Remote Medicaid Policy & Configuration Lead

Gainwell Technologies LLC; Columbus (OH); Remote; USD 69,000 - 99,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Job summary

Gainwell Technologies LLC seeks a Senior Medicaid Business Analyst to translate state and federal Medicaid policy into product features, system configuration, and design artifacts. You will collaborate with the Domain Lead, Technical Analysts, and cross-functional teams to ensure successful implementation and operational readiness.

The role includes requirements sessions, policy interpretation, and hands-on configuration work across MMIS and Medicaid Pharmacy domains, with a strong emphasis on

Qualifications

• Bachelor’s degree in CS/IS/Health Informatics or related field.
• 5–8 years hands-on experience supporting healthcare system implementations including MMIS and Medicaid Pharmacy platforms.
• Experience with QNXT and similar healthcare provider/claims management systems.
• Strong knowledge of state and federal Medicaid policy, regulations, and program rules.
• Strong understanding of Medicaid domains (claims, member, provider, prior authorization).
• Experience translating policy and program rules into system requirements, configuration and design artifacts.
• Strong SQL knowledge for data analysis and validation.
• Strong client communication skills and experience with SDLC/Agile.

Responsibilities

• Translate state and federal Medicaid policy into product features, system configuration, and design artifacts.
• Lead collaborative requirements and design sessions with clients and internal teams.
• Interpret Medicaid policy, regulations, and program rules for implementation guidance.
• Serve as policy/domain SME supporting analysis, interpretation, and recommendations.
• Develop and maintain domain design documentation and traceability of requirements.

Skills

SQL proficiency

Medicaid policy knowledge

SDLC & Agile experience

Client communication

Requirements gathering

Education

Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or related field

Tools

QNXT

EDI/X12

Job description

Gainwell Technologies LLC seeks a Senior Medicaid Business Analyst to translate state and federal Medicaid policy into product features, system configuration, and design artifacts. You will collaborate with the Domain Lead, Technical Analysts, and cross-functional teams to ensure successful implementation and operational readiness.

The role includes requirements sessions, policy interpretation, and hands-on configuration work across MMIS and Medicaid Pharmacy domains, with a strong emphasis on