Expert Business Analyst - Construction Manager

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

The Principal Solution Architect will be responsible for designing and overseeing the development and integration of Medicaid Management Information Systems (MMIS) solutions to support Medicaid operations. This role requires strong expertise in enterprise architecture, healthcare information systems, and a deep understanding of Medicaid programs and federal compliance. The MMIS Solution Architect will also engage with clients through presentations, discussions, and technical consultations, ensuring the technical architecture aligns with both business and regulatory requirements, with a specific focus on the Medicaid Information Technology Architecture (MITA) business process areas.

Your role in our mission

Take charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes.

• Lead the design and implementation of scalable, secure, and compliant MMIS solutions that meet state Medicaid program needs.
•  Leverage deep functional knowledge of MITA (Medicaid Information Technology Architecture) business process areas, including:
  • Member Management, Provider Management, Claims Processing, Care Management, Financial Management, Third-Party Liability (TPL), Managed Care, and Pharmacy Benefit Management (PBM)
• Serve as the technical point of contact for clients, facilitating solution discussions, answering queries, and ensuring clear communication regarding system architecture and design.
• Create and deliver presentations, system demonstrations, and technical documentation to clients and stakeholders, explaining the architectural vision and how it aligns with their Medicaid program requirements.
• Develop strategies for integrating MMIS with other healthcare systems, ensuring seamless data exchange across platforms.
• Ensure MMIS solutions comply with federal and state regulations, including CMS guidelines, HIPAA, and MITA framework.
• Design solutions for effective data management, reporting, and analytics within the MMIS to support Medicaid program operations.
• Risk Management

What we're looking for

• Bachelor's degree in Computer Science, Information Systems, or a related field (Master’s degree preferred)
• Minimum 8-10 years of experience in IT solution architecture, with at least 5 years in Medicaid or healthcare systems.
• Functional knowledge of MITA business process areas, including Member Management, Claims Processing, Provider Management, Care Management, and Financial Management.
• Expertise in SOA (Service-Oriented Architecture), cloud technologies, and modern integration techniques.
• Proficiency in data management, security protocols, and regulatory compliance in healthcare environments.
• Excellent communication and collaboration skills, with the ability to engage both technical and non-technical stakeholders.
• Presentation Skills, Client-Focused.
• Experience with modular MMIS solutions and the transition from legacy systems.
• Familiarity with healthcare data standards such as HL7, FHIR, or X12.
• Knowledge of cloud platforms like AWS, Azure, or Google Cloud in a healthcare context.

What you should expect in this role

• Fully remote options from most US locations and territories