Gainwell Technologies is hiring a Product Owner to guide the development, delivery, and evolution of Medicaid Claims Administration capabilities. You will own the product vision for QNXT-based systems, with a strong focus on medical claims policy adjudication and pharmacy-related claims. This role supports both active production clients and new implementations, ensuring functionality meets regulatory requirements and advances the platform's future-state vision.

What You'll Do

Own the product vision, roadmap, and backlog for the QNXT-based Claims Administration module.
Translate complex business and regulatory requirements into actionable user stories with clear acceptance criteria.
Manage and continuously groom the product backlog based on business value and stakeholder input.
Develop and maintain product roadmaps aligned with other critical product areas.
Act as a liaison between internal development teams and external stakeholders.
Participate in Agile practices such as sprint planning, backlog refinement, and retrospectives.
Provide day-to-day direction to development teams, answer questions, and clarify user stories.
Ensure the final product meets quality expectations, user needs, and Medicaid compliance requirements.
Collaborate on sales activities and meeting client needs.
Ensure accurate implementation of Medicaid policy, CMS guidance, and state-specific rules within QNXT.
Provide deep functional guidance on claims scenarios, edge cases, and exception handling.
Support defect triage and prioritization related to claims adjudication issues.
Support and evolve pharmacy-related claims administration capabilities and integration points.
Partner with pharmacy SMEs, operations, and technical teams to ensure alignment between medical and pharmacy adjudication.
Incorporate pharmacy policy changes and operational needs into backlog prioritization.
Participate in client discussions, demos, and working sessions to explain functionality and roadmap direction.
Collaborate with implementation teams to reduce customization and accelerate client onboarding.

What We're Looking For

5+ years of experience as a Product Owner, Business Analyst, or Product Manager, preferably in Medicaid or public health.
Solid understanding of Medicaid Programs, Policies, and Business Processes such as Eligibility, Claims, or Provider Management.
Strong experience working within Agile/Scrum environments.
Proficient in backlog management, requirements gathering, and stakeholder communication.
Hands-on experience with Claims Administrator, QNXT, and related Medicaid claims processing applications.
Excellent organizational, presentation, analytical, and interpersonal skills.