Perry County, Ohio, United States · Remote OK
$69k–$99k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Medicaid Pharmacy, MMIS, SQL, Business Analysis, Healthcare Claims Management
St. George, Louisiana, United States · Hybrid
$27k–$42k/yr
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 opport…
Skills: Compliance Assessment, Provider Enrollment, Regulatory Analysis, Documentation, Site Surveying
District of Columbia, United States · Hybrid
$55k–$79k/yr
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 opport…
Skills: Corporate Training, Instructor-Led Training, Curriculum Development, Adult Learning Principles, Onboarding
Perry County, Ohio, United States · Remote OK
$95k–$136k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Big Data Architecture, Python, Java, Scala, Spark
Muskingum County, Ohio, United States · Hybrid
$91k–$130k/yr
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 opport…
Skills: Operations Management, Provider Enrollment, Contact Center Operations, KPI Management, SLA Management
Perry County, Ohio, United States · Remote Solely
$76k–$109k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: AWS IAM, Azure IAM, Terraform, CloudFormation, Ansible
Tada, Andhra Pradesh, India · Remote OK
Summary As a C Unix Developer at Gainwell, you will be performing design, development, testing activities. Supporting the full life cycle of development processes for creating services. Investigating and resolve complex…
Skills: C, Unix, Linux, Oracle SQL, PL/SQL
Tada, Andhra Pradesh, India · Remote OK
Summary As a C Unix Developer at Gainwell, you will be performing design, development, testing activities. Supporting the full life cycle of development processes for creating services. Investigating and resolve complex…
Skills: C, Unix, Linux, Oracle SQL, PL/SQL
Perry County, Ohio, United States · Remote Solely
$60k–$80k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: .NET Core, ASP Webforms, C#, Rest API, MVC
Tada, Andhra Pradesh, India · Remote OK
Summary As a C Unix Developer at Gainwell, you will be performing design, development, testing activities. Supporting the full life cycle of development processes for creating services. Investigating and resolve complex…
Skills: C, Unix, Linux, Oracle SQL, PL/SQL
Muskingum County, Ohio, United States · Remote Solely
$87k–$124k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Product management, Medicaid domain expertise, Claims processing, Product strategy, Stakeholder management
West Sacramento, California, United States · Hybrid
$76k–$108k/yr
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 opport…
Skills: Customer service, Call center management, Workforce management, Relationship building, Cross-functional leadership
Muskingum County, Ohio, United States · Remote Solely
$87k–$124k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Product management, Medicaid domain expertise, Claims processing, Product strategy, Healthcare technology
Perry County, Ohio, United States · Remote Solely
$44k–$62k/yr
Put your passion to work and grow your career by learning from healthcare innovators and mentors. By joining our team, you’ll work with industry pioneers who do incredible things to move healthcare forward. From day one,…
Skills: Application design, Software development, Technical documentation, Testing strategies, Application integration
Tallahassee, Florida, United States · On-site
$29k–$41k/yr
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 opport…
Skills: Mailroom operations, Document processing, Records management, Print production, Document imaging
Perry County, Ohio, United States · Remote Solely
$44k–$62k/yr
Put your passion to work and grow your career by learning from healthcare innovators and mentors. By joining our team, you’ll work with industry pioneers who do incredible things to move healthcare forward. From day one,…
Skills: Application design, Software development, Technical documentation, Testing strategies, Application integration
Perry County, Ohio, United States · Remote Solely
$63k–$90k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Quality assurance, Defect analysis, Software testing, Quality metrics, Project management
Perry County, Ohio, United States · Remote Solely
$63k–$90k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Quality assurance, Defect analysis, Software testing, Quality metrics, Process improvement
Muskingum County, Ohio, United States · Remote Solely
$95k–$136k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Database Activity Monitoring, IBM Guardium, Imperva, Oracle, MS SQL
Oklahoma City, Oklahoma, United States · On-site
$35k–$41k/yr
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll h…
Skills: Customer Service, Call Center Operations, Multitasking, Technical Support, Data Entry
Perry County, Ohio, United States • Remote OK
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Translates state and federal Medicaid policy into product features, system configurations, and design artifacts for MMIS and Pharmacy environments. Supports end-to-end delivery including requirements gathering, configuration, testing, and operational readiness.
Requires a Bachelor's degree and 5-8 years of experience in healthcare system implementations, specifically with MMIS and Medicaid Pharmacy platforms. Proficiency in SQL and strong knowledge of Medicaid regulations and claims management systems like QNXT are required.
Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
As a Senior Business Analyst - Medicaid Pharmacy (MMIS) 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. Here are the details on this position.
The Senior Business Analyst supports business, policy, and technical execution across one or more functional domains within MMIS Medicaid Management Information Systems (MMIS) and/or the Medicaid Pharmacy environment. Supported domains may include Member, Provider, Claims (Medicaid, Dental and/or Pharmacy), Finance, Plan and Care Management, and Business Relationship Management.
This role supports end‑to‑end domain delivery by translating state and federal Medicaid policy and program requirements into product features, system configuration, and design artifacts. The Business Analyst works closely with the Domain Lead, Technical Analysts, and cross‑functional teams to ensure successful implementation and operational readiness.
Requirements & Design
Ensures compliance alignment by validating that solution design and configuration adhere to CMS guidance, state policy, and documented business rules. Supports the Engagement Lead (EL) in scope negotiations and change control, providing domain expertise to evaluate trade-offs and assess functional, regulatory, and operational impacts of change requests. Leads and participates in collaborative requirements and design sessions with clients and internal teams. Interprets Medicaid policy, regulations, and program rules, translating them into product features, system configurations, and design artifacts.
Partners with the Domain Lead to provide analysis, interpretation, and solution recommendations. Develops and maintains comprehensive design documentation—centered on the Design Document—covering workflows, interfaces, X12 EDI transactions, letters, and reports. Ensures requirements and acceptance criteria are accurate, complete, and traceable. Documents and communicates key decisions, risks, assumptions, and dependencies, including downstream impacts.
Build / Configuration
Supports domain-specific configuration and implementation within DDI projects. Responsible for configuring solutions and collaborating with technical teams to ensure alignment with approved designs, Medicaid policy interpretations, and business rules. Key configuration areas include:
Testing
Reviews test cases to ensure alignment with requirements, policy interpretation, and acceptance criteria. Provides SME support during System Integration Testing (SIT) and User Acceptance Testing (UAT). Assists with defect analysis, root-cause investigation, resolution, retesting, and validation of functional readiness.
Operational Readiness & Deployment
Supports operational readiness, including environment, data, process, and staffing preparation. Contributes domain and policy input to Operational Readiness Reviews (ORR), parallel testing, and performance testing. Assists with cutover planning, transition to operations, and hypercare support.
Collaboration & Client Engagement
Works closely with the Domain Lead and Technical Analysts as a trusted domain and policy SME. Leads and supports client engagement activities, including requirements discussions, design reviews, and issue resolution. Plans and delivers functional demos and solution walkthroughs to validate alignment with client needs. Facilitates collaborative sessions with stakeholders and cross-functional teams. Supports documentation, knowledge transfer, and ongoing operational support.
#LI-HC1
#LI-MMIS
#LI-Medicaid Pharmacy
The pay range for this position is $69,400 - $99,200 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 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does. We're the essential ingredient that makes Medicaid work. For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health. Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most. When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare. Less burden, more mission. Gainwell.
Offices: United States, US
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does. We're the essential ingredient that makes Medicaid work. For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health. Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most. When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare. Less burden, more mission. Gainwell.
Offices: United States, US
