Business Analyst – MMIS, Pharmacy

🕒 May 19

🤠 Texas – Remote

🤠 Texas – Remote

💵 $86.8k - $124k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

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

• Supports business, policy, and technical execution across MMIS and/or the Medicaid Pharmacy environment. • Acts as the primary Domain SME and trusted advisor on business processes and regulatory impacts. • Ensures compliance alignment and validates solution design. • Lead and participate in requirements and design sessions with clients and teams. • Develop and maintain domain design documentation and ensure accuracy of requirements.

🎯 Requirements

• 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.

🏖️ Benefits

• Generous, flexible vacation policy • Educational assistance • Comprehensive health benefits • 401(k) employer match • Leadership and technical development academies