Advisor Technical Business Analyst - Medicaid FHIR Architecture & Interoperability

Gainwell Technologies LLC•Any city, OH

4d•$86,800 - $124,000•Remote

About The Position

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.

Requirements

9+ years experience as a Business Analyst or Technical Business Analyst in healthcare or public sector systems
Strong Medicaid domain expertise, including MMIS and state Medicaid operations
Hands‑on experience with FHIR (R4) in production or large‑scale implementations
Demonstrated experience performing data translation between legacy Medicaid formats and FHIR
Strong understanding of:
Proven ability to work effectively in architecture‑driven delivery models

Nice To Haves

Familiarity with Gainwell’s Provider+ Product data and system design
Experience supporting CMS interoperability initiatives (Patient Access API, Provider Directory API, PA API)
Familiarity with integration platforms and tools: Postman, Swagger/OpenAPI Interface engines (Mirth, Rhapsody) Cloud‑based integration services
Experience working on Medicaid transformation or modular MMIS modernization projects
Agile or hybrid SDLC experience in large enterprise environments
Strong systems thinking and architectural mindset
Able to balance policy, data, and technology considerations
Excellent written and verbal communication
High attention to detail and regulatory compliance
Comfortable influencing without authority across teams

Responsibilities

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.
Support governance reviews, standards compliance, and documentation required by state Medicaid programs and CMS.
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 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.