Senior Medicaid Claims Configuration Advisor - Remote

Gainwell Technologies; Washington (District of Columbia); On-site; USD 93,000 - 133,000; Full time

Job summary

Gainwell Technologies is seeking a senior Advisor Business Analyst - Claims Configuration to lead Medicaid claims configuration within a Maintenance & Operations environment. You will translate requirements into scalable QNXT configurations and guide a team of Configuration BAs, ensuring quality and client satisfaction.

The role requires deep QNXT expertise, advanced SQL and relational database knowledge, and the ability to investigate complex claims issues, communicate recommendations, and work

Qualifications

• 9+ years of hands-on QNXT configuration experience across contracts, benefits, fee schedules and multiple payment methods.
• Strong knowledge of relational databases, healthcare data models, schemas, keys, and data relationships.
• Proven ability to write complex SQL queries for claims analysis, validation and reporting.

Responsibilities

• Lead and mentor a team of Claims Configuration Business Analysts.
• Serve as senior configuration SME for assigned CEF Maintenance & Operations accounts.
• Review designs, plans, and validation results for quality and impact.
• Establish configuration practices, documentation standards, and knowledge transfer.

Skills

QNXT configuration

Relational databases

SQL queries

Education

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

Tools

ServiceNow

Jira

Job description

Gainwell Technologies is seeking a senior Advisor Business Analyst - Claims Configuration to lead Medicaid claims configuration within a Maintenance & Operations environment. You will translate requirements into scalable QNXT configurations and guide a team of Configuration BAs, ensuring quality and client satisfaction.

The role requires deep QNXT expertise, advanced SQL and relational database knowledge, and the ability to investigate complex claims issues, communicate recommendations, and work