Senior Business Systems Analyst
4 days ago
Role Overview
Gainwell Technologies is seeking a skilled Senior Business Systems Analyst to join our team. As a key member of our configuration team, you will play a critical role in analyzing and documenting business processes, gathering and defining requirements, and collaborating with stakeholders to ensure the successful implementation of solutions that meet the unique challenges and requirements of the healthcare industry.
Key Responsibilities
- Analyze and document business processes and gather and define requirements
- Collaborate with stakeholders to ensure successful implementation of solutions
- Support configuration team with solution development, proof of concept testing, and development of audit reports and data validation checkpoints
- Complete configuration/data loads within schedule timelines and configuration best practices
- Experience with coordinating and managing incoming referential data, validating & obtaining approvals, and investigating data variances
- Reference Data Management - support and troubleshoot data variances in conversion and other phases of the DDI
Requirements
- 8 or more years of configuration experience; or working with the Data Schema of QNXT or FACETS applications (Focus on the following areas: Contracts, Benefits, Successful Data Points for X12 Transactions, CARCs/RARCs, Fee Schedules/Different Payment Methodologies, Capitation, & Rules)
- Understands relational database concepts and schemas
- Experience writing & executing SQL queries for data analysis
- Experience working with Medicaid/MMIS systems. Preferred experience includes DDI (Design, Development, and Implementation) and operations & maintenance phase
- Support configuration team with triage & root cause analysis of Medicaid claims and encounters adjudication results
- Experience with Requirement Traceability Matrices
- Healthcare/business knowledge in member, eligibility, TPL, claims processing, provider, pharmacy claims
- Experience working in a virtual team environment performing self-directed tasks
- Understands relational database concepts and schemas
- Experience writing SQL queries for data analysis
- Experience working with Medicaid/MMIS systems
What You Can Expect
- A fast-paced, challenging, and rewarding work environment
- A work-life balance
- A hybrid office environment
- Will require late evening work to overlap US work hours
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