Gainwell Technologies LLC
Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we've been innovating in the industry for more than 50 years.
Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries nationwide and manage 1 billion encounters annually. Additionally, about 1.5 billion immunization records are maintained, and we serve more than 3 million providers annually.
We do this while saving our state and commercial clients 5.5 billion dollars annually in cost avoidance. Our commitment to clients drives continuous improvement in the quality of healthcare for beneficiaries nationwide through vital healthcare technology.
In summary, there's no company better positioned in the Medicaid and HHS (Health and Human Services) market than Gainwell.
For more information on Gainwell, visit www.gainwelltechnologies.com
Summary
Essential Job Functions
Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities.
Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates.
Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design.
Assists in developing and modifying systems requirements documentation to meet client needs.
Participates in meetings with clients to gather and document requirements and explore potential solutions.
Executes systems tests from existing test plans. Assists in analyzing test results in various phases.
Participates in technical reviews and inspections to verify intent of change is carried through phase of project.
What we're looking for
Business Analyst
Summary
Assists in the research and assessment of business goals, objectives and needs to align information technology solutions with business initiatives for multiple, less complex accounts. Serves as the liaison between technical personnel and business area for multiple accounts.
Basic Qualifications
3+ years of experience in Business Analyst, Claims adjudication, Medicaid or Medicare, SQL.
3+ years of business functional experience in one or more areas such as Eligibility, Claims.
Strong SQL knowledge. Ability to write complex queries.
Ability to gather requirements effectively; document requirements and confirm observations with business owners. Also, to perform fit/gap analysis based on requirements.
Experience using Microsoft Office Tools, specifically Excel.
Ability to create detailed and thorough design documents and test plans/execution for medium to large initiatives.
Being able to research, analyze, validate and document business requirements.
What you should expect in this role
Fast-paced, challenging and rewarding work environment.
Work life balance.
Hybrid Office environment.
Will require late evening work to overlap US work hours.
Req-30055
Business Analyst (Medicaid) - Claims

HC & Insurance Operations Associate

Quality Engineer - Contract Role

Business Analyst (Medicaid) - Claims

Non Voice Process Executive

Prior Authorization Specialist

Customer Service & Operations Analyst

Senior CODER