Principal Business Analyst - Medicaid

About the position

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. Your role in our mission oversees, plans and designs highly complex business processes and makes recommendations in order to improve and support business activities. You will analyze and document client's complex business requirements and processes; construct conceptual data and process models, including data dictionaries and volume estimates to communicate requirements. You will perform 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. Additionally, you will coordinate and facilitate meetings with clients on larger accounts to gather and document requirements and explore complex solutions. You will also coordinate business analyst tasks on information technology projects and provide project team member guidance/support throughout the project life cycle, while providing work guidance and mentoring to less experienced personnel. You will participate and provide expertise in technical reviews and inspections to verify the implementation of 'intent of change' through the entire project, create and maintain the architecture for highly complex business process domains to ensure alignment with the organization's technology priorities.

Responsibilities

• 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.
• Functions 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 provides 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.

Requirements

• 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, its 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.

Benefits

• Generous, flexible vacation policy
• Educational assistance
• 401(k) employer match
• Comprehensive health benefits
• Leadership and technical development academies