Expert Configuration Business Analyst

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

As an Expert Configuration Business Analyst 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.

The primary responsibility of a Configuration Business Analyst is to analyze and document business processes, gather and define requirements, and collaborate with stakeholders to ensure the successful implementation of solutions that meet the unique challenges and requirements of the healthcare industry. The successful candidate will be an intellectually curious, self-directed individual with excellent organizational skills and attention to detail. This role is highly collaborative in nature providing support for IT and business teams. Performs complex analyses of State Medicaid Policies, and Legacy System business rules from data extracts.

Here are the details on this position.

Your role in our mission

• Analyzes client requests for proposals and applies advanced subject matter knowledge to solve complex business issues and is regarded as a subject matter expert
• Adheres to and supports Configuration team approach and other configuration principles, methodologies, and practices
• Ensures communication among all key stakeholders
• Exercises significant independent judgment within broadly defined policies and practices to determine best method for accomplishing work and achieving objectives
• May provide mentoring and guidance to lower-level employees
• Works closely with the implementation team to analyze and document client's business requirements and processes. Communicates these requirements by constructing configuration deliverables
• Creates test cases from functional requirements, executing test cases, and documenting results
• Participates in technical reviews and inspections to verify 'intent of change' is carried out through the entire project
• Assists in coordinating business analyst tasks on information technology projects and provide support to other team members

..... your role continued

• Provide accurate status and time reporting for project related tasks
• Utilized your Medicaid Systems work experience
• Ability to exercise discretion and independent judgment
• Analyzes configuration data and structure to isolate defects.
• Research and define solutions for new configuration, legislation, or client rules.
• Creates proof of concept testing for new business processes or outcome requests.
• Creates and presents solution, proof of concept, or testing results to customer.
• Completes configuration within schedule timelines and configuration best practices.

What we're looking for

• Bachelor's degree or equivalent combination of education and experience.  Bachelor's degree in business administration, information systems, or related field preferred
• Six or more years of Configuration business analysis experience
• Openly and actively communicates information and takes initiative to communicate extensively
• Four or more years’ experience configuring in QNXT/Facets:
  • Contracts/benefits
  • System data points needed for successful X12 transactions, Claim Adjustment Reason Codes and Remittance Advice Code
  • Contracts for provider services, benefits for member coverage, fee schedules, capitation, and claim editing enforcement.
  • Understands Medicaid Program structure in carriers, programs, benefit plans, policy, policy plans, sponsor, and orgpolicies.
  • Understands Provider (Contract and Pricing) data including but not limited to provider type, specialty, taxonomy, enrollment impacts, service locations, certifications and licensing, affiliations, and reimbursement impacts.
  • Understands Member data including but not limited to aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers.
  • Understands relational database concepts and schemas
    • Experience writing SQL queries for data analysis
  • Experience with Configuration Implementation Build & Maintenance

Additional requirements

• Highly proficient in the use of Microsoft Office Products (PowerPoint, Excel, Word. Visio, Outlook)
• Experience working with complex systems at a detailed level
• Experience working in a virtual team environment performing self-directed tasks
• Experience working with Medicaid/MMIS systems.  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
• Ability to exercise sound judgment and make decisions in a manner consistent with the essential job function
• Preferred experience working with HP Application Lifecycle Management (ALM)
• Knowledgeable in supporting CMS Certification, ORR and have an understanding of all MITA Business areas
• Knowledgeable in writing Stored Procedure (SP) Specifications Document to be used by SP Developers

Other qualifications

• Interpersonal skills to interact with customers and team members
• Regular and reliable attendance is an essential function of the position
• Handles difficult situations diplomatically
• Good written and verbal communication skills to ensure clarity
• Good analytical and problem-solving skills
• Presentation skills to present to management and customers
• Ability to work as a team and independently
• Adaptable to changing priorities
• Ability to manage multiple priorities ensuring deadlines are achieved
• Team and goal orientated
• Ability to work in a remote environment and be self-directed with minimal supervision

What you should expect in this role

• Fully remote options from most US locations and territories
• 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 is December 27, 2024.

• #LI-HC1

The pay range for this position is $81,100.00 - $115,900.00 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.