Gainwell Technologies · 2 days ago
Senior Business Analyst - Medicaid
United States
Full-time
Remote
Mid, Senior Level
$65K/yr - $93K/yr
5+ years expGainwell Technologies is dedicated to improving the health and well-being of vulnerable communities through innovative technology solutions. As a Senior Business Analyst - Medicaid, you will lead requirements elicitation, analyze healthcare claims processes, and collaborate with IT teams to design effective solutions while mentoring junior analysts.
Health CareInformation Technology
Responsibilities
Lead requirements elicitation sessions with business stakeholders and technical teams
Analyze and document current-state and future-state processes for Medicare and Medicaid claims
Serve as a subject matter expert (SME) on CMS guidelines, state Medicaid rules, and claims adjudication workflows
Develop detailed business and functional requirements for system enhancements and integrations
Partner with IT teams to design solutions and validate technical feasibility
Oversee User Acceptance Testing (UAT) and ensure quality deliverables
Monitor KPIs such as claim turnaround time, denial rates, and compliance adherence
Provide guidance and mentorship to junior analysts
Prepare executive-level reports and presentations on claims performance and regulatory compliance
Qualification
Required
Bachelor's degree in Healthcare Administration, Business, or related field (Master's preferred)
5+ years of experience in healthcare claims analysis, with strong Medicare/Medicaid expertise
In-depth knowledge of CMS regulations, HIPAA compliance, and state-specific Medicaid requirements
Hands-on experience with claims adjudication systems (Facets, QNXT, or similar)
Strong analytical and problem-solving skills with proficiency in SQL and data visualization tools (Power BI, Tableau)
Excellent communication and stakeholder management skills
Preferred
Experience in Agile methodology and healthcare IT projects
Familiarity with EDI transactions (837, 835) and ICD/CPT coding
Ability to lead cross-functional teams and manage multiple priorities
Benefits
Generous, flexible vacation policy
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