Business Analyst - Prior Authorization & Interoperability (PAI Project)

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

As a Business Analyst - Prior Authorization & Interoperability (PAI Project) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. The Professional Business Analyst will support the Advancing Interoperability and Improving Prior Authorization Processes project by contributing to operational readiness activities, requirements documentation, and testing efforts. This is a remote role, with up to 10% travel for key workshops, training events, or stakeholder sessions. The analyst will work closely with senior analysts, operational leaders, and technical teams to help evaluate current workflows, document future‑state processes, and prepare business operations for changes related to new prior authorization capabilities. This position requires solid analytical skills, effective communication, and the ability to support projects that integrate new technology, federal regulations, and evolving operational practices. Your role in our mission Gainwell empowers you show you’re a pro and help clients deliver better health and human services outcomes using innovative technology and solutions. Operational Process & Readiness Support

• Documents current operational workflows and assists in identifying process gaps or improvement areas.
• Supports development of future‑state process flows and operational readiness materials.
• Assists with preparing staffing inputs, workload assumptions, and operational support documentation.
• Contributes to operational transition and readiness activities for new prior authorization workflows.

Business Analysis & Requirements

• Participates in eliciting functional and operational requirements from business and technical stakeholders.
• Documents requirements, business rules, and process details using standard formats.
• Supports development of workflow diagrams, data flow details, and operational metrics.
• Helps maintain traceability of requirements throughout the project lifecycle.
• your role continued

Testing & Validation

• Assists in developing test cases and acceptance criteria with an operational focus.
• Participates in system, user acceptance, and operational readiness testing activities.
• Tracks defects, monitors issues, and coordinates resolution with project teams.
• Helps validate that implemented changes align with intended operational outcomes.

Project Delivery & Collaboration

• Supports communication between operations, policy teams, and technical project staff.
• Assists in identifying operational impacts of system or policy changes.
• Helps develop training materials, SOP updates, and documentation for transition to operations.
• Supports project planning activities related to analysis and readiness.
• Assists in virtual and occasional in‑person training for impacted operational staff

What We're Looking For

• Bachelor’s degree or equivalent combination of education and experience.
• Two to four years of business analysis, process documentation, or operations support experience.
• Experience with workflow analysis, requirements gathering, or business process mapping.
• Experience collaborating with cross‑functional teams in a remote or hybrid environment.
• Exposure to healthcare operations, prior authorization workflows, or regulatory implementations is preferred.

Other Qualifications

• Strong written and verbal communication skills.
• Ability to document processes clearly and accurately.
• Solid analytical and problem‑solving capabilities.
• Ability to manage multiple tasks and meet deadlines.
• Proficiency with Microsoft Office and basic business or process modeling tools.
• Effective in a remote work environment with strong virtual collaboration skills.
• Willingness to travel up to 10% for essential project activities.

What You Should Expect In This Role

• Fully remote options from Contiguous US locations only
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• The deadline to submit applications for this posting is March 5, 2026

Authorization The pay range for this position is $55,600.00 - $71,460 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. Apply tot his job Apply To this Job