[Hiring] Business Analyst Advisor - Provider+ @Gainwell Technologies LLC

Role Description

As a Advisor Business Analyst - Provider+ 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.

• Support business, policy, and technical execution across one or more functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment.
• Translate state and federal Medicaid policy and program requirements into product features, system configuration, and design artifacts.
• Work closely with the Domain Lead, Technical Analysts, and cross-functional teams as a domain and policy subject-matter expert (SME).

Qualifications

• 9+ years of hands-on experience supporting healthcare system implementations, including MMIS solutions and Medicaid Pharmacy platforms.
• Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field.
• Experience with QNXT or similar healthcare claims/encounter management systems.
• Strong knowledge of state and federal Medicaid policy, regulations, and program rules.
• Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes.
• Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts.
• Strong knowledge of SQL, particularly for data analysis and validation.
• Strong client communication skills, with experience interacting directly with business stakeholders.
• Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions.
• Strong documentation, facilitation, and analytical skills.
• Experience working in SDLC and Agile delivery environments.

Requirements

• Acts as the primary Domain Subject Matter Expert (SME) and trusted advisor to the Engagement Lead (EL).
• Ensures solution design and configuration align with CMS guidance, state policy, and documented business rules.
• Supports in-scope negotiations and change control by evaluating scope trade-offs and associated functional, regulatory, and operational impacts.
• Leads and participates in requirements and design sessions with clients and internal teams.
• Interprets federal and state Medicaid policy, translating it into product features, system configurations, business rules, and design artifacts.
• Develops and maintains domain design documentation covering workflows, interfaces, X12 EDI transactions, letters, and reports.
• Ensures requirements and acceptance criteria are accurate, complete, and traceable.
• Documents and communicates decisions, risks, assumptions, and dependencies.
• Supports configuration and implementation activities across Design, Development, and Implementation (DDI).
• Partners with technical teams to ensure alignment with approved designs, policy interpretation, and business rules.
• Reviews test cases for alignment with requirements and policy.
• Provides SME support during System Integration Testing (SIT) and User Acceptance Testing (UAT).
• Supports operational readiness across environments, data, processes, and staffing.
• Partners closely with Domain Leads, technical teams, and stakeholders as a trusted SME.
• Plans and delivers demos and walkthroughs to validate solutions against requirements.

Benefits

• Fully remote options from most US locations and territories.
• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to help build your skills and capabilities.