Senior Technical Business Analyst - CEF Configuration

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 Senior Technical Business Analyst - CEF Configuration at Gainwell, you will serve as a hands-on technical analyst and SQL developer supporting Medicaid claims, healthcare data, and configuration-related solutions within a Maintenance & Operations environment. You will translate client requirements, Medicaid policy, operational needs, data relationships, and system-processing outcomes into technical specifications, advanced SQL solutions, custom stored procedures, validation utilities, and repeatable audit processes. This role requires advanced SQL development skills, strong technical writing, and the ability to work across business analysis and development responsibilities. The ideal candidate can independently analyze complex data and system issues, document the technical design for a custom stored procedure, develop or modify the code, validate results, and clearly communicate the solution, risks, and downstream impacts to technical and non-technical stakeholders. Your role in our mission Technical Analysis, SQL Development, and Solution Delivery • Design, develop, test, document, and maintain advanced SQL queries, reusable scripts, custom stored procedures, functions, and related database utilities that support analysis, correction, auditing, troubleshooting, and reporting. • Create developer-ready technical specifications for custom stored procedures, including purpose, scope, assumptions, source and target tables, joins, input and output parameters, processing logic, exception handling, dependencies, security considerations, performance requirements, test scenarios, and deployment or rollback considerations. • Translate approved technical specifications into production-ready or deployment-ready SQL code in accordance with development, peer-review, source-control, testing, and release-management standards. • Develop reusable SQL toolkits that help teams update approved fields, retrieve supporting data, combine query inputs, and reproduce or debug test cases. • Optimize SQL solutions for accuracy, maintainability, performance, scalability, and safe execution across large Medicaid claims and healthcare datasets. • Partner with business analysts, Advisors, database administrators, application developers, testing teams, and release teams to move solutions from requirements through implementation and post-production validation Audit Automation and Data Quality • Build controlled update scripts for approved, repeatable data corrections or maintenance activities, using safeguards such as pre-update checks, transaction handling, row-count verification, exception reporting, and post-update reconciliation. • Develop automated audit and comparison processes that identify incorrect, invalid, incomplete, or missing database information across large record populations and classify exceptions for remediation. • Produce repeatable, Excel-ready datasets and exception reports that support remediation, technical review, and audit response while reducing manual review time. • Conduct post-implementation monitoring and reconciliation to confirm that database changes and stored procedure results satisfy the approved technical design without unintended downstream impacts. Claims and Production Support • Analyze and support QNXT claims-processing and healthcare data solutions across contracts, benefits, fee schedules, payment methodologies, capitation, business rules, claims adjudication logic, edits, X12 transaction data requirements, and CARC/RARC processing. • Gainwell Technologies | Proprietary and Confidential | Senior Professional BA, CEF Claims Configuration Engineering • Write and execute advanced SQL to analyze claims, claim lines, provider affiliations, contracts, benefits, pricing, member eligibility, edits, process steps, accumulators, encounters, remittance, and financial data. • Perform claim-level and population-level root cause analysis for denials, pends, unexpected edits, underpayments, overpayments, duplicate conditions, encounter rejections, data-quality issues, and other processing anomalies. • Determine whether an issue is caused by configuration, database data, stored procedure logic, policy interpretation, user processing, interface behavior, product functionality, or an upstream or downstream dependency. • Quantify affected claims and populations, compare expected and actual results, document evidence, and recommend technically actionable corrective solutions. • Support production incidents, client inquiries, audit requests, configuration defects, approved data fixes, custom reporting, and priority troubleshooting. Technical Writing, Controls, and Collaboration • Produce clear, supportable technical documentation, including SQL design documents, data mappings, table and field definitions, process flows, test cases, implementation plans, validation evidence, runbooks, and support procedures. • Explain complex SQL logic and database findings in clear business terms, including operational impact, affected populations, risks, alternatives, and recommendations. • Participate in requirements sessions, technical design and code reviews, defect triage, solution walkthroughs, release-readiness reviews, and knowledge-transfer activities. • Follow established separation-of-duties, peer-review, change-control, security, and production-access requirements for da