Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary As a
Senior Pharmacy Analyst - WI 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 - Working under the supervision of the Pharmacy Benefit Manager within the Bureau of Clinical Policy and Pharmacy and serves as an embedded resource on the pharmacy team.
- The pharmacy section develops and implements drug coverage and reimbursement policies for outpatient drugs.
- This position collaborates with a team of policy analysts, systems analysts, and clinical staff.
- Primary responsibility is for the assessment, monitoring, and ongoing maintenance of the drug reference file, which includes items covered under the pharmacy benefit and physician-administered drugs.
- Serves primarily as an information and data analyst for the drug reference file and is responsible for the evaluation and ongoing management needed for accurate maintenance of the drug reference file and its functionality within Wisconsin's Medicaid Management Information System (MMIS).
- Ongoing activities include, but are not limited to, drug file data maintenance, analysis, research, and published data table maintenance.
- Long-term activities include analyzing proposed changes to the drug reference file, developing alternatives, and proposing initiatives to improve the quality and efficiencies of the drug reference file.
What we're looking for - 6 or more years of experience as Business Analyst in Healthcare / Pharmacy Industry including 3 or more years of Medicaid and Medicare experience
- Access database and Medicaid Pharmacy Benefit experience is a plus
- Experience in Pharmacy reimbursement and understanding of drug coverage rules
- Experience as a systems business analyst
- Understanding of National drug codes (NDC)
- Experience with drug claims processes
What you should expect in this role - Remote residing within the state of WI- occasional in office training may occur
- 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 July 30, 2026
#LI-HC1
#LI-Medicaid Pharmacy Benefit
#LI-Wisconsin
The pay range for this position is $69,400.00 - $99,200.00 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. 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.
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