QNXT jobs in Richmond, VA

Remote

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5d 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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Third Party, Contract

Depends on Experience

Business Analyst - CMdS Claims, Member & Finance Implementation (MES)

Richmond, Virginia

•

Today

JOB TITLE: Business Analyst - CMdS Claims, Member & Finance Implementation (MES) JOB LOCATION: Remote WAGE RANGE*: $50-60/hr JOB NUMBER: 26-01186 REQUIRED EXPERIENCE: Required qualifications 12+ years business analysis experience in Medicaid MMIS / MES, with deep hands-on work in at least two of: Claims, Member/Eligibility-Enrollment, Finance/Financial Accounting. Proven experience developing and implementing claims systems / MMIS / MES platforms, such as Conduent CMdS (Conduent Medicaid Sui

Full-time

USD 50.00 - 60.00 per hour

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

Remote

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13d 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

Conversion Data Analyst (US Cit to pass Security Clearance)

Remote

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3d 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

MMIS (Medicaid Management Info Systems) Domain Lead

Remote

•

3d 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

•

3d 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

•

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

FACETS Developer

Remote or Hybrid

•

2d ago

Remote position Required Skills 5+ years of experience in FACETS development or healthcare payer application development. Strong hands-on experience with Cognizant TriZetto FACETS. Strong knowledge of healthcare insurance/payer processes. Experience with Claims, Membership, Enrollment, Benefits, Billing, and Provider modules. Strong Oracle/SQL development skills. Experience with FACETS configuration, customization, and integrations. Experience with Java/J2EE or related application development t

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Third Party

Pega Developer

Remote

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6d ago

Job Description Pega Professionals Positions: Lead/Senior Pega Mid-Sr Pega Developer Project: Healthcare Payer Claims Automation Project Overview The project focuses on using Pega to automate the matching of prior authorizations/service authorizations to provider-submitted claims, reducing manual review. Position 1: Lead/Senior Pega Responsible for architecture and technical expertise. Position 2: Mid-Sr Pega Developer Focused on development, integrations, roboti

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Contract, Third Party

Depends on Experience

Heathcare Enrollment Specialist

Remote

•

24d ago

Healthcare Enrollment Specialist LONG TERM CONTRACT FULLY REMOTE STARTS ASAP Job Title:Healthcare Enrollment Specialist Location:Remote Job Summary We are seeking a detail-oriented and dependableEnrollment Specialistto join our team. You will be responsible for accurately processing health plan enrollment, changes, and terminations for our members. You will work within our healthcare administration software, ensure compliance with regulatory standards (CMS, ACA, state guidelines), and support sm

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Contract

Depends on Experience

QNXT jobs in Richmond, VA, USA