Senior Benefit Configuration Analyst – QNXT
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Job Description
Senior Benefit Configuration Analyst responsible for QNXT configurations and claims compliance. Analyze and validate benefit plans while collaborating with cross-functional teams and mentoring juniors.
Responsibilities:
- Analyze benefit plan documentation (e.g., EOCs, SOBs) and translate into QNXT configuration requirements.
- Build and configure new and updated benefits in QNXT, including Product, Plan, Service Codes, Copay/Coinsurance, Accumulators, Limits, and Authorization rules.
- Use QNXT Configuration Management Tool (CMT) and QNXT Configuration Console Suite (QCS) to manage configuration packages and perform impact analysis.
- Execute back-end data validations using SQL to ensure configuration accuracy and resolve complex issues.
- Participate in end-to-end testing (UAT) of benefit builds and coordinate defect resolution with QA and claims teams.
- Support annual benefit configuration activities such as Medicare, Medicaid contract updates, or Exchange plan changes.
- Serve as a subject matter expert (SME) for benefit build logic, configuration architecture, and claims-related business rules.
- Document configuration logic and maintain version-controlled artifacts for audit and compliance purposes.
- Provide mentorship and support to junior configuration analysts and assist in training initiatives.
- Collaborate with cross-functional teams during product launches, regulatory changes, or system upgrades.
Requirements:
- Minimum 6 years of experience, which includes 2 years of directly related experience in lieu of a bachelor’s degree required.
- Or Bachelor’s degree in healthcare administration, Information Systems, or related field with 4 years of progressive, relevant professional experience required
- Required to have hands-on benefit configuration experience, preferably in a managed care or health plan environment.
- Required to have a strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration.
- Required to have strong understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans.
- Required to have excellent analytical, organizational, and problem-solving skills.
- Strong written and verbal communication including technical documentation.
- Excellent interpersonal skills and team oriented.
- Preferred Qualifications: Proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting.
- Experience with CMT and QCS tools for version management, configuration migrations, and build monitoring.
- Familiarity with implementation methodologies for new products or market launches.
- Knowledge of healthcare claims lifecycle, pricing, and accumulators.
- Lean Six Sigma or process improvement background is a plus.
Benefits:
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
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