Job description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary The Lead Business Analyst - BPM/Training at Gainwell, is responsible for leading business analyses that align information technology solutions with the strategic goals and objectives of multiple, complex accounts. Acting as a subject matter expert and liaison between technical and non-technical personnel, the Senior Business Analyst ensures seamless collaboration across teams and drives effective solution delivery. This role oversees requirements validation, business process modeling, and documentation while providing mentorship and guidance to less experienced team members. The position applies Medicaid pharmacy and care management expertise to translate clinical and operational policies into clear requirements, process models, use cases, and role-based training content that support solution adoption and operational readiness. Your role in our mission • Lead the analysis, design, documentation, and optimization of business processes to support organizational and project objectives. • Facilitate stakeholder workshops and client meetings to gather, validate, and document business requirements, identify gaps, and recommend effective solutions. • Develop and maintain business process models, workflows, use cases, and supporting documentation using BPMN 2.0 and other industry-standard methodologies. • Ensure requirements, design artifacts, and project documentation align with business needs, operational goals, and stakeholder expectations. • Lead and coordinate business analysis activities across multiple projects, providing guidance and mentorship to junior team members. • Develop project estimates and support planning efforts for business analysis, process modeling, and training-related activities. • Partner with business, operational, technical, clinical, and vendor stakeholders to evaluate impacts, define business rules, and support end-to-end solution delivery. • Maintain documentation standards, perform quality reviews, and manage the publication of process models and other knowledge assets. • Assess training needs and oversee the development and delivery of training programs, eLearning content, job aids, procedures, and operational readiness materials. • Support Learning Management System (LMS) administration activities, including learning paths, training surveys, content deployment, and instructor-led training coordination. Pharmacy Business Analysis & Training Expertise • Apply Medicaid pharmacy and care management expertise to analyze, document, and optimize workflows related to utilization management, prior authorization, appeals, formularies, drug utilization review, clinical edits, member lock-in programs, and care coordination. • Collaborate with pharmacists, clinicians, care management teams, policy staff, operations, product, configuration, and technical teams to elicit requirements and validate pharmacy-related business processes. • Translate pharmacy policies, clinical criteria, system configurations, and operational procedures into business requirements, process models, training materials, user guides, and job aids. • Develop scenario-based training, demonstrations, and validation materials for pharmacy and care management users, including state agencies, providers, prescribers, pharmacists, operational teams, and support staff. What we're looking for • Bachelor’s degree or equivalent combination of education and experience. • 9+ years of business analysis experience, including healthcare or government healthcare system implementations. • Experience analyzing and designing business processes, workflows, use cases, and functional requirements using BPMN 2.0 or similar methodologies. • Strong understanding of CMS, MITA, Medicaid operations, compliance requirements, data management, and customer service delivery processes. • Expertise in relational databases, system integrations, technical documentation, and translating complex healthcare concepts into business and training solutions. • Experience developing and delivering training programs, including LMS administration, eLearning content, learning paths, surveys, and instructor-led training. Professional Attributes • Exceptional interpersonal and communication skills for collaborating with clients, stakeholders, and team members. • Advanced leadership and project coordination skills. • Strong analytical, presentation, and client-facing capabilities. • Willingness to travel based on project needs. What you should expect in this role • Fully remote options from most US locations, Alaska, Pacific and Mountain Time zones • Office Hours: 8a-5p Alaska time as need to be available to support Alaska time zone • Video cameras must be used during all interviews, as well as during the initial week of orientation • Photo will be taken during screening for verification in all steps of the recruitment process. • This posting is intended for pipelining. This is a developing position therefore the job description is subject to change. • #LI-HC1 Please ensure you join all screenings, interviews and meetings from a quiet location with a stable internet connection. Video is required for screenings and interviews, so please test your camera and microphone in advance. Do not use AI tools, virtual backgrounds/filters, or visual enhancements during the interview. The pay range for this position is $86,800 - $124,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

Requirements

Must-haves

Your role in our mission
Lead the analysis, design, documentation, and optimization of business processes to support organizational and project objectives.
Facilitate stakeholder workshops and client meetings to gather, validate, and document business requirements, identify gaps, and recommend effective solutions.
Develop and maintain business process models, workflows, use cases, and supporting documentation using BPMN 2.0 and other industry-standard methodologies.
Ensure requirements, design artifacts, and project documentation align with business needs, operational goals, and stakeholder expectations.
Lead and coordinate business analysis activities across multiple projects, providing guidance and mentorship to junior team members.
Develop project estimates and support planning efforts for business analysis, process modeling, and training-related activities.
Partner with business, operational, technical, clinical, and vendor stakeholders to evaluate impacts, define business rules, and support end-to-end solution delivery.
Maintain documentation standards, perform quality reviews, and manage the publication of process models and other knowledge assets.
Assess training needs and oversee the development and delivery of training programs, eLearning content, job aids, procedures, and operational readiness materials.
Support Learning Management System (LMS) administration activities, including learning paths, training surveys, content deployment, and instructor-led training coordination.
Pharmacy Business Analysis & Training Expertise
Collaborate with pharmacists, clinicians, care management teams, policy staff, operations, product, configuration, and technical teams to elicit requirements and validate pharmacy-related business processes.
Translate pharmacy policies, clinical criteria, system configurations, and operational procedures into business requirements, process models, training materials, user guides, and job aids.
Develop scenario-based training, demonstrations, and validation materials for pharmacy and care management users, including state agencies, providers, prescribers, pharmacists, operational teams, and support staff.
Bachelor’s degree or equivalent combination of education and experience.
9+ years of business analysis experience, including healthcare or government healthcare system implementations.
Experience analyzing and designing business processes, workflows, use cases, and functional requirements using BPMN 2.0 or similar methodologies.
Strong understanding of CMS, MITA, Medicaid operations, compliance requirements, data management, and customer service delivery processes.
Expertise in relational databases, system integrations, technical documentation, and translating complex healthcare concepts into business and training solutions.
Experience developing and delivering training programs, including LMS administration, eLearning content, learning paths, surveys, and instructor-led training.
Professional Attributes
Exceptional interpersonal and communication skills for collaborating with clients, stakeholders, and team members.
Advanced leadership and project coordination skills.

Nice-to-haves

None flagged.

Application prep

Use the role’s language and application details while tailoring your materials.

Keywords to mirror

Platform: successfactors
Effort: medium

Benefits

Benefits detected in the listing.

401(K)