Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at HMS, a Gainwell Company carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary As an Advisor Business Analyst - Fraud, Waste & Abuse at Gainwell, you may contribute your skills as we harness the power of technology to help our clients identify and investigate healthcare fraud and abuse. You will serve as a core member of the FraudCapture product team responsible for building, maintaining and enhancing our web-based SaaS solution. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission Requirements & Product Development Support - Translate business needs into detailed UI mock-ups and requirements/user stories that guide development efforts - Proactively identify opportunities for system enhancements or gaps that increase product value and operational efficiency based upon new industry trends/schemes or client need - Define acceptance criteria and expected system behavior. Apply the test scenarios to execute User Acceptance Testing to verify that systems are functioning properly and business requirements are incorporated into the system design - Participate in post-deployment testing sessions that occur after normal business hours (Typically one Thursday evening every month) - Communicate effectively with both technical and non-technical audiences and capable of building and maintaining relationships with key stakeholders - Create and maintain organized product project plans through integrated management tools to support product development (i.e., Azure DevOps or other tools) Client Engagement & Product Solution Delivery - Utilize product knowledge combined with extensive Payment/Program Integrity subject matter expertise to lead requirement elicitation meetings with clients and stakeholders - Configure and tailor client system environments (rules, alerts, case workflows, etc.) - Deliver product demos, walkthroughs, and training as needed - Develop and maintain internal & client training documents, job aids, and product enhancements/release notes - Support daily product maintenance and client satisfaction What we're looking for - 5+ years of SME experience leading healthcare fraud and abuse detection and investigations - 2+ years of experience in requirement elicitation, analyzing and documenting business processes and system requirements that are leveraged by development teams - Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members - Ability to clearly and concisely translate technical requirements to a non-technical audience Certification: Professional certification as a Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) is desirable. What you should expect in this role - Fully Remote from Contiguous US locations only - Video cameras must be used during all interviews, as well as during the initial week of orientation - Opportunities to travel through your work for industry training, client implementation or requirements gathering (0-10%) - Work environment is a mix of client interaction, internal teamwork and individual work - Fast-paced SaaS environment The deadline to submit applications for this posting is April 30, 2026 - #LI-HC1 - #LI-FWA - #LI-Healthcare Fraud and Abuse detection - #LI-RequirementsAnalysis The pay range for this position is $86,800.00 - $124,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at HMS, a Gainwell Company. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with HMS, a Gainwell Company, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS, A Gainwell Technologies Company at our company website and visit our Careers site for all available job role openings. HMS, a Gainwell Company, is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. HMS defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

Responsible for leading system or application development or support. Provides vision to the team and assist in technical and/or specialized work in the areas of design, development, enhancements, maintenance, troubleshooting, monitoring, reporting, and support of business applications and systems. For assigned projects and initiatives, analyze customer requirements, evaluate technology options, develop tactical and strategic plans, evaluate vendor products, recommend end-to-end solutions, implement solutions, and ensure overall quality of deliverables against requirements Serve as product owner in the design, development, enhancement, and implementation of integrated system solutions and reporting Operate as a change agent – work with the team to find innovative ways of meeting business demand while delivering exemplary support and delivery services thru supported applications Analyze core database schemas to facilitate and develop accurate custom reporting including ad hoc and daily, weekly, monthly, etc. production reporting of performance metrics Management, administration, real-time monitoring, and adjustment of business applications to enable and optimize the performance of the business Provide hands-on support to troubleshoot, diagnose, and resolve business impacting issues in conjunction with business partner, IT, and vendor Propose changes to address system issues/problems/improved functionality and capability from a system/application support perspective Document, track, and monitor problems to ensure a timely resolution Perform continuous in-depth analysis on results and provide strategic solutions to improve performance Facilitate user acceptance testing with end-users before deployment Participate in the development of on-line knowledge management tools for system procedures through effective interaction with business partners and broad understanding of policies and procedures within the division Coordinate system changes to ensure data integrity Assist in evaluating vendor packages and make recommendations For medium to large project efforts, analyze data, identify informational or process requirements/needs, write user stories, identify problems, provide technical advice or consultation, and develop logical solutions to problems Analyze, diagnose, and draw conclusions on simple to complex technical problems Create new and/or revised technical procedures and processes and/or follow established procedures, service, and support standards Job Specifications Typically has the following skills or abilities: Bachelor’s Degree in Business Administration or related field, or equivalent experience 4+ years business or systems analyst experience Experience managing vendors to a contractual agreement with defined service levels Experience managing stakeholder relationships Experience planning, implementing and managing process change in an organization Advanced knowledge of Microsoft Excel, Cognos, and/or SQL Ability to work with and analyze large sets of data Excellent verbal and written communication skills, including the ability to translate complex technical concepts into understandable terms and able to tailor communication to audience Strong analytical and organizational skills Demonstrated ability to problem solve and troubleshoot simple to relatively complex systems or process issues and design specific solutions Ability to provide 24x7 global on-call production support as needed Ability to regularly exercise discretion and independent judgment in the performance of his/her job duties #LI-VISIONCARE Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. Salary Ranges: $63,000.00 - $108,675.00 VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing. Unincorporated LA County Residents: Qualified Applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act, and any other similar laws. Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees.  VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.

Develop, research, test, and implement business process improvements, procedures, and system changes. Use independent judgement to gather and evaluate information to make recommendations for improvements to business processes or systems. Develop alternative views and future business needs to assist management in making business changes to stay ahead of the competition Research the external market and internal business to find and leverage patterns and best practices to improve business processes Apply advanced analysis skills in the development of business process models, procedures, and systems Lead teams to continually look at process improvement strategies for business processes and systems Evaluate business process changes to identify and document business impacts and benefits at a corporate level Act as subject matter expert to provide business requirements for process improvements and system enhancements Conduct effective interview/research to determine and document the stakeholders, business needs and requirements Serve as a mentor for requirement methodology and analysis best practices Review technical design deliverables to ensure business objectives are reached Assist business stakeholders to design user acceptance testing, defect reporting and resolution, with the ability to lead others in these activities Identification of training and development materials, communications of changes, manuals, etc. Provide post-implementation support, such as problem resolution, adjustments to new procedures, and change management Develop presentations of materials, models, findings, plans, and/or conclusions Job Specifications Typically has the following skills or abilities: Bachelor’s Degree in Business Administration or related field, or equivalent experience 4+ years of experience in data gathering, research & analytics, problem identification, and presenting solution recommendations 4+ years of experience with financial and risk analysis, making recommendations and preparing business cases including cost benefit analysis 4+ years of in-depth knowledge of project planning techniques and methodologies 4+ years of experience with business process analytics using Excel, flowcharting, activity diagrams and workflow models Demonstrated ability to document, propose, negotiate, and present approaches and solutions Ability to visualize and create plans for future business outcomes and changes Thorough understanding of business implications, project interdependencies, and system interfaces Strong conflict management skills Proficient at facilitating meetings, and negotiating across all levels of the organization Ability to multi-task and work in a team environment Proven ability to effectively communicate information to a wide variety of technical and non-technical individuals or groups at all levels of the organization Regularly exercise discretion and independent judgment in the performance of job duties #LI-VISIONCARE Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. Salary Ranges: $63,000.00 - $108,675.00 VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing. Unincorporated LA County Residents: Qualified Applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act, and any other similar laws. Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees.  VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.

Join us as an Operations Transformation Business Analyst - Take on a pivotal role with Operations Transformation team in Customer & Operations, understanding the customer and operations needs and designing innovative solutions that shape the future of our end-to-end service delivery - You’ll lead meaningful transformation by problem-solving and partnering with senior stakeholders and cross‑bank teams to design solutions that unlock better ways of working - Join a vibrant, forward-looking team where you’ll hit the ground running, develop in-demand skills, and accelerate your career What you’ll do As our Operations Transformation Business Analyst, you’ll play an important part in shaping our future-state designs by turning business and customer needs into clear, actionable requirements for Operations. You’ll help teams understand what’s needed, why it matters, and how it connects to the broader Operations strategy. You’ll also be front-and-centre in building strong, trusted relationships with senior stakeholders and third-party suppliers across multiple franchises and functions. Drawing on your specialist knowledge and experience in operations, processes and systems, you’ll drive smart, innovative solutions that make a real impact. You’ll look beyond the immediate task to spot wider business effects and interdependencies, so every outcome fits smoothly into the bigger picture. You’ll also be: - Capturing, validating and documenting business and system requirements, making sure they align with key strategic principles and the Operations strategy - Working with Operations colleagues, key stakeholders and the team to gather and document both functional and non-functional needs - Reviewing existing process and system documentation to identify opportunities for operational improvements - Providing temporary support for the delivery of critical projects or programmes, or acting as a temporary lead for new initiatives when required - Helping identify team priorities based on feedback from Operations colleagues, key stakeholders and the wider team The skills you'll need To thrive in this role, you’ll bring an accredited business analyst certification, such as BAX, CPRE or CBAP, along with a sharp analytical mindset. You’ll also need strong organisational skills that help you stay on top of competing priorities. You’re someone who can move confidently through ambiguity, balancing big‑picture thinking with meticulous attention to detail. You’ll have the curiosity and drive to explore emerging technical capabilities and understand how Operations can put them to work. You’ll also need: - Experience analysing business systems and processes to identify opportunities and solve complex problems using data from Operational, Technology, Finance and HR - Strong working knowledge of Agile values, principles and methodologies, with hands-on experience of working within an Agile environment - Ability to translate high‑level concepts into clear, actionable requirements - Excellent stakeholder management and influencing skills - Proven experience designing and delivering change within a banking operations team, driving measurable customer and business outcomes - Strong collaboration skills, with the ability to engage and communicate effectively with multiple stakeholders across the bank, including senior audiences Hours 35 Job Posting Closing Date: 20/04/2026 Ways of Working:Remote First