Principal Business Analyst - Medicaid

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 an Principal 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.

Your role in our mission

• Oversees, plans and designs highly complex business processes and makes recommendations in order to improve and support business activities.
• Analyzes and documents client's complex business requirements and processes; constructs conceptual data and process models, including data dictionaries and volume estimates to communicate requirements.
• Performs the function of a lead in creating complex test case scenarios for testing and/or monitoring the testing of business applications to verify that client requirements are incorporated into the system design.
• Function as a lead and provides input into the development and modification of systems to meet client needs.
• Coordinates and facilitates meetings with clients on larger accounts to gather and document requirements and explore complex solutions.
• Coordinates business analyst tasks on information technology projects and provide project team member guidance/support throughout the project life cycle. Provides work guidance and mentoring to less experienced personnel.
• Participates and provides expertise in technical reviews and inspections to verify the implementation of 'intent of change' through the entire project.
• Provides time estimates for project related tasks.
• Creates and maintains the architecture for highly complex business process domains to ensure alignment with the organization's technology priorities.

What we're looking for

• 12+ years of relevant Information Technology experience in a Business Analyst role with experience in Medicaid Management Information Systems (Claims Processing, Adjudication); Medicaid Industry, Payer Systems and HIPAA/X12/XML transactions are a must.
• Strong background in QNXT Framework (5.0+) development cycle, it's underlying capabilities, integrations with third party products and outlier solutions and great understanding of its SQL data models (PlanData).
• Strong client communication skills translating client needs to actionable objectives, and analytical and business process re-engineering experience
• Experience using analytical software (Microsoft Excel or SQL), and other requirement-mapping tools (ALM, Application Lifecycle Management, Azure DevOps) tools
• Knowledge of software development methodologies; Agile, Scrum, SAFe.
• Experience with Lean Management, and Continuous & Business Process Improvement with the ability to collaborate with team members, engineering, DDI and stakeholders and follow established processes to meet team's goals.
• 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

• Opportunities to travel through your work (0-10%)
• Fully remote options from most US locations and territories
• 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 is June 24, 2025.

#LI-HC1

The pay range for this position is $108,500.00 - $155,000.00 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 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.