Business Analyst (Medicaid) - Immunization Registry

Summary

About Gainwell:

Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services.

We generate over $2 billion in annual revenue, and we’ve been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries nationwide and manage 1 billion encounters annually. Additionally, about 1.5 billion immunization records are maintained, and we serve more than 3 million providers annually.

We do this while saving our state and commercial clients ~5.5 billion dollars annually in cost avoidance. Our commitment to clients drives continuous improvement in the quality of healthcare for beneficiaries nationwide through vital healthcare technology.

In summary, there’s no company better positioned in the Medicaid and HHS (Health and Human Services) market than Gainwell.

For more information on Gainwell, visit www.gainwelltechnologies.com

Your role in our mission

Essential Job Functions

• 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

Job Description

• 5 or more years of experience in a relevant Business Analyst position with 3 or more years of Medicaid and Medicare experience preferred
• Knowledge of computer programming concepts such as configuration, development and batch processing
• Advanced knowledge in analytical software such as Microsoft Excel or SQL and other requirement-mapping tools such as Application Lifecycle Management (ALM) tools
• Strong client communication skills translating client needs to actionable objectives
• Strong analytical and business process re-engineering skills
• Strong executive presence and communication skills to deliver messages to business leaders, clients and technical personnel
• A leader who motivates others to action and communicates key technical ideas in a digestible way
• Experience writing SQL queries for data analysis. Experience working with Medicaid/MMIS systems.
• Support the integration of immunization registries with Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and Medicaid Management Information Systems (MMIS).
• Conduct gap analysis to identify system enhancements and compliance requirements for immunization data reporting.
• Gather, analyze, and document business and functional requirements for immunization registry solutions.
• Collaborate with Medicaid agencies, providers, and IT teams to design and implement data exchange processes.
• Define data standards and validation rules for immunization records exchanged between Medicaid systems and registries.
• Ensure compliance with Health Level Seven (HL7) standards for immunization data exchange (e.g., HL7 etc.,).
• Support data mapping, transformation, and validation between immunization registries and Medicaid systems.
• Act as a bridge between business users, IT teams, and Medicaid stakeholders to ensure clear communication of immunization registry needs.
• Provide training and support to Medicaid providers, payers, and public health teams on immunization registry usage and reporting.
• Preferred experience includes DDI (Design, Development, and Implementation) and operations phases.
• Experience processing Medicaid claims and ability to troubleshoot adjudication results.
• Demonstrated aptitude for learning new technologies and keeping current with industry best practices.
• Experience with Requirement Traceability Matrices.
• Ability to multi-task and maintain organization in a fast-paced environment.
• Ability to create and maintain highest levels of confidentiality when dealing with proprietary or private information.
  
  

What you should expect in this role

Fast-paced,challenging and rewarding work environment.

Work life balance.

Hybrid Office environment.

Will require late evening work to overlap US work hours.