Benefit Configuration Manager

This is a fully remote position, open to applicants in Alabama, +25 more states.

📋 Description

• Supervise the analysis, design, configuration, implementation, and maintenance of benefit plans within QNXT.

• Ensure precise configuration of products, plans, service codes, accumulators, limitations, authorization requirements, and cost-sharing structures.

• Lead annual benefit change initiatives, new product rollouts, regulatory updates, and market expansion activities.

• Establish governance protocols for configuration requests, prioritization, approvals, and production deployments.

• Monitor the quality, accuracy, and timeliness of configurations through KPIs, SLAs, and quality assurance programs.

• Act as a point of escalation for complex regulatory interpretations and decisions regarding benefit implementation.

• Function as the business owner and primary configuration representative for enterprise projects and strategic initiatives.

• Oversee User Acceptance Testing, configuration validation, defect management, and ensure production readiness.

• Promote continuous process improvement and collaborate with IT on opportunities for automation.

• Analyze trends, identify root causes of configuration defects, and develop corrective action plans.

• Provide executive-level reports on configuration activities, risks, resource capacity, and strategic initiatives.

• Offer leadership, coaching, and performance management for QNXT benefit configuration supervisors and staff.

• Set team goals, performance metrics, and productivity standards.

⛳️ Requirements

• Bachelor's degree in Healthcare Administration, Information Systems, Business Administration, or a related field; relevant experience may be considered in lieu of a degree.

• Over 8 years of progressive experience in health plan benefit configuration using QNXT or a similar claims administration platform.

• More than 5 years of experience in leading configuration teams, supervisors, or operational functions.

• Proficient in Commercial, Exchange, Medicare, and Medicaid benefit designs and regulatory requirements.

• In-depth knowledge of benefit configuration logic, claims adjudication, accumulators, and authorization rules.

• Experience in managing large-scale benefit implementations or annual maintenance activities.

• Strong analytical, organizational, project management, and problem-solving capabilities.

• Exceptional written, verbal, presentation, and stakeholder management skills.

• Ability to lead cross-functional teams and drive organizational initiatives.

• Competence in creating SQL queries for benefit configuration validation and claims analysis.

• Familiarity with QNXT architecture and benefit configuration.

• Experience with the QNXT Configuration Management Tool (CMT) and QNXT Configuration Console Suite (QCS).

• Working knowledge of SQL Server and data validation techniques for QNXT.

• Lean Six Sigma, PMP, Agile, or other process improvement/project management certifications are preferred.

• Additional posting indicates that no specific degree is required, but 3 years of relevant experience in operations, IT, or reporting is necessary.

🏝️ 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

• Pet Insurance

• Legal Resources Plan

• Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met

• Professional development

• Continued employment philosophy