Senior Business Analyst – MMIS, Medicaid Pharmacy
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Job Description
Senior Business Analyst supporting MMIS and Medicaid Pharmacy implementations at Gainwell. Collaborating with technical teams and ensuring compliance with Medicaid policies and regulations.
Responsibilities:
- 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.
- The Business Analyst works closely with the Domain Lead, Technical Analysts, and cross-functional teams to ensure successful implementation and operational readiness.
- Ensures compliance alignment by validating that solution design and configuration conform to CMS guidance, state policy, and documented business rules.
- Supports the EL with in-scope negotiations and change control, providing domain expertise to assess scope trade-offs and the functional, regulatory, and operational impacts of change requests.
- Lead and participate in collaborative requirements and design sessions with clients and internal teams to validate functional and technical needs.
Requirements:
- 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:
- generous, flexible vacation policy
- educational assistance
- comprehensive health benefits
- 401(k) employer match
- leadership and technical development academies
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