Gainwell Technologies · 1 week ago
Senior Business Analyst - Medicaid
Wisconsin, United States
Full-time
Onsite
Mid, Senior Level
$69K/yr - $99K/yr
6+ years expGainwell Technologies is a company focused on improving health and well-being through innovative technology solutions. As a Senior Business Analyst - Medicaid, you will leverage your expertise to enhance healthcare processes and systems, ensuring compliance and addressing client needs in claims processing and benefit administration.
Health CareInformation Technology
Responsibilities
Plans, designs, and recommends business processes to improve and support healthcare-related business activities
Analyzes and documents client business requirements and processes, with a focus on claims processing workflows (institutional and professional), benefit plan rules, and adjudication logic
Communicates requirements by constructing conceptual data and process models, including data dictionaries and volume estimates
Creates test scenarios and develops test plans to validate healthcare claims processing functionality, ensuring compliance with Medicaid and other payer requirements
Provides input into developing and modifying systems to meet client needs, including MMIS or similar healthcare platforms
Facilitates meetings with clients to gather and document requirements and explore potential solutions for claims processing and benefit plan administration
Assists in coordinating business analyst tasks on healthcare IT projects and provides support to other team members
Participates in technical reviews and inspections to verify that changes align with business intent and regulatory compliance
Assists in providing time estimates for project-related tasks
Develops methods and procedures to ensure current business goals and objectives meet organizational and regulatory needs
Qualification
Required
Six or more years of business analysis experience in Healthcare industry
Experience in healthcare claims processing (institutional and professional), benefit plan rules, and adjudication logic required
Experience working with the interface of information technology and functional groups within an organization
Experience with business processes and re-engineering
Familiarity with computer programming concepts and basic language
Strong interpersonal skills to interact with customers and team members
Excellent communication and analytical skills
Ability to present findings and recommendations to management and clients
Proficiency with personal computer and business solutions software
Ability to work collaboratively in a team environment
Willingness to travel as needed
Preferred
Bachelor's degree in business administration, information systems, healthcare administration, or related field preferred. or equivalent combination of education and experience
Experience with Medicaid Management Information Systems (MMIS) or similar healthcare platforms strongly preferred
To a lesser extent, experience with dental claims processing is also desirable
Benefits
Generous, flexible vacation policy
A 401(k) employer match
Comprehensive health benefits
Educational assistance
Variety of leadership and technical development academies
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
H1B Sponsorship
Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)
Funding
Current Stage
Late StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase