Principal Business Analyst - Medicaid

Summary

As an Principal Business Analyst - Medicaid 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

• Oversees, plans and designs highly complex business processes and makes recommendations in order to improve and support business activities.
• Analyzes and documents client's complex business requirements and processes; constructs conceptual data and process models, including data dictionaries and volume estimates to communicate requirements.
• Performs the function of a lead in creating complex test case scenarios for testing and/or monitoring the testing of business applications to verify that client requirements are incorporated into the system design.
• Function as a lead and provides input into the development and modification of systems to meet client needs.
• Coordinates and facilitates meetings with clients on larger accounts to gather and document requirements and explore complex solutions.
• Coordinates business analyst tasks on information technology projects and provide project team member guidance/support throughout the project life cycle. Provides work guidance and mentoring to less experienced personnel.
• Participates and provides expertise in technical reviews and inspections to verify the implementation of 'intent of change' through the entire project.
• Provides time estimates for project related tasks.
• Creates and maintains the architecture for highly complex business process domains to ensure alignment with the organization's technology priorities.

What we're looking for

• 12+ years of relevant Information Technology experience in a Business Analyst role with experience in Medicaid Management Information Systems (Claims Processing, Adjudication); Medicaid Industry, Payer Systems and HIPAA/X12/XML transactions are a must.
• Strong background in QNXT Framework (5.0+) development cycle, it’s underlying capabilities, integrations with third party products and outlier solutions and great understanding of its SQL data models (PlanData).
• Strong client communication skills translating client needs to actionable objectives, and analytical and business process re-engineering experience
• Experience using analytical software (Microsoft Excel or SQL), and other requirement-mapping tools (ALM, Application Lifecycle Management, Azure DevOps) tools
• Knowledge of software development methodologies; Agile, Scrum, SAFe.
• Experience with Lean Management, and Continuous & Business Process Improvement with the ability to collaborate with team members, engineering, DDI and stakeholders and follow established processes to meet team’s goals.
• Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members
• A caring team leader who motivates and coaches less experienced resources

What you should expect in this role

• Opportunities to travel through your work (0-10%)
• Fully remote options from most US locations and territories
• 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 June 24, 2025.

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