QNXT SME Role

  • Posted 11 hours ago | Updated 11 hours ago

Overview

Remote
Depends on Experience
Full Time
Accepts corp to corp applications
Able to Provide Sponsorship

Skills

Analytical Skill
Data Migration
QNXT
Database
Regulatory Compliance
Gap Analysis
MASS
PPO
Point Of Sale
Testing
SQL
Mapping
HMO

Job Details

We are Photon, one of the world s largest Digital Platform Engineering companies, blending Strategy Consulting, Creative Design, and Technology Services for a global clientele.

We proudly partner with 40% of Fortune 100 companies, delivering niche products that power digital transformation. Watch more about us here: Photon Overview.

Short Description:
We are seeking a QNXT Subject Matter Expert (SME) with deep expertise in benefits configuration and claims processes for both commercial and government plans. This is a great opportunity to leverage your QNXT skills and grow in a high-impact, collaborative environment.

Role: QNXT Benefits Configuration Specialist

Key Responsibilities:

  • Configure and test benefits in QNXT (initial setup & renewal cycles)
  • Design and implement multi-tier benefits (copays, deductibles, accumulators)
  • Perform data migration, mapping, and mass updates for benefit configurations
  • Conduct gap analysis and recommend workarounds or custom solutions
  • Validate claims and troubleshoot benefit configurations
  • Run SQL queries to validate configurations and analyze QNXT database (members, claims, benefits, etc.)
  • Work with QCS and CMT tools for configuration management
  • Collaborate across teams to align benefits design with business needs

Must-Have Skills:

  • Hands-on experience with QNXT core modules: Benefits, Claims, Enrollment, Authorizations
  • Strong knowledge of benefit structures (HMO, PPO, POS, ASO)
  • Proficient in SQL and understanding of QNXT database structures
  • Ability to lead benefit configuration and testing end-to-end
  • Experience with QCS and CMT tools

Ideal Candidate Profile:

  • Analytical and detail-oriented
  • Strong communicator and team collaborator
  • Comfortable navigating complex benefit logic and compliance requirements

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.