Senior Business Analyst - Medicaid Claims

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 Senior Business Analyst - Medicaid Claims 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

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

• Plans, designs and recommends business processes to improve and support business activities.
• Analyzes and documents client business requirements and processes and communicates these requirements by constructing conceptual data and process models, including data dictionaries and volume estimates from organization.
• Creates test scenarios and develops test plans to be used in testing the business applications in order to verify that client requirements are incorporated into the system design and assists in analyzing testing results throughout the project.
• Provides input into developing and modifying systems to meet client needs and develops business specifications to support these modifications
• Facilitates meetings with clients to gather and document requirements and explore potential solutions.
• Assists in coordinating business analyst tasks on information technology projects and provide support to other team members.
• Assists in analyzing testing results in all phases.
• Participates in technical reviews and inspections to verify intent of change is carried out through the entire project.
• Assists in providing time estimates for project related tasks.
• Assists with developing the methods and procedures required to identify whether current business goals and objectives meet organizational needs.

What we're looking for

• 6 or more years of Business Analyst experience in Healthcare industry with 3 or more years of Medicaid and Medicare experience preferred
• Experience working with MMIS Claims (but no EDI please)
• Pharmacy Claims experience is a plus
• Bachelor’s degree in business administration, information systems, or a related field preferred; or an equivalent combination of education and experience.
• Experience working with the interface of information technology with functional groups within an organization
• Experience working with business processes and re-engineering
• Experience working with computer programming concepts and basic language

Additional Skills

• Interpersonal skills to interact with customers and team members
• Strong communication skills
• Good analytical and problem-solving skills
• Presentation skills to present to management and customers
• Personal computer and business solutions software skills
• Good ability to work in a team environment with multiple team members
• Willingness to travel

What you should expect in this role

• Fully remote options from continental US locations only
• 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 February 24, 2026

#LI-HC1

#LI-MMIS Claims

The pay range for this position is $64,900.00 - $92,700.00 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