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Note:

This is a contract-to-hire position. Eligibility for conversion to direct hire at the end of the contract is limited to individuals residing in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Senior QNXT Benefit Configuration Analyst

Role Overview

The Senior QNXT Benefit Configuration Analyst is responsible for designing, configuring, validating, and maintaining complex benefit setups within the QNXT platform to ensure accurate claims adjudication and regulatory compliance. This role partners closely with Product, Compliance, IT, Network, and Claims teams to support new implementations, annual renewals, and ongoing benefit maintenance.

Must-Have Qualifications

• 7+ years of hands-on QNXT benefit configuration experience
• Strong expertise across QNXT core modules: Benefit Configuration, Claims, Enrollment, Authorization
• Proficiency in Microsoft SQL Server (T-SQL) for data validation, troubleshooting, and configuration analysis
• Solid understanding of Commercial and Government plan designs (HMO, PPO, POS, ASO, Medicare, Medicaid, ACA)
• Experience configuring and testing benefits during new implementations and annual renewal cycles
• Ability to design and configure benefits including copays, deductibles, service codes, and accumulators (flexible on depth of multi-tier complexity)
• Hands-on experience with data migration, mapping, conversions, and mass benefit updates
• Proven ability to perform gap analysis between business requirements and QNXT capabilities, including recommending workarounds or custom solutions
• Strong troubleshooting skills for benefit configuration issues, claims validation, and unit/integration testing
• Proficiency with QCS and CMT tools for configuration management and migrations
• Strong analytical, documentation, and communication skills

Nice-to-Have

• Experience with new product implementations or market launches
• Knowledge of end-to-end healthcare claims lifecycle and pricing logic
• Lean Six Sigma or process improvement experience.

Interested candidates may submit their resumes online or call at 310-906-4780 for further information regarding the position.

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