Senior Business Analyst – Provider

Gainwell Technologies

Senior Business Analyst handling MMIS and Medicaid Pharmacy implementations at Gainwell. Collaborating with technical teams to ensure solutions meet policy and regulations requirements.

Posted 7/3/2026full-timeRemote • Texas • 🇺🇸 United StatesSenior💰 $69,400 - $99,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicaid Management Information Systems (MMIS) and Medicaid Pharmacy environments, with a strong focus on translating federal and state policies into actionable system configurations and design documentation. Proficient in SQL for data analysis and validation, with a solid background in healthcare system implementations and Agile methodologies.

Highest-signal resume keywords

MMIS SolutionsMedicaid Pharmacy PlatformsSQL Data AnalysisMedicaid Policy KnowledgeAgile Delivery Environments

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

SQLHealthcare System ImplementationsSystem ConfigurationDesign DocumentationX12 EDI TransactionsData ValidationRequirements GatheringPolicy TranslationWorkflow DesignClaims Management

Soft Skills

Client CommunicationDocumentation SkillsFacilitation SkillsAnalytical SkillsCollaboration

Tools & Technologies

QNXTMMISAgile ToolsSDLC Tools

Industry Keywords

MedicaidHealthcarePolicy ComplianceBusiness RulesOperational Readiness

Tech Stack

Tools & technologies

SDLCSQL

About the role

Key responsibilities & impact

Supporting business, policy, and technical execution across functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment.
Ensuring solutions align with CMS guidance, state policy, and documented business rules.
Leading and participating in requirements and design sessions with clients and internal teams to validate functional and technical needs.
Interpreting federal and state Medicaid policies and translating them into system configuration, product features, business rules, and design artifacts.
Developing and maintaining domain design documentation, including a comprehensive Design Document covering workflows, interfaces, X12 EDI transactions, letters, and reports.
Supporting operational readiness across environments, data, processes, and staffing.

Requirements

What you’ll need

Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field
5 to 8 years of hands-on experience supporting healthcare system implementations, including MMIS solutions and Medicaid Pharmacy platforms
Experience with QNXT or similar healthcare claims/encounter management systems
Strong knowledge of state and federal Medicaid policy, regulations, and program rules (required)
Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes
Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts
Strong knowledge of SQL is required, particularly for data analysis and validation.
Strong client communication skills, with experience interacting directly with business stakeholders
Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions
Strong documentation, facilitation, and analytical skills
Experience working in SDLC and Agile delivery environments.

Benefits

Comp & perks

generous, flexible vacation policy
educational assistance
comprehensive health benefits
401(k) employer match
leadership and technical development academies