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NOTE: This is a 100% remote role. Candidates will be working on EST hours.
QNXT Benefits Configuration SME
Seeking an experienced QNXT Benefits Configuration SME to support the design, configuration, and testing of complex benefits structures within QNXT. The role requires hands-on expertise with QNXT core modules, strong analytical skills, and the ability to translate business requirements into effective system configurations.
Must-Have Qualifications
- Proven expertise in QNXT core modules: Benefit Configuration, Claims, Enrollment, Authorization
- Strong knowledge of commercial and government benefit structures and plan designs (HMO, PPO, POS, ASO)
- Experience in configuring multi-tier copays, service codes, deductibles, and accumulators
- Ability to manage benefit configuration design from requirements gathering through implementation
- Hands-on experience with data migration and mass configuration updates
- Proficiency in writing SQL queries for validation and analysis of QNXT database structures
- Experience troubleshooting and resolving benefit configuration edits and validating claims
- Familiarity with QCS and CMT tools for benefit configuration and testing
Responsibilities
- Design, configure, and test benefits within QNXT for new implementations and annual renewal cycles
- Collaborate with stakeholders to gather requirements and develop benefit configuration designs
- Perform data migration, conversion, mapping, and benefit configuration mass updates
- Conduct gap analyses between client needs and QNXT capabilities; recommend system workarounds or custom solutions
- Write and execute intermediate to advanced SQL queries for validation and configuration analysis
- Troubleshoot benefit configuration issues and support unit and integration testing
- Utilize tools such as QCS and CMT for benefit configuration and testing
Pluses
- Experience in service group setup and front-end QNXT configuration
- Familiarity with MOOP (Maximum Out-of-Pocket) configuration
- Prior involvement in large-scale migrations or implementations
Interested candidates may submit their resumes online or call at 310-906-4780 for further information regarding the position.
NS-QNXT-NS_1752682563