Business Analyst - Reference

Summary

As a Business Analyst - Reference 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.

In this role, you will support Benefit Plan Administration (BPA) by analyzing and documenting benefit structures, eligibility rules, and plan configurations, while partnering closely with configuration teams to ensure requirements are accurately translated into system setup and reference data updates. You’ll collaborate with cross‑functional teams to design effective processes, enhance system functionality, and contribute to the continuous improvement of critical Medicaid and Medicare programs.

Your role in our mission

• Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities.
• Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates.
• Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design.
• Assists in developing and modifying systems requirements documentation to meet client needs.
• Participates in meetings with clients to gather and document requirements and explore potential solutions.
• Executes systems tests from existing test plans. Assists in analyzing test results in various phases.
• Participates in technical reviews and inspections to verify 'intent of change' is carried through phase of project.

What we're looking for

• 3 or more years of experience in a relevant Business Analyst position with 2 or more years of Medicaid and Medicare experience preferred
• 2+ years of Claims experience required 
• Experience with Benefit Plan Administration (BPA), including benefit plan setup, rules interpretation, configuration validation, and plan change impact assessment
• Hands-on knowledge of system configuration processes, including configuration design, reference data updates, business rule maintenance, or similar configuration lifecycle activities
• Bachelor’s Degree in IT, MIS, Computer Science, or similar is preferred

Core Competencies

• Technical & Analytical Expertise: Skilled in computer programming concepts (configuration, development, batch processing) with advanced proficiency in analytical tools such as Microsoft Excel, SQL, and requirement-mapping platforms like ALM.

• Business Process Optimization: Strong analytical skills with proven experience in business process re-engineering and translating complex requirements into actionable solutions.

• Strategic Communication: Exceptional ability to convey technical and business concepts clearly to executives, clients, and technical teams, ensuring alignment and informed decision-making.

• Leadership & Influence: A motivating leader who inspires action, fosters collaboration, and simplifies technical ideas for diverse audiences to drive successful outcomes.

What you should expect in this role

• Opportunities to travel through your work (0 -10%)
• Fully remote options from continental US and Alaska locations only
• Office Hours : Central Time Zone 8a-5p (Core Hours: 9a - 4p central time, required)
• 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 has been extended until a suitable candidate is selected

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