QNXT jobs in Massachusetts

Health Plan ASO Product Configuration & Benefits SME- Remote- 6 Months

Remote

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Today

Health Plan ASO Product Configuration & Benefits SMELocation: Remote Contract:6 Months Work Hours: EST hours preferred Experience: 8 15+ years Job OverviewWe are looking for an experienced Health Plan ASO Product Configuration & Benefits SME to support the design and implementation of a new ASO (Administrative Services Only) / Self-Funded health plan offering.The ideal candidate will have strong experience in commercial health plan benefits, ASO/self-funded products, benefits configuration, and

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Contract, Third Party

Depends on Experience

Sr Claims Architect

Remote

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21d ago

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

Health Plan Product & Benefits Configuration Lead - Fully Remote!!

Remote

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Today

Role: Health Plan ASO Product Configuration & Benefits SME Location: USA (Remote) Duration: 6+ months Role purpose The ASO Product Configuration & Benefits SME will lead the detailed definition and documentation of product, benefit, and configuration decisions required to launch a new ASO offering. This individual will work across Product, Benefits, Claims, Configuration, Operations, Technology, Clinical, Pharmacy, Network, Legal/Compliance, Sales, and vendor teams to translate high-level produc

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Contract

Depends on Experience

Facets Product Consultant-W2- Remote

Remote

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Today

Job Summary: * Create solutions based on the customer needs and review solutions with client business and IT teams; * Perform analysis, design, coding, testing and implementation of quality custom solutions within the software development life cycle in Healthcare domain. * Design and develop moderate to complex software applications to meet the customers business needs. * Validation and gaining approval of technical and business requirements to ensure both feasibility and completeness of solutio

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Contract

Depends on Experience

Revenue Cylcle Enrollment Mangement

Remote

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23d 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

Senior Business Analyst Medicaid Enterprise Systems

Remote

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Today

Position: Senior Business Analyst Medicaid Enterprise Systems 100% Remote Hiring: W2 Contract / Fulltime Domain: Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Key responsibilities Own requirements and functional design for assigned CMdS modules (Claims, Member, Finance, and related interfaces).Define epics, user stories, and definition of done; prioritize against Medicaid policy, MES certification goals, and release plans.Facilitate working sessions; clarify

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Full-time

Depends on Experience

Lead AI Data Engineer - Healthcare Payer Systems, Claims & Payment Integrity

Remote

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19d ago

< class="t-24 ">Lead AI Data Engineer - Healthcare Payer Systems, Claims & Payment Integrity Remote (US) Contract OpportunityMust-Have: A minimum of 5 years of experince with Healthcare Payer Systems, Claims & Payment Integrity Primary Skills: ETL Fundamentals, SQL, SQL (Basic + Advanced), Alation, Talend, Matillion, Python, Data Warehousing, IICS, Modern Data Platform Fundamentals, Data Modelling Fundamentals, PLSQL, T-SQL, Stored ProceduresSpecialization ETL Specialization: Lead Data Engineer

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Contract

Depends on Experience

Healthcare Medicaid Business Analyst(Medicaid/MMIS Domain)

Remote

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2d ago

Job Description: Job Title: Healthcare Business Analyst Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: Domain: Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary: Serve as Business Analyst for CMdS product development and implementation on a Medicaid modernization program. Translate legacy MMIS claims, member, and finance behavior and state Medicaid policy into CMdS functional design, requirements, and acceptance

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Full-time

$70,000 - $95,000

Business Analyst (Healthcare domain)

Remote

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Today

Business Analyst CMdS Claims, Member & Finance Implementation (MES) Location:Maryland (Remote) Domain:Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary: Serve as Business Analyst forCMdS product development and implementationon a Medicaid modernization program. Translate legacy MMIS claims, member, and finance Behavior and state Medicaid policy into CMdS functional design, requirements, and Acceptance criteria. Partner with development, QA, archite

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Contract, Third Party

50 - 55

QNXT jobs in Massachusetts, USA