Business Analyst - Reference
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
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
#LI-HC1
#LI-Claims
#LI- Benefit Plan Administration
The pay range for this position is $55,600.00 - $79,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
Apply To This Job
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
#LI-HC1
#LI-Claims
#LI- Benefit Plan Administration
The pay range for this position is $55,600.00 - $79,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
Apply To This Job