Business Analyst - Medicaid Buy-In Operations

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Date:
Oct 16, 2026

Location:

Any city, IN, US, 99999 Topeka, KS, US, 66611

Work Mode:
Virtual (Exception only)

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.

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.

• 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.

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.

• Medicare and Medicaid expertise
• Member support
• Eligibility and enrollment analysis
• Critical thinking and problem-solving
• Clear verbal and written communication
• Empathy and professionalism
• Confidential handling of sensitive healthcare information

This role helps Medicare beneficiaries access and understand coverage while supporting essential state healthcare programs.

Build your career with Gainwell, where collaboration, innovation, and inclusion help make healthcare work better for everyone.

• Bachelor’s degree or equivalent experience.
• At least 3 years of experience in Medicare, Medicaid, healthcare eligibility, enrollment, member services, or operations.
• Experience discussing healthcare coverage with members, beneficiaries, providers, or customers.
• Strong knowledge of Medicare Parts A and B, Medicare Savings Programs, and Medicaid.
• Excellent communication, customer service, analytical, and problem-solving skills.
• Ability to explain complex healthcare information clearly and professionally.
• Proficiency in Microsoft Office and healthcare systems.

• Knowledge of CMS regulations, Medicare eligibility, and Medicare Savings Programs (QMB, SLMB, QI, QDWI).
• Experience with state Medicaid agencies or government healthcare programs.
• Call center, member services, or beneficiary support experience.

• Fully remote options from most US locations and territories
• 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.
• The deadline to submit applications for this posting is November 5, 2026

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