QNXT jobs in Los Angeles, CA

Remote

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16d ago

Position- HRSN Medicaid Claims Analyst Type- 100% Remote (PST Hours) Visa- No H1 What you'll do: Review and resolve HRSN claims assigned through QNXT work queues including rent, rental arrears, utility assistance, storage, and housing support claims. You'll analyze pended, denied, and audit-flagged claims, correct claim data, resolve QNXT edits, review potential duplicate submissions, and move valid claims through adjudication and payment. Much of the initial work focuses on reducing the existin

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Contract, Third Party

Depends on Experience

Data Analyst with Healthcare / QNXT experience

Remote

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8d ago

We are seeking to hire a Conversion Data Analyst with expertise in Medicare / Healthcare Claims systems, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Paid Federal Holida

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Full-time

Depends on Experience

Technical Project Manager - Healthcare (Claims, Benefits & Membership)

Remote

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23d ago

Job Title: Technical Project Manager Healthcare (Claims, Benefits & Membership) 100% Remote Role Summary We are seeking an experienced Technical Project Manager to lead enterprise healthcare modernization initiatives. The ideal candidate will have deep healthcare payer experience and a proven track record of managing large-scale system implementations involving claims, benefits, membership, and data modernization. Experience with QNXT is highly preferred. Key Responsibilities Lead end-to-end del

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Contract

Depends on Experience

Sr Claims Architect

Remote

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Yesterday

Job Description: Senior Claims Domain Consultant with deep expertise in Healthcare Payer Claims Operations and working knowledge of Generative AI tools such as Claude, Copilot, ChatGPT, or similar LLM-based platforms. The consultant will work closely with business, operations, technology, product, and client stakeholders to assess current claims processes, identify improvement opportunities, and define AI-enabled solutions that enhance claims accuracy, reduce manual effort, improve first-pass ad

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Contract

Depends on Experience

Business Technology Strategy Lead - Claims, Finance, HR, Legal & Compliance

Los Angeles, California

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Today

Salary Range: $121,056.00 (Min.) - $160,400.00 (Mid.) - $199,742.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality he

Full-time

USD 121,056.00 per year

MMIS (Medicaid Management Info Systems) Domain Lead

Remote

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14d ago

We are seeking to hire a MMIS (Medicaid Management Information Systems) Domain Lead with expertise in Medicaid Pharmacy, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Pai

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Full-time

Depends on Experience

MMIS Data & Analytics Reporting Lead

Remote

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8d ago

We are seeking to hire a MMIS (Medicaid) Data and Analytics Reporting Lead with expertise in Medicaid Provider and Pharmacy implementations, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance,

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Full-time

Depends on Experience

Principal Architect, Information Systems - Provider Horizontal Application Portfolio/AI Implementations - Remote

Remote

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Today

Job Description Job Description Job Summary Architects company specific systems and technology expertise across multiple infrastructure and development 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

Full-time

USD 105,958.12 - 229,575.94 per year

Senior Healthcare Business Analyst / Behavioral Health SME

Remote

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Today

Hi Our client is looking for a Senior Healthcare Business Analyst / Behavioral Health SME project in Remote below is the detailed requirement. Job positing Title: Senior Healthcare Business Analyst / Behavioral Health SME Location: Remote Required Skills: Healthcare Payer,Behavioral Health Job description: Bachelors degree in related field 10+ years of Healthcare Payer experience with 5+ years in Behavioral Health (Mental Health & Substance Use Disorders). Strong understanding of the end-

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Contract, Third Party

Depends on Experience

Claims Architect

Remote

•

Today

Position: Claims Architect Location: Remote Job Description: Senior Claims Domain Consultant with deep expertise in Healthcare Payer Claims Operations and working knowledge of Generative AI tools such as Claude, Copilot, ChatGPT, or similar LLM-based platforms. The consultant will work closely with business, operations, technology, product, and client stakeholders to assess current claims processes, identify improvement opportunities, and define AI-enabled solutions that enhance claims

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Third Party, Contract

Depends on Experience

Product Owner - Healthcare Conversational AI / Voice Bots

Remote

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Today

Job Description: Role Summary Seeking a Product Owner to lead the design and implementation of AI-powered voice bots supporting provider and member calls. The role acts as the bridge between Contact Center Operations, Business SMEs, and Bot Development teams, translating healthcare workflows into voice bot requirements and conversational experiences. Key Responsibilities Define and manage the product backlog for voice bot solutions.Gather requirements and write user stories, business rules, dec

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Contract

Depends on Experience

Revenue Cylcle Enrollment Mangement

Remote

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3d ago

Job Title: Revenue Cycle & Enrollment ManagerLocation: Remote (Fully Remote)Job Type: Long-Term ContractStart Date: ASAPJob SummaryWe are seeking a highly efficient, detail-oriented Revenue Cycle & Enrollment Manager to oversee our revenue cycle department and health plan enrollment operations. In this dual-focus leadership role, you will manage department staff, optimize financial workflows, and ensure the accurate processing of member enrollments, claims, billing, and appeals. You will be resp

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Contract

Depends on Experience

QNXT jobs in Los Angeles, CA, USA