Gainwell Technologies is an award-winning digital health technology company that supports the administration of healthcare and human services programs. In past
Senior Business Analyst – Provider
Location
Texas
Posted
4 days ago
Salary
$69.4K - $99.2K / year
Seniority
Senior
Job Description
Senior Business Analyst – Provider
Gainwell Technologies
• Supporting business, policy, and technical execution across functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment. • Ensuring solutions align with CMS guidance, state policy, and documented business rules. • Leading and participating in requirements and design sessions with clients and internal teams to validate functional and technical needs. • Interpreting federal and state Medicaid policies and translating them into system configuration, product features, business rules, and design artifacts. • Developing and maintaining domain design documentation, including a comprehensive Design Document covering workflows, interfaces, X12 EDI transactions, letters, and reports. • Supporting operational readiness across environments, data, processes, and staffing.
Job Requirements
- Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field
- 5 to 8 years of hands-on experience supporting healthcare system implementations, including MMIS solutions and Medicaid Pharmacy platforms
- Experience with QNXT or similar healthcare claims/encounter management systems
- Strong knowledge of state and federal Medicaid policy, regulations, and program rules (required)
- Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes
- Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts
- Strong knowledge of SQL is required, particularly for data analysis and validation.
- Strong client communication skills, with experience interacting directly with business stakeholders
- Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions
- Strong documentation, facilitation, and analytical skills
- Experience working in SDLC and Agile delivery environments.
Benefits
- generous, flexible vacation policy
- educational assistance
- comprehensive health benefits
- 401(k) employer match
- leadership and technical development academies
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