Senior Business Analyst - Claims

Summary

As a Senior Business Analyst - Claims 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.

Your role in our mission

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

• Help coordinate a business analyst team’s duties and activities on IT projects and nurture newer team members by providing guidance and support
• Facilitate meetings with clients to gather and document requirements and explore potential solutions.
• Create test scenarios and develop test plans to be used in testing the business applications in order to verify that client requirements are incorporated into the system design. Analyze testing results throughout the project.
• Provide time estimates for project related tasks.
• Provide lessons learned and ways to improve processes
• Be a knowledgeable bridge between clients, project managers and technical staff to define, document and share business requirements and expected impact
• Work with the client to develop business specs at the start of a technical project
• Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
• Help verify that all requirements have been met by approving and validating test results
• Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work

What we're looking for

• 6 or more years of experience in a relevant Business Analyst position with experience in Health Care/Health Insurance
• Strong background in Medicaid, specifically claim processing using Institutional and Physician claim forms.
• Knowledge of Prior Authorization, Member, Provider, Long-Term Care, Inpatient/Outpatient concepts.
• Experience working with project and change management tools such as ALM, iTrace/rTrace.
• Software Development Life Cycle (SDLC) experience; waterfall methodology
• Experience creating deliverable documentation, user manuals, and training documentation.
• Experience with implementing benefit plan configuration updates in Medicaid Management Information System (MMIS).

What you should expect in this role

• Office hours for this position are 8a-5p mountain time.
• Fully remote options from continental US locations only
• 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 has been selected.

• #LI-HC1

  #LI-Medicaid Claims

  #LI-iTrace/rTrace

The pay range for this position is $69,400.00 - $99,200.00 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 , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.