Gainwell Technologiesis hiring for the position of Business Analyst in Bangalore, India. Candidates with Bachelor’s Degreeare eligible to apply for this position. The complete information, eligibility criteria and requirements are provided below.
Job Description:
Company Name
Gainwell Technologies
Position
Business Analyst
Qualifications
Bachelor’s Degree
Experience
Experienced
Location
Bangalore, India (Hybrid)
Key Responsibilities:
Analyze client requests for proposals, applying advanced subject matter expertise to solve complex business issues and provide expert guidance.
Adhere to and support the Configuration team’s methodologies, principles, and practices.
Ensure effective communication among all key stakeholders to facilitate collaboration and project alignment.
Exercise significant independent judgment within broadly defined policies to determine the best methods for achieving objectives.
Provide mentoring and guidance to junior employees, fostering their development and expertise.
Collaborate with the implementation team to analyze and document client business requirements and processes, translating them into configuration deliverables.
Develop and execute test cases based on functional requirements and document results.
Participate in technical reviews and inspections to ensure project changes align with the intended outcomes.
Coordinate business analyst tasks on IT projects and provide support to team members.
Provide accurate status updates and time reporting for project-related tasks.
Utilize Medicaid Systems work experience to contribute effectively to project goals.
Exercise discretion and independent judgment in evaluating and addressing project needs.
Analyze configuration data and structure to identify and resolve defects.
Research and define solutions for new configurations, legislation, or client rules.
Create and test proof-of-concept solutions for new business processes or client requests.
Present solutions, proof-of-concept findings, or testing results to customers effectively.
Complete configuration tasks within established timelines, adhering to best practices and standards.
Eligibility Criteria:
Bachelor’s degree or an equivalent combination of education and experience.
Three or more years of experience in business analysis.
Proven ability to communicate openly and actively, taking initiative to share information extensively.
Three or more years of experience in configuring QNXT or FACETS systems, including:
Contracts and benefits.
System data points for successful X12 transactions, Claim Adjustment Reason Codes, and Remittance Advice Codes.
Contracts for provider services, member benefit coverage, fee schedules, capitation, and claim editing enforcement.
In-depth understanding of Medicaid program structures, including carriers, programs, benefit plans, policies, policy plans, sponsors, and policies.
Comprehensive knowledge of provider data, including provider type, specialty, taxonomy, enrollment impacts, service locations, certifications, licensing, affiliations, and reimbursement impacts.
Expertise in member data management, including aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers.
Experience in configuration implementation, build, and maintenance.
Hands-on experience working with complex systems at a detailed level.
Skilled in performing self-directed tasks within a virtual team environment.
Solid understanding of relational database concepts and schemas.
Proficiency in writing SQL queries for data analysis.
Experience working with Medicaid/MMIS systems.
Preferred experience includes participation in Design, Development, and Implementation (DDI) and operations phases.
Proven ability to process Medicaid claims and troubleshoot adjudication results effectively.
Demonstrated ability to learn new technologies and stay current with industry best practices.
Experience with creating and utilizing Requirement Traceability Matrices.
Preferred skills:
Ability to multi-task, stay organized, and adapt to a fast-paced environment.
Strong commitment to maintaining the confidentiality of proprietary and private information.
Demonstrated sound judgment and decision-making skills aligned with essential job functions.
Preferred experience working with HP Application Lifecycle Management (ALM).
About Company:
For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus.
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