Senior Application Architect

Gainwell Technologies LLC•Any city, OH

3d•$95,100 - $135,800•Remote

About The Position

The role works across one or more healthcare functional domains, such as Member, Provider, Claims/UM, Pharmacy, Finance, Plan, or VUE360, bridging business needs with technical execution. In collaboration with Business Analysts and Configuration Analysts, the position helps ensure solutions are technically sound, data-driven, and aligned with project and system architecture. It supports system design and technical specification creation, data setup, testing, and decision-making throughout the SDLC. The description emphasizes healthcare and Medicaid pharmacy claims, including NDC-based pricing, DUR edits, prior authorization workflows, and pharmacy benefit rules. The position translates detailed business requirements into technical specifications and data models; analyzes system data, integrations, data flows, and dependencies; and uses advanced SQL and Data Element Dictionaries to support solution design, testing, and quality assurance. It serves as a liaison among business users, developers, QA, and configuration teams, documents technical decisions and risks, recommends scalable solutions aligned with enterprise architecture, mentors junior technical analysts, and supports defect resolution, configuration validation, and pre-deployment checks. This is a fully remote opportunity for candidates in the U.S., with minimal travel (0–10%). Video cameras are required during interviews and the initial week of orientation. The application deadline is October 27, 2026. The stated annual pay range is $95,100–$135,800, with actual base pay varying based on factors including geographic region, internal equity, job-related knowledge, skills, and experience.

Requirements

3–5 years of experience in a technical analyst, data analyst, or healthcare systems analyst role.
Advanced SQL skills, including joins, data transformations, and manipulation of large datasets; pharmacy claims dataset experience is relevant.
Strong understanding of healthcare systems and Medicaid concepts, including Medicaid pharmacy claims processing, NDC-based pricing, DUR edits, prior authorization workflows, and pharmacy benefit rules.
Familiarity with Data Element Dictionaries (DEDs), interface specifications, and integration design, including pharmacy-related interfaces such as NCPDP.
Excellent communication and documentation skills.

Nice To Haves

Experience working in SDLC and Agile environments.
Understanding of system implementation in cloud platforms such as AWS, Azure, or Google Cloud.

Responsibilities

Translate detailed business requirements into technical specifications and data models, including pharmacy claims adjudication logic, pricing methodologies, DUR edits, and prior authorization workflows.
Support business analysts by explaining how system data and integrations meet operational and policy needs, including pharmacy benefit rules and claims data structures.
Apply healthcare and pharmacy domain knowledge to validate logic, dependencies, and downstream effects of technical decisions.
Use advanced SQL to extract, analyze, and validate data for solutioning, testing, and quality assurance, including pharmacy claims data elements.
Interpret Data Element Dictionaries (DEDs) to understand data structures and relationships across modules, including pharmacy-specific dictionaries.
Analyze and document data flows, integration logic, and technical dependencies across internal systems and external interfaces, including NCPDP pharmacy interfaces and pharmacy PA systems.
Liaise among business users, developers, QA, and configuration teams to establish shared understanding of requirements and pharmacy-specific rules.
Document and communicate technical decisions, risks, and impacts to stakeholders, including pharmacy program impacts.
Develop technical solution models and recommend scalable approaches aligned with enterprise architecture and platform capabilities.
Mentor junior technical analysts on data standards, SQL best practices, and documentation expectations.
Provide analytical support for defect resolution, system configuration validation, and pre-deployment quality checks, including pharmacy claims adjudication and DUR logic validation.