[Hiring] Technical Business Analyst @Gainwell Technologies LLC

Role Description

As an Advisor Technical Business Analyst - Medicaid FHIR Architecture & Interoperability 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.

Gainwell Technologies is seeking a Technical Business Analyst with deep Medicaid experience and strong FHIR architecture expertise to support large-scale Medicaid modernization and interoperability initiatives. This role sits at the intersection of state Medicaid policy, enterprise architecture, and modern data exchange standards and plays a key part in translating complex Medicaid data and workflows into scalable, FHIR-based solutions.

The ideal candidate has hands-on experience with Provider+, FHIR architecture, profiling, and data translation, and can operate as a trusted advisor to architects, engineers, and state clients—ensuring interoperability solutions are compliant, sustainable, and aligned to CMS and Gainwell standards.

Qualifications

• Nine or more years of experience working as a business analyst or ‘requirements translator’ between technical and non-technical personnel, with 3 or more years of Medicaid and Medicare experience preferred
• Knowledge of Microsoft Excel advanced features such as macros and/or relational database software
• Ability to clearly and concisely translate technical requirements to a non-technical audience
• Skills working with business processes and re-engineering
• 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

Requirements

• Serve as a FHIR-focused technical business analyst supporting Gainwell’s Medicaid interoperability and data exchange solutions.
• Translate state Medicaid business requirements, CMS mandates, and client-specific policies into FHIR-aligned technical requirements.
• Support architecture decisions related to FHIR-based integration patterns, including APIs, canonical data models, and transformation strategies.
• Partner with solution architects to ensure interoperability designs are scalable, reusable, and consistent with Gainwell enterprise standards.
• Serve as a technical translator between Medicaid business stakeholders, state agencies, and engineering teams.
• Clearly explain FHIR architecture and interoperability concepts to non-technical audiences.
• Lead analysis and documentation for mapping Medicaid data to and from FHIR (R4), including:
• MMIS data models ↔ FHIR
• X12 (270/271, 834, 837, 835) ↔ FHIR
• HL7 v2 ↔ FHIR
• Define and maintain FHIR profiles, extensions, value sets, and implementation guidance appropriate for Medicaid use cases.
• Support FHIR API design by reviewing resource structures, payloads, search parameters, and business rules.
• Ensure FHIR implementations align with CMS Interoperability and Prior Authorization rules, Patient Access and Provider Directory API requirements, and Gainwell reusable integration assets and patterns.
• Produce clear, detailed technical artifacts, including:
• FHIR data mapping documents
• API and integration use cases
• Sequence diagrams and process flows
• Acceptance criteria and validation rules
• Actively collaborate with integration and platform engineers, enterprise and solution architects, state Medicaid SMEs, and external vendors.
• Review and validate transformation logic, schemas, and API contracts.
• Support SIT and UAT by validating data accuracy, business compliance, and end-to-end interoperability.

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.