Senior Benefit Configuration Analyst – QNXT

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Evaluate benefit plan documentation (e.g., EOCs, SOBs) and convert it into QNXT configuration specifications.

• Develop and configure both new and updated benefits in QNXT, encompassing Product, Plan, Service Codes, Copay/Coinsurance, Accumulators, Limits, and Authorization rules.

• Utilize the QNXT Configuration Management Tool (CMT) and QNXT Configuration Console Suite (QCS) to oversee configuration packages and conduct impact analysis.

• Perform back-end data validations using SQL to verify configuration precision and address complex issues.

• Engage in end-to-end testing (UAT) of benefit configurations and work collaboratively with QA and claims teams to resolve defects.

• Assist in annual benefit configuration tasks such as updates to Medicare, Medicaid contracts, or changes to Exchange plans.

• Act as a subject matter expert (SME) regarding benefit build logic, configuration architecture, and claims-related business regulations.

• Document configuration logic and maintain version-controlled artifacts for compliance and audit purposes.

• Provide guidance and support to junior configuration analysts and contribute to training initiatives.

• Collaborate with cross-functional teams during product launches, regulatory shifts, or system enhancements.

⛳️ Requirements

• At least 6 years of experience, including 2 years of directly relevant experience in place of a bachelor’s degree.

• Alternatively, a Bachelor’s degree in healthcare administration, Information Systems, or a related field with 4 years of progressively relevant professional experience is required.

• Must possess hands-on benefit configuration experience, ideally within a managed care or health plan setting.

• Strong working knowledge of QNXT system architecture is required, including configuration tables, benefit logic, and claims integration.

• A solid understanding of regulatory requirements relating to Medicare, Medicaid, ACA, and Commercial plans is essential.

• Excellent analytical, organizational, and problem-solving abilities are a must.

• Strong written and verbal communication skills, including technical documentation, are necessary.

• Excellent interpersonal skills and a team-oriented approach are required.

• 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 is preferred.

• Familiarity with implementation methodologies for new products or market introductions is advantageous.

• Knowledge of the healthcare claims lifecycle, pricing, and accumulators is beneficial.

• A 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 are met.