QXNT Benefits Configuration Analyst/Remote

Title: QXNT Benefits Configuration Analyst

Location: Remote

Must Haves:

Minimum of 7 years QNXT benefit Configuration expereince

Proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting

Solid knowledge of commercial, Government benefit structures and plan designs ( HMO, PPO, POS, ASO etc.)

Expertise in QNXT core modules Benefit Config, Claims, Enrollment, authorization

Configure and test benefits offline during initial setup or annual renewal cycles

Proficient in benefit design to include multi-tier copay, service codes, copays, deductibles, and accumulator **** FLEX ON THIS REQUIREMENT

Data migration/conversion/mapping/benefit configuration mass updates

Perform gap analysis between client needs and QNXT capabilities; recommend system workarounds or custom solutions.

Intermediate to advance SQL queries for validation, configuration analysis and QNXT db structures for member, benefit, claims, plandata etc.

Ability to troubleshoot benefit configuration edits, validate claims and conduct unit, integration testing

Proficient in QCS and CMT Tool

Official Job Description: 

Overview

The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform to support accurate claims adjudication and compliance. This role works closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements.

The senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance.

Certification/Licensure

• No specific certification or licensure requirements

Experience

• Required to have 7+ years of hands-on QNXT benefit configuration experience, preferably in a managed care or health plan environment.
• Required to have strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration.
• Required to have proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting.
• Required to have experience with CMT and QCS tools for version management, configuration migrations, and build monitoring.
• 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

• 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.