Senior Business Analyst - Medicaid Claims & Eligiblity

Gainwell Technologies LLC•Any city, OH

1d•$69,400 - $99,200•Remote

About The Position

As a Senior Business Analyst - Medicaid Claims & Eligibility at Gainwell, you will leverage your expertise in Medicaid programs, business analysis, and process improvement to support critical healthcare initiatives that serve our clients and their members. The most successful candidates bring experience supporting Medicaid claims and eligibility operations, combined with strong analytical and business analysis skills. They excel at understanding complex business processes, translating stakeholder needs into clear requirements, identifying opportunities for operational improvement, and collaborating effectively with business and technical teams to deliver successful outcomes. Join a team that harnesses the power of technology to improve healthcare outcomes while providing opportunities for professional growth, flexibility, and career development.

Requirements

6 or more years of experience in a relevant Business Analyst position with 3 or more years of Medicaid and Medicare experience preferred.
Experience in Medicaid claims processing and eligibility business functions strongly preferred.
Knowledge of computer programming concepts such as configuration, development, and batch processing.
Advanced knowledge of analytical software such as Microsoft Excel or SQL and requirement-mapping tools such as Application Lifecycle Management (ALM) tools.
Strong client communication skills translating client needs into actionable objectives.
Strong analytical, business process re-engineering, and business process modeling skills.
Demonstrated ability to gather, elicit, analyze, document, and validate business requirements.
Strong critical thinking and problem-solving capabilities.
Strong executive presence and communication skills to deliver messages to business leaders, clients, and technical personnel.
A leader who motivates others to action and communicates key technical ideas in a digestible way.
Proven ability to elicit, analyze, document, and validate business and system requirements.
Strong verbal and written communication skills, with the ability to effectively collaborate with business stakeholders, clients, and technical teams.
Experience with Business Process Modeling and process improvement methodologies.
Demonstrated critical thinking, analytical problem-solving, and decision-making skills.
Knowledge of Medicaid claims processing, including claims lifecycle workflows and related business processes.
Experience with Medicaid eligibility and claims operations strongly preferred.
Proficiency with Microsoft Word and Microsoft Excel required on day one.
Experience using analytical and requirement management tools such as Excel, SQL, ALM, or similar platforms preferred.
Ability to learn client-specific systems, applications, and business process tools as needed.

Nice To Haves

3 or more years of Medicaid and Medicare experience preferred.
Experience in Medicaid claims processing and eligibility business functions strongly preferred.
Experience with Medicaid eligibility and claims operations strongly preferred.
Experience using analytical and requirement management tools such as Excel, SQL, ALM, or similar platforms preferred.

Responsibilities

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.
Help coordinate a business analyst team’s duties and activities on IT projects and nurture newer team members by providing guidance and support.
Be a knowledgeable bridge between clients, project managers and technical staff to define, document and share business requirements and expected impact.
Work with the client to develop business specs at the start of a technical project.
Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals.
Help verify that all requirements have been met by approving and validating test results.
Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work.