Career Opportunities: Senior Pharmacy Benefit Administration - Modeler/Trainer (30863)

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Full Remote
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Offer summary

Qualifications:

6+ years of experience in a Business Analyst role, with 3+ years in Medicaid and Medicare preferred., Expertise in Pharmacy Benefit Management processes, including formulary management and claims adjudication., Proficiency in training methodologies and eLearning content development., Strong analytical skills with experience in business process design and relational database concepts..

Key responsibilities:

  • Lead the planning and design of business processes to support key areas.
  • Facilitate analysis and documentation of client business requirements and processes.
  • Oversee business analyst tasks and mentor junior team members.
  • Manage training material development and coordinate training for operational staff.

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Gainwell Technologies LLC Large http://www.gainwelltechnologies.com
10001 Employees
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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

As a Senior Pharmacy Benefit Administration - Modeler/Trainer 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.

Your role in our mission

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

  • Leads the planning, design, and recommendation of business processes to improve and support key business areas.
  • Facilitates in-depth analysis and documentation of client business requirements and processes, including constructing detailed business process models and workflows.
  • Takes ownership of requirement and design documentation, ensuring alignment with project objectives and stakeholder expectations.
  • Leads and facilitates client meetings to validate requirements, identify gaps, and propose actionable solutions.
  • Oversees and coordinates business analyst tasks across multiple information technology projects, mentoring junior team members.
  • Develops comprehensive time estimates for project-related activities, including training development and business process modeling.
  • Designs and implements methods to evaluate how business goals align with organizational needs and project objectives.
  • Provides leadership, mentoring, and work guidance to less experienced business analysts.
  • Publishes business process models to centralized Knowledge Exchange (KE) repositories and oversees documentation standards.
  • Collaborates with clients, contractors, and site training managers to assess training needs, audience segmentation, and delivery schedules.
  • Coordinates and supports provider and operational staff training, utilizing train-the-trainer or direct delivery methods as needed.
  • Manages training material development, including eLearning videos, job aids, and desk-level procedures, to support go-live and operational readiness
What we're looking for
  • 6 or more years of experience in a relevant Business Analyst position with 3 or more years of Medicaid and Medicare experience preferred
  • Medicaid and MITA Expertise: Knowledge of PBM-specific processes, including formulary management, claims adjudication, drug rebate processing, and pricing methodologies. Pharmacy technologist background preferred.
  • Proven experience in analyzing and designing business processes and workflows.
  • Expertise in relational database concepts and system integration methodologies.
  • Proficiency in training methodologies, including Learning Management Systems and eLearning content development.
What you should expect in this role
  • Fully remote options from continental 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 May 9, 2025
  • #LI-HC1

 

The pay range for this position is $64,900.00 - $92,700.00 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 committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.

 

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Training And Development
  • Mentorship
  • Collaboration
  • Leadership

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