1 - 20 of 72 Jobs

QNXT Data Architect:

Infinite Computer Solutions (ICS)

Remote

Full-time

Data Architect: Job description : Key Responsibilities: Establish data policies and standards to ensure data quality, security, and compliance. Design and optimize database models to store and retrieve information. Contribute to data architecture design for migration to Azure Data bricks from Synapse, SQL Server Integrate data from various claims systems such as QNXT and home grown claim systems into a unified architecture. Implement and maintain security measures to protect sensitive data

PBA Advisor Configuration Business Analyst - Pharmacy/QNXT

Gainwell Technologies LLC

Kansas City, Missouri, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As an PBA Advisor Configuration Business Analyst - Pharmacy/QNXT at Gainwell, you can contribute your skills as we harness the

PBA Senior Configuration Business Analyst - Pharmacy/QNXT

Gainwell Technologies LLC

Kansas City, Missouri, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a PBA Senior Configuration Business Analyst - Pharmacy/QNXT at Gainwell, you can contribute your skills as we harness the po

Experienced QNXT Developer

Gainwell Technologies LLC

Austin, Texas, USA

Full-time

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have

Experienced QNXT Developer

Gainwell Technologies LLC

Houston, Texas, USA

Full-time

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have

Experienced QNXT Developer

Gainwell Technologies LLC

Dallas, Texas, USA

Full-time

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have

PBA Configuration Business Analyst - Pharmacy/QNXT

Gainwell Technologies LLC

Kansas City, Missouri, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a PBA Configuration Business Analyst - Pharmacy/QNXT at Gainwell, you can contribute your skills as we harness the power of

Senior QNXT Developer :: Remote

Strategic Systems Inc

Remote

Contract

Job Title: Senior QNXT Developer Location: Remote Duration : 6-12 Months Experience Level: Senior (8+ years) Job Overview We are seeking highly skilled and experienced Senior QNXT Developers to join our growing team. The ideal candidates will have a strong background in the QNXT Framework and a comprehensive understanding of Healthcare IT systems, particularly in Medicaid and payer systems. This is an exciting opportunity to support mission-critical healthcare technology initiatives, including c

QNXT Benefits Configuration SME -- REMOTE JOB

KPG 99 Inc.

US

Third Party, Contract

Position : QNXT Commercial Benefits Configuration SME Location : Remote Job Duration: 6-12 Months Strong QNXT Benefit Configuration SME's on the Commercial side Technical QNXT Benefit Configuration, Commercial LOB Must Haves: Need to know QNXT benefits configuration (NOT JUST QNXT CLAIM NEEDS TO BE SPECIFC TO QNXT BENEFITS and know the ins and outs. will dive deep there in interviews.) Need to know commercial side (Ideal is 75% commercial; 25% Medicare) Knowledge of SQL. **writing SQL Querie

Lead Engineer, Applications - Edifecs/Qconnect/QNXT - Remote

Molina Healthcare

Remote or Long Beach, California, USA

Full-time

Job Description JOB DESCRIPTION Job Summary Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g., stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business problems "end-to-end": including people, process, and technology, both within and outside the enterprise, as part of any

HEDIS Data and Reporting Analyst - Direct Hire - Hybrid to Elkridge, MD

Elite Technical

Elkridge, Maryland, USA

Full-time

HEDIS Data and Reporting Analyst Elite Technical is seeking a Data and Reporting Analyst to support our Healthcare customer. The selected candidate will be responsible for compiling claims and member data, analyzing files for accuracy, and creating reports (via Power BI) for audits and quality performance measurements. The individual will support the Compliance Department and liaison with other departments to complete regulatory compliance documents. Collaborate with departments to design, imple

Sr Specialist, Provider Network Admin

Molina Healthcare

Remote or Long Beach, California, USA

Full-time

Job Description Candidates must be able to work in the PST or MST time zones JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Generates and prepar

Lead Engineer, Applications

Molina Healthcare

Remote or Long Beach, California, USA

Full-time

Job Description JOB DESCRIPTION Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g., stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business problems "end-to-end": including people, process, and technology, both within and outside the enterprise, as part of any design solut

Senior Specialist, Provider Network Administration

Molina Healthcare

Remote or Long Beach, California, USA

Full-time

Job Description JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. This multifaceted role supports both operational efficiency and strategic project delivery for process improvement initiatives as it pertains to other provider network management areas. KNOWLEDGE/SKILLS/ABILITIES Bridge communication and collaboration between IT, PMO, provider n

Claims System Process Improvement Program Manager

Kern Health Systems

Bakersfield, California, USA

Full-time

KHS reasonably expects to pay starting compensation for the position of Claims System Process Improvement Program Manager in the range of $83,625 -106,622 Annual On-site Position About us Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role Under management direction, responsible for supervising the testing, configuration and auto adjudication activities in the Claims Department to ensure accuracy

.Net Developer

Avinya Infotech

New York, New York, USA

Contract

Responsibilities Develop and provide day-to-day support for the internally-developed Document Management System and other third-party applicationsDevelop and maintain healthcare payer EDI solutions (primarily HIPAA X12 transactions) around QNXT Claims Processing SystemWork on development of non-X12 EDI imports and exports, XML and text file processing, data mapping and data conversion projectsQualifications Minimum three (3) years of experience with healthcare payer technologies, preferably wit

EvolveNXT Technical Analyst

Wavespire

North Carolina, USA

Full-time, Part-time, Third Party, Contract

EvolveNXT Technical Analyst Remote working in PST hours for 3-month contract EvolveNXT as their CRM and is seeking a Technical Analyst to lead deployment from requirements to go-live, ensure BRD completeness, UAT testing, system integration (QNXT, phone systems, vendors), and provide expertise across modules (OB, PM, PDB, TMO, LMS, CM, MSE, BAE, SOA, HRA). 100% remote,.

Sr. EvolveNXT Cons required for a Long Term Remote Position

Svam International, Inc.

Remote

Third Party, Contract

We are trying to source Sr. EvolveNXT consultant for our direct client for a Long Term Remote project. We need Senior Consultant with strong background in Healthcare industry. It is a long - term remote position.Required Skills Experience leading the end-to-end deployment of the EvolveNXT software platform (CRM) from requirements gathering to go-live.Experience in ensuring that all requirements gathered are contained in the BRD.UAT testing experience of EvolveNXT capabilities. EvolveNXT engageme

Remote Project/Program Manager with Healthcare EDI Experience

Infinite Computer Solutions (ICS)

Remote

Full-time

Note : GCEAD, L2EAD, consultant can apply for this position who can work on W2. Job Descriptions : Job Description - To be success Manages high-risk program with multiple projectsSingle point of accountability for up to 50 direct and/or matrixed staff, including sub-contractor(s)Project Manager with 9+ years of experience managing large, mission critical programsKnowledgeable of EDI X12 HIPAA transactions and business process flows that involve EDI, requiredKnowledge of IBM Sterling, desiredKn

Remote Salesforce Solutions Architect with Apex and LWC

Infinite Computer Solutions (ICS)

Remote

Full-time

Note : GCEAD, L2EAD, consultant can apply for this position who can work on W2. Job Descriptions : Job Description - To be success Manages high-risk program with multiple projectsSingle point of accountability for up to 50 direct and/or matrixed staff, including sub-contractor(s)Project Manager with 9+ years of experience managing large, mission critical programsKnowledgeable of EDI X12 HIPAA transactions and business process flows that involve EDI, requiredKnowledge of IBM Sterling, desired