (QNXT/Facets) is to analyze and document business processes, gather and define requirements, and collaborate with stakeholders to ensure the successful implementation of solutions that meet the unique challenges and requirements of the healthcare industry. The successful candidate will be an intellectually curious, self-directed individual with excellent organizational skills and attention to detail. This role is highly collaborative in nature providing support for IT and business teams. Performs complex analyses of State Medicaid Policies, and Legacy System business rules from data extracts.

  • 8 or more years of configuration experience; or working with the Data Schema of QNXT or FACETS applications (Focus on the following areas: Contracts, Benefits, Successful Data Points for X12 Transactions, CARCs/RARCs, Fee Schedules/Different Payment Methodologies, Capitation, & Rules)
  • Understands relational database concepts and schemas
  • Experience writing & executing SQL queries for data analysis
  • Experience working with Medicaid/MMIS systems.  Preferred experience includes DDI (Design, Development, and Implementation) and operations & maintenance phase
  • Support configuration team with triage & root cause analysis of Medicaid claims and encounters adjudication results
  • Experience with Requirement Traceability Matrices.
  • Healthcare/business knowledge in member, eligibility, TPL, claims processing, provider, pharmacy claims
  •  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.
     

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.

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