Gainwell Technologies

Business Analyst

• Analyze, plan, design, document and make recommendations to improve business processes to support client’s technological aspirations
• Be a supportive bridge between clients, project managers and technical personnel to define, track and communicate business requirements and their expected impact by building basic conceptual data and process models
• Create, execute or analyze basic test scenarios to verify that client requirements are built into system design
• Ensure that 'intent of change' is carried out through every project phase by participating in technical reviews and inspections

Business Analyst – Project Management Office

Consultant

• Review Medicaid Prior Authorizations based on medical necessity in accordance with State policy guidelines
• Provide guidance and support for Medicaid Providers
• Act as a clinical SME (or liaison) for internal Gainwell entities
• Adjudicating Durable Medical Equipment and prior authorizations based on medical necessity and eligibility
• Reviewing and evaluating prior authorization submissions
• Entering prior authorization outcome into the Medicaid Management Information System (MMIS) for processing
• Participation in monthly meetings with Gainwell leadership, operational staff support, clinical peers and State stakeholders
• Providing assistance and education to the provider community related to specific prior authorization submissions
• Offering analysis and recommendations to Gainwell and State leadership on methods and potential process improvements.

Durable Medical Equipment Consultant

Business Intelligence Analyst

• 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
• 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

Senior Reporting Business Analyst

Software Engineer

• Participate in requirements gathering sessions to build Requirement Specification and Design Documents
• Prepare time estimates and justifications for assigned tasks
• Code, test, debug, implement and document moderately-complex to complex technical programs
• Provide on-call support, troubleshoot production issues, and perform root cause analysis
• Participate in and conduct peer reviews as needed
• Evaluate existing systems and programs to recommend potential enhancements
• Liaise with clients and management to provide technical consulting on complex programming projects

Batch Developer

• Play a critical part in ensuring Gainwell is meeting our clients’ objectives in pharmacy benefit management (PBM) services.
• Support PBM or Drug rebate implementations and configurations
• Support PBM operations and maintenance on established accounts
• Work with a team of pharmacy clinicians and subject matter experts to configure the pharmacy systems to deliver services to our state clients.
• Assist in implementation of a pharmacy payer system.
• Perform Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters
• Be a knowledgeable bridge between operations staff, clients, project managers and technical staff to define, document and share pharmacy business requirements and expected impact
• Work with the client to develop business rules and configuration requirements
• 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
• Testing point of sale (POS) pharmacy claims as required
• Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work

Senior Business Analyst – Pharmacy

General

• Process cases submitted by providers for enrollment into the program
• Review and process requests submitted by providers to update their information
• Communicate with providers through email and internal software systems, with occasional phone communication as needed
• Collaborate closely with team members to move provider requests through various stages of processing and quality assurance reviews
• Deliver exceptional customer service internally, to providers, and to clients

Provider Enrollment Agent

Project Manager

• Manage multiple projects and/or programs of varying complexity throughout the full project lifecycle
• Lead cross-functional teams to achieve project and program objectives
• Serve as project manager for smaller initiatives within assigned functions
• Collaborate with other project managers to allocate resources across projects
• Act as a team lead by assigning resources, mentoring team members, and serving as an escalation point
• Partner with Business Leads and clients to manage assigned systems, identify demand, and implement improvements

Delivery Project Manager

Full-stack Engineer

• Code, test, debug, implement and document moderately complex programs.
• Analyze, design and write specs and reqs from which we develop and code programs.
• Evaluate existing systems and programs; assist project the manager in assigning tasks and work closely with a team.
• Liaise with clients and management to provide technical consulting on complex programming projects, validate program requirements and resolve issues that arise.
• Develop test plans and participate in QA activities such as coding reviews.
• Participate as a member of a development team and lead a small sub-team of developers as needed.
• Design system components and delegate responsibilities to team members.

Senior Batch Developer – Linux, C, SQL

Analytics Engineer

• Design, develop, and maintain Databricks ETL/ELT pipelines to process Medicaid claims, eligibility, encounters, provider files, and supplemental datasets
• Ingest data from MMIS systems, state data warehouses, managed care organizations, and other Medicaid program data sources
• Implement transformation, validation, and enrichment logic aligned to Medicaid data quality standards
• Optimize Spark jobs for performance and cost efficiency across large Medicaid datasets
• Build and maintain Data Lake models for auditability, lineage, and compliance
• Develop Power BI semantic models, dashboards, and reports that support Medicaid operations
• Collaborate with Medicaid program staff, policy teams, actuaries, and data governance groups

Senior Power BI, Databricks ETL Engineer

Program Manager

• Acts as the point of contact for all Project Management Office topics with the client
• Develops, refines, and manages all Project Governance for the account
• Assisting in the monitoring and tracking of all Service Level Agreements
• Manages formal client correspondence including Corrective Action Plans and Internal account improvement initiatives
• Oversees assigned Project Management personnel for their engagement
• Manages resource assignment and allocation and provides resource utilization forecasts
• Works closely with the Account General Manager and Application Delivery Manager to hit account goals and objectives
• Provide a centralized management structure for all project management functions
• Change Control management
• Schedule Management
• Deliverable Management
• Risk/Issue/Action Management
• Communication Management
• Project Governance Updates
• Mentor, coach and effectively transfer expertise to others
• Ensure that the PMO is helping deliver our projects to exceed client expectations

Principal – Program Management

• Codes, tests, debugs, implements, and documents highly complex programs
• Develops complex test plans to verify logic of new or modified programs
• Designs systems and programs to meet highly complex business needs
• Prepares detailed specifications from which programs are developed and coded
• Creates appropriate documentation in work assignments such as program code, and technical documentation
• Gathers information from existing systems, analyzes program and time requirements
• Prepares time estimates and justifications for assigned tasks and provides recommendations to project managers
• Supports project personnel in resolving fairly complex program problems
• Works with client and management to resolve issues and validate programming requirements within their areas of responsibility
• Provides technical advice on complex programming
• May serve as technical project lead; provides leadership and work guidance to less experienced personnel
• Conducts quality assurance activities such as peer reviews
• Provides consulting services in a technical and/or managerial capacity to management and technical staff

Programmer Analyst

Manager

• Cultivate client relationships and be the voice of Gainwell as a trusted advisor and thought leader
• Manage the operations of your account, including SLAs, security remediation, outage management, resource oversight, staffing, project health, implementations, and quality assurance
• Understand the data and own the outcomes for your client
• Develop a client-centered innovation agenda to proactively engage with the client on their business needs and goals
• Harness Gainwell's innovative spirit to meet and exceed contractual commitments
• Guide and mentor the delivery and operations team for your account
• Manage the financial quality of the account

Account General Manager

• Help power critical healthcare claims solutions at Gainwell.
• Work on complex, high-impact systems, partner with technical leadership, solve meaningful production and integration challenges.
• Design, build, test, and support complex applications and batch solutions in a C, Unix/Linux, and Oracle environment.
• Own key technical deliverables across the full development lifecycle.
• Contribute to modernization, release readiness, and continuous improvement across a critical healthcare technology platform.

Senior C/Unix Batch Developer – Healthcare Claims

• Lead the development and modernization of healthcare claims solutions
• Mentor engineers, drive technical delivery, and partner across teams
• Own technical delivery across the software development lifecycle, from design through release and support
• Guide architecture, development, and modernization of C/Unix-based healthcare claims applications
• Partner with product, business, and operations teams to align solutions with client needs
• Drive engineering excellence through code quality, testing, release readiness, and continuous improvement

Technical Lead – C/Unix Batch Development, Healthcare Claims

Customer Support

• Provide knowledgeable responses to basic client questions; elevate more complex cases to appropriate staff as needed
• Put your skills to work to solve client problems, update account history and follow up with clients to confirm their inquiry or request is resolved
• Adhere to the client’s SLAs and consistently meet production targets
• Collaborate with team members, management and clients to resolve client inquiries; cross-train new resources in customer service processes
• Process client inquiries more efficiently and effectively by reviewing and recommending changes to procedures and workflow