Business Analyst with US Medicaid/Medicare Healthcare in Claims, Provider

Gainwell Technologies • Bangalore, Indiana, United States • 3m ago

Summary

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 a new company (divested from DXC Technologies) with over 50+ years of proven experience, a reputation for service excellence and unparalleled industry expertise with approximately $1+ billion dollars of revenue, ~8,000+ employees who support clients across 41 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 offer our clients scalable and flexible solutions for their most complex challenges.

These capabilities make our company a trusted partner for organizations seeking reliability, innovation and transformational outcomes. About 49M Medicaid beneficiaries are being supported. 1.3B immunization records are maintained by engaging 3.0 M providers. Our commitment to clients, drives continuous improvement in the quality of healthcare for beneficiaries nationwide through vital healthcare technology.

Your role in our mission

Assists in the research and assessment of business goals, objectives and needs to align information technology solutions with business initiatives for multiple, less complex accounts. Serves as the liaison between technical personnel and business area for multiple accounts.

What you should expect in this role

Key Responsibilities

• 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.
• Provide accurate status and time reporting for project related tasks.
• 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

Essential Job Functions

Business analysis experience in U.S. Medicaid Healthcare- Claims, Member, Provider, PIUR, Portal, EDI preferred
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 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.

Basic Qualifications

Bachelor's degree or equivalent combination of education and experience
Bachelor's degree in business administration, information systems, or related field preferred
Four or more years of business analysis experience, U.S. Medicaid management preferred. Hands on in business functional experience in one or more areas such as Eligibility, Claims, Provider.
Experience working with the interface of information technology with functional groups within an organization
Experience working with business processes and re-engineering
Experience working with computer programming concepts and basic language, especially involving relational databases

Other Qualifications

Interpersonal skills to interact with customers and team members
Communication skills
Analytical and problem-solving skills
Presentation skills to communicate with management and customers
Personal computer and business solutions software skills
Ability to work in a team environment with multiple team members and the ability to multitask
Willingness to travel

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