Business Analyst - Medicaid Buy-In Operations

About this role

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
As a
Business Analyst - Medicaid Buy-In Operations
at Gainwell, you will support Medicare Buy-In operations. This subject matter expert will help Medicare-eligible members with coverage, eligibility, enrollment, and Buy-In questions.


The ideal candidate has Medicare and Medicaid experience, strong analytical skills, and the ability to explain complex healthcare information clearly and compassionately. Responsibilities include answering Buy-In calls, researching eligibility and coverage issues, and coordinating resolutions with internal and external partners.


Your role in our mission

• Answer Buy-In calls about coverage, benefits, enrollment, and eligibility.
• Clearly explain Medicare Parts A and B, Medicare Savings Programs, and Medicaid Buy-In benefits.
• Research and resolve coordination-of-benefits, eligibility, coverage, and enrollment issues.
• Document inquiries, findings, and resolutions according to procedures.
• Coordinate with members, state agencies, CMS, health plans, and internal teams.
• Interpret Medicare and Medicaid policies to resolve inquiries.
• Identify trends and process improvement opportunities.
• Help develop requirements, procedures, and training materials.
• Comply with HIPAA, CMS regulations, and Gainwell policies.

What We're Looking For
The ideal candidate has
3–5+ years of Medicare and Medicaid experience
, is comfortable assisting beneficiaries by phone, understands coverage and eligibility rules, and independently resolves complex inquiries with excellent service.


Skills & Competencies

• Medicare and Medicaid expertise...