Senior Business Analyst – Medicaid Pharmacy

🕒 Junho 5

🌽 Illinois, Texas – Remoto

info

💵 $69.400 - $99.200 / ano

⏰ Tempo Integral

🟠 Sênior

🧐 Analista de Negócios

🦅 Patrocina Visto H1B

info

🗣️🇺🇸🇬🇧 Inglês obrigatório

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Gainwell Technologies

10.000+ funcionários

⚕️ Seguro de Saúde

💰 Grant em 2023-06

Healthcare Insurance • Human Services • Healthcare

A Gainwell Technologies é a principal provedora do país de soluções digitais e cloud-enabled em todo o ecossistema de serviços humanos e saúde pública. Com uma abordagem orientada por propósito, a Gainwell atende clientes nos 50 estados dos EUA, com foco em melhorar os desfechos em saúde e oferecer experiências intuitivas e centradas nas pessoas. Seu portfólio abrangente inclui modernização do Medicaid Enterprise, data analytics, serviços para prestadores e soluções para farmácia — tudo projetado para impulsionar o futuro da saúde e promover o bem-estar das comunidades.

Descrição

• Supports business, policy, and technical execution across one or more functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment • Works closely with Domain Lead, Technical Analysts, and cross-functional teams to ensure successful implementation and operational readiness • Ensures compliance alignment by validating that solution design and configuration conform to CMS guidance, state policy, and documented business rules • Supports the Domain Lead with analysis, interpretation, and solution recommendations • Develops and maintains domain design documentation, with the Design Document as a core deliverable • Supports operational readiness activities, including environment, data, process, and staffing readiness • Acts as a trusted domain and policy SME leading client communication, including requirement discussions, design reviews, and issue resolution.

🎯 Requisitos

• Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field • 5 to 8 years of hands-on experience supporting healthcare system implementations, including MMIS solutions and Medicaid Pharmacy platforms • Experience with QNXT or similar healthcare claims/encounter management systems • Strong knowledge of state and federal Medicaid policy, regulations, and program rules (required) • Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes • Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts • Strong knowledge of SQL is required, particularly for data analysis and validation • Strong client communication skills, with experience interacting directly with business stakeholders • Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions • Strong documentation, facilitation, and analytical skills • Experience working in SDLC and Agile delivery environments.

🏖️ Benefícios

• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • leadership and technical development academies

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