Business Analyst – Medicaid Buy-In Operations

🕒 October 17

🌪️ Kansas – Remote

🌪️ Kansas – Remote

💵 $55.6k - $79.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Answer Buy-In calls about coverage, benefits, enrollment, and eligibility • Explain Medicare Parts A and B, Medicare Savings Programs, and Medicaid Buy-In benefits • Research and resolve coordination-of-benefits, eligibility, coverage, and enrollment issues • Document inquiries, findings, and resolutions according to procedures • Coordinate with members, state agencies, CMS, health plans, and internal teams • Interpret Medicare and Medicaid policies to resolve inquiries • Identify trends and process improvement opportunities • Help develop requirements, procedures, and training materials • Comply with HIPAA, CMS regulations, and Gainwell policies • Support Medicare Buy-In operations and help Medicare-eligible members with coverage, eligibility, enrollment, and Buy-In questions

🎯 Requirements

• Bachelor’s degree or equivalent experience • At least 3 years of experience in Medicare, Medicaid, healthcare eligibility, enrollment, member services, or operations • Experience discussing healthcare coverage with members, beneficiaries, providers, or customers • Strong knowledge of Medicare Parts A and B, Medicare Savings Programs, and Medicaid • Excellent communication, customer service, analytical, and problem-solving skills • Ability to explain complex healthcare information clearly and professionally • Proficiency in Microsoft Office and healthcare systems • Medicare Buy-In program experience preferred • Knowledge of CMS regulations, Medicare eligibility, and Medicare Savings Programs (QMB, SLMB, QI, QDWI) preferred • Experience with state Medicaid agencies or government healthcare programs preferred • Call center, member services, or beneficiary support experience preferred • Fully remote options from most US locations and territories • Video cameras must be used during all interviews and during the initial week of orientation • Photo will be taken during screening for verification in all steps of the recruitment process • Stable internet connection and quiet location required for screenings, interviews, and meetings • Video required for screenings and interviews

🏖️ Benefits

• Work flexibility • Learning and career development • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies

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