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 Gainwell 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 a 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. Here are the details on this position. We are seeking an experienced Medicaid Business Analyst to join our client delivery team supporting the Medicaid Management Information System (MMIS). While supporting operational execution of Medicaid workflow, this role will serve as a critical point of contact for our client and external stakeholders including MCOs, Providers and third parties. You will be the "front line" for triaging complex requirement issues, facilitating high-stakes conversations with state government stakeholders, and translating urgent operational needs into clear, actionable technical specifications for our internal product teams. The role requires active leadership, rapid problem-solving, and deep domain expertise in Medicaid workflows. Your role in our mission Client Liaison & Stakeholder Management - Act as the primary functional liaison between the client, MCOs, and our internal technical teams for all MMIS operations workflows - Lead requirements gathering sessions and "triage" meetings to address any surges in defects, change requests (CRs), and operational gaps. - Manage client expectations regarding system capabilities, timelines for fixes, and regulatory constraints. Requirements Engineering - Analyze and document complex requirement issues namely Claims (FFS & Encounters), Financials, Capitation, Provider Enrollment and others. - Translate high-level policy changes or operational pain points into detailed User Stories, Functional Design Documents (FDDs), and Technical Specifications for developers. - Validate that proposed technical solutions solve the business problem before development begins. .... your role continued Requirement issue resolutions - Investigate root causes of systemic issues reported by Providers or MCOs (e.g., mass claim denials, capitation payment errors, EDI rejection loops). - Collaborate with the Operations team to distinguish between "system defects" and "user training gaps," creating workarounds or documentation as needed. Domain Leadership - Serve as the Subject Matter Expert (SME) on Medicaid workflows, ensuring compliance with federal Centers for Medicare & Medicaid Services (CMS) and local (District) regulations. - Support the Compliance Manager in assessing the impact of new mandates (e.g., 1095-B reporting, T-MSIS data quality) on current system functionality. - Understanding of MITA 3.0 framework and CMS-64 financial reporting. What we're looking for - 5+ years of Business Analysis experience in Healthcare IT, with at least 2 years dedicated to ‘Medicaid MMIS’ (including CMS) or state-level Eligibility & Enrollment systems. - Domain knowledge - Deep understanding of Core MMIS modules: Claims Adjudication, Encounters Processing, Financial Management, Provider Management, MCO Capitation, 837/835 EDI transactions. - Technical proficiency - Experience with ALM tools (JIRA, Microfocus ALM, SharePoint) for requirements traceability. - Strong understanding of the SDLC in an Agile/Hybrid environment - Knowledge of Microsoft Excel advanced features such as macros and/or relational database software - Powerpoint and presentation skills Soft skills - Client-Facing Confidence: Proven ability to lead meetings with government clients and push back diplomatically when necessary. - Crisis Management: Ability to remain calm and structured during "surge" periods of high-volume issues and reporting. - 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 What you should expect in this role - Fully remote options from Contiguous US locations only - Office Hours: 8a - 5p Eastern time - Opportunities to travel through your work (0-10%) - Video cameras must be used during all interviews, as well as during the initial week of orientation - The deadline to submit applications for this posting has been extended until a suitable candidate is selected - #LI-HC1 - #LI-Medicaid MMIS The pay range for this position is $59,500.00 - $79,400 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 Gainwell. 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 Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies 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. Gainwell Technologies 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.

• Partner and Support PMT Stakeholders and PMT Initiatives • Serve as a business partner to Advisor Services Directors and PMT members to translate requests into clear requirements, prioritization, and deliverables. • Own intake for reporting and system requests (triage, scope, success criteria, timelines) and coordinate cross-functional resolution. • Prepares standard and consistent reporting for scheduled meetings between Advisor Services Directors, other PMT participants, and Advisor Team Leads. • Coordinates and prepares monthly Advisor Team reporting, key metrics, and variance analyses. • Analyzes and validates results to ensure accuracy, accountability, and data integrity. • Perform detailed ad hoc analysis to understand drivers of trends or results. • Maintain and enhance repeatable reporting assets and templates; write and maintain procedure documentation and metric definitions. • Maintain and improve service model reporting (expected vs. delivered touchpoints by tier, region/department and related roll ups) • Support engagement scoring processes and reporting outputs used in leadership and operational reviews • Partner with stakeholders to identify data gaps, improve classification, and reduce manual effort in recurring reporting • ActiFi: Support configuration, reporting/analytics, assessments, training/adoption, and enhancement requests in partnership with the vendor and internal stakeholders. • Salesforce Support Org: Support data integrity, user access/permissions questions, and field governance; partner with Helpdesk/Technology for admin changes. • Ensure key channels (Salesforce, Support Org, ActiFi, and downstream reporting) are updated with correct and accurate data. • Consolidate and maintain PMT data and statistics on an ongoing basis (e.g., NCNM, ECNM, net flows, engagement/activity metrics) across sources. • Identify data quality issues and drive resolution with appropriate data owners; implement lightweight controls and reconciliation checks. • Support automation/AI initiatives that improve the capture of follow-up items and streamline recurring reporting workflows. • Assist with preparation of presentations and leadership-ready materials (PowerPoint decks, one-pagers) for events such as Regional Roundtables and PMT initiatives. • Support communications strategy on behalf of PMT/Advisor Services, including updating intranet/Connections content when needed. • Prepare Growth Leaders Circle and Micro Monday reporting and statistics to be posted on Connections and presented, as requested.

Configuration experience in the Pricing, Provider, enrollment, and benefit modules of QNXT. - Provider reimbursement configuration set-up and maintenance. - Primary care provider capitation configuration set-up and maintenance. - Membership/divisions configuration set-up and maintenance. - Group/member premium configuration set-up and maintenance. - Medical management configuration set-up and maintenance. - Analysis, documentation, data entry, configuration and testing of the configuration set-up to support current operations and new market growth. - Maintenance and updates of various files and documentation, utilizing software such as Word, Excel, Access and Visio. - Knowledge of health plan operations in regard to information systems, system configuration and testing. Salary Range Now, a little about us … At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first—both patients and those who dedicate their lives to delivering care. And at the very core of this vital work is our incredibly talented people. People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare. Perks and benefits Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career. - Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family. - Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more. - And everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way. Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All qualified candidates are encouraged to apply.

• Guide discovery for project deliverables including software configuration, custom development, and integration. Record key decisions and business cases for project archive. • Analyze client needs and business processes. Identify functional and technical requirements needed to meet the client’s goals. • Write specifications to guide development efforts that meet those goals. • Proactively provide recommendations and best practice advice on meeting goals through software system configuration, customization, process improvement, and/or staff training. • Lead data focused projects with the client from scope to final solutions. • Develop and maintain relationships with clients and senior leadership. • Be the first point of contact for response to client technical questions. • Oversee Quality Assurance testing to ensure work products meet client requirements. • Educate and train clients on system functionality, particularly for go-live stabilization, offering users guidance to become proficient in use of new tools. • Participate in our knowledge-sharing culture by contributing to internal documentation and best practices. • Intentionally cultivate a collaborative environment that encourages creative problem-solving from all involved parties. • *The above statements are not intended to be a complete statement of job content, rather to act as a guide to the essential functions performed by the employee assigned to this classification. Management retains the discretion to add or change the duties of the position at any time.*