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QNXT Benefits Configuration SME

MASH Pro Tech

•

Remote

Contract, Third Party

Role : QNXT Benefits Configuration SME (QNXT SME) Location : Remote. Solid knowledge of commercial, Government benefit structures and plan designs ( HMO, PPO, POS, ASO etc.) Expertise in QNXT core modules Benefit Config, Claims, Enrollment, authorization Configure and test benefits offline during initial setup or annual renewal cycles Proficient in benefit design to include multi-tier copay, service codes, copays, deductibles, and accumulator Data migration/conversion/mapping/benefit configurat
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Posted 4 days ago

QNXT Benefits - Sr Consultants

Photon

•

Remote

Full-time, Third Party

Description for Internal Candidates Must have: Solid knowledge of commercial, Government benefit structures and plan designs ( HMO, PPO, POS, ASO etc.) Expertise in QNXT core modules Benefit Config, Claims, Enrollment, authorization Configure and test benefits offline during initial setup or annual renewal cycles Proficient in benefit design to include multi-tier copay, service codes, copays, deductibles, and accumulator Data migration/conversion/mapping/benefit configuration mass updates
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Posted 6 days ago | Updated 4 days ago

Senior IT Business Analyst with Guidewire

Global Soft Systems

•

Tampa, Florida, USA

Contract

Role: Senior IT Business Analyst with Guidewire Software's ClaimsCenter platform Onsite working in Westshore near Tampa, FL Duration: 3 month contract to hire Work Authorization Status: , , TN-Visa or EAD Must Haves: Property & Casualty Insurance experience Experience with Guidewire Software The Claims Business Analyst will work with stakeholders across the enterprise to deliver business solutions that meet the needs of the stakeholders and the organization. This role involves gathering and d
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Posted 17 days ago | Updated moments ago

EDI Operations Analyst

Computer Enterprises, Inc.

•

Remote

Contract

EDIOperationsAnalyst Morristown,NJ(fullyremote) 6 monthcontract w/ right to hire $50-$60/hourW2 CEIislookingforanEDIAnalysttojoinournationalhealthcareclientsteam!Inthisrole,youllsupportacriticalprojectfocusedonprovidingsuperiorhealthcareclaimlifecyclesolutionstopayors,providers,andindividualsfrompre-paymentthroughpayment. UseadvancedtesteditorsandothertechnologytoolstoreviewX12forissues,toincludebutnotlimitedtothefollowing: Balance,structure,syntactical,datatypeandcontenterrors;todevelopandexec
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Posted 23 hours ago | Updated 20 hours ago

Business Analyst - EDIFECS

Avance Consulting

•

Hartford, Connecticut, USA

Full-time

Job Title : Business Analyst - EDIFECS Location : Hartford, Connecticut ( Onsite ) Job Type : Full-time Required Skills : Bachelor s degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of education. At least 4 years of Information Technology experience. At least 4 years' experience with healthcare payer, preferably on Claims, Benefits, and Care Management. At least 2 years of experie
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Posted 4 days ago | Updated 3 days ago

Business Systems Analyst

Dahl Consulting

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Eagan, Minnesota, USA

Contract

We are seeking a skilled Business Systems Analyst to join our team! Dahl Consulting is currently partnering with a leader in the health insurance industry. We work one-on-one with great candidates to help connect them with local employment opportunities. This company is hiring a Business Systems Analyst for a contract position. Interested? Get more details below!Worksite Location: Eagan, MN | HybridCompensation: $58.00-$64.00 per hourWhat you ll do as the Business Systems Analyst:Lead and facili
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Posted 3 days ago

Business Systems Analyst 3 (Healthcare/Claims)

Primus Software Corp

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King of Prussia, Pennsylvania, USA

Contract

Job Title - Business Systems Analyst Duration - 6+ months Contract Possibility of extension Location - REMOTE Job Description - HTHD (High touch high demand) customer, and around the clock support - 100% Client facing - Fast paced environment - Tight deadlines and strict processes to follow - Able to assist and create solutions for the problems with minimal supervision - Excellent communication skills - Being able to adapt to changes and follow the directions - Excellent customer commu
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Posted 60+ days ago | Updated 3 days ago

Claim Processor with California Medicaid Experience

Pyramid Consulting, Inc.

•

Remote

Full-time

Immediate need for a talented Claim Processor with California Medicaid Experience. This is a Fulltime opportunity with long-term potential and is located in EST/CST(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID: 25-80737 Pay Range: $18 - $19/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Requirements and Technology Experi
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Posted 1 day ago

Sr. Consultant - QNXT - Benefit configuration - Remote

Photon

•

Remote

Full-time

QNXT SME Job Description:Must have: Solid knowledge of commercial, Government benefit structures and plan designs ( HMO, PPO, POS, ASO etc.) Expertise in QNXT core modules Benefit Config, Claims, Enrollment, authorization Configure and test benefits offline during initial setup or annual renewal cycles Proficient in benefit design to include multi-tier copay, service codes, copays, deductibles, and accumulator Data migration/conversion/mapping/benefit configuration mass updates Perform gap
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Posted 17 days ago | Updated 10 days ago

QXNT Benefit Configuration SME

Gov Services Hub

•

Remote

Contract

This is a remote position. Title: QXNT Benefit Configuration SME Duration: 12+ months Location : Remote Must Haves: Solid knowledge of commercial, Government benefit structures and plan designs ( HMO, PPO, POS, ASO etc.) Expertise in QNXT core modules Benefit Config, Claims, Enrollment, authorization Configure and test benefits offline during initial setup or annual renewal cycles Proficient in benefit design to include multi-tier copay, service codes, copays, deductibles, and accumulator Data
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Posted 18 days ago | Updated 21 hours ago

EDI Functional testing with Tosca

Infinite Computer Solutions (ICS)

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Remote

Full-time

2-7 years of Experience in Functional testing extensively worked on Agile MethodologyExpertise in SQLStrong understanding of healthcare domainGood Knowledge in Claims, Membership creationGood knowledge in Providers creationStrong experience on EDI 837 Files is requiredExperience in creating Test cases and Maintaining it QtestHands-on Experience on JIRA to maintain the Test cases, Defects and ExecutionStrong understanding of Healthcare Claims module and Provider moduleHands-on experience with TOS
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Posted 1 day ago

Analytics Expert Pharmaceutical Commercial Analytics

Purple Drive Technologies LLC

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Boston, Massachusetts, USA

Full-time

Job Title: Analytics Expert Pharmaceutical Commercial Analytics Location: Boston, MA Employment Type: Full-Time Position Summary We are seeking a skilled Analytics Expert with deep experience in pharmaceutical commercial analytics to support Neurology and Oncology therapeutic areas. This role involves interpreting complex datasets, building insightful reports, and supporting strategic commercial decisions through data-driven analysis. Key Responsibilities Analyze and interpret commercial pharma
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Posted 1 day ago

Senior Medical Director Health Plan Analytics & Policy Strategy

Ztek Consulting

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Remote

Part-time

Job title: Senior Medical Director Health Plan Analytics & Policy Strategy role Location: Remote Department: Medical Management / Payment Integrity Reports to: Chief Clinical Officer or SVP of Medical Affairs Experience Level: 10+ years in a senior leadership role within health plan or payer environments Position Overview: We are seeking a strategic, data-driven Senior Medical Director with deep expertise in health plan operations, medical policy development, and cost management analytics. This
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Posted 3 days ago

Business Analyst - EDIFECS

Avance Consulting

•

Hartford, Connecticut, USA

Full-time

Role: Business Analyst - EDIFECS Location - Hartford, CT - Onsite At least 8+ years of Information Technology experience. At least 4 years' experience with healthcare payer, preferably on Claims, Benefits, and Care Management. At least 2 years of experience in EDIFECs Preferred Qualifications: Planning and Co-ordination skills. Good Communication and Analytical skills. Experience and desire to work in a management consulting environment that requires regular travel. Experience and desire to wor
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Posted 2 days ago | Updated 5 hours ago

Business Analyst - EDIFECS

Avance Consulting

•

Hartford, Connecticut, USA

Full-time

Job Title :- Business Analyst - EDIFECSLocation: - Hartford ,CT Job DescriptionAt least 4 years of Information Technology experience. At least 4 years' experience with healthcare payer, preferably on Claims, Benefits, and Care Management. At least 2 years of experience in EDIFECs Preferred Qualifications: Planning and Co-ordination skills. Good Communication and Analytical skills. Experience and desire to work in a management consulting environment that requires regular travel. Experience and d
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Posted 3 days ago | Updated 3 days ago

Healthcare Business Analyst HEOR (Health Economics and Outcomes Research)

Learn Beyond Consulting LLC

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Remote

Contract

Job Title: Healthcare Business Analyst HEOR (Health Economics and Outcomes Research) Company Description Client is a leader in delivering innovative healthcare IT solutions that empower providers, payers, and healthcare organizations to improve patient outcomes, streamline operations, and meet regulatory compliance. Job Description We are seeking an experienced Healthcare Business Analyst with a strong background in clinical and health economics-related analytics (HEOR) and healthcare data manag
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Posted 2 hours ago

BUSINESS ANALYST With ETL

Nextgenpros Inc

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Remote

Contract

Role: BUSINESS ANALYST With ETL Location: Remote or CST time Zone | Duration: Contract Required Skills 10+ years of experience as a Business Analyst in data-centric projects.Strong ETL concepts understanding (Informatica).Healthcare domain experience (Claims, EDI, Enrollment, Member/Provider data, etc.) is mandatory.Experience with SQL for data analysis and validation.Ability to work with complex data mappings, transformations, and data flow diagrams.Familiarity with data warehousing concepts a
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Posted 18 hours ago

SME - QNXT Benefit Configuration

Photon

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Remote

Third Party, Contract

About PhotonPhoton, a global leader in AI and digital solutions, helps clients accelerate AI adoption and embrace Digital Hyper-expansion to make tomorrow happen today . We work with 40% of the Fortune 100, enabling them to stay agile and future-ready in an era of converging digital and AI boundaries. Powering billions of touchpoints a day, Photon combines AI management, digital innovation, product design thinking, and engineering excellence to drive lasting transformation for F500 clients. We
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Posted 15 days ago

Entry Level Business Analyst

Dhalite

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Remote

Full-time

Entry Level Business Analyst - Healthcare Remote Full-Time Role. Job Summary:We are seeking an entry-level Business Analyst to support healthcare operations by gathering requirements, analyzing processes, and assisting in the development of technology-driven solutions. You will work closely with stakeholders, clinicians, and IT teams to enhance patient care delivery and operational efficiency. Responsibilities: Gather and document business requirements from clinical, administrative, and IT stake
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Posted 9 days ago

Medicaid EDI Manager

IDR Inc.

•

Mason, Ohio, USA

Full-time

IDR is seeking a dedicated and detail-oriented Medicaid EDI Manager to join one of our top clients in Mason, OH. If you're looking for an opportunity to work with a large organization in a team-oriented environment, please apply today! Position Overview/Responsibilities for the Medicaid EDI Manager: Serve as the subject matter expert for EDI transactions (EDI 837, 835, 820, 276/277, 278) for Medicaid and Medicare programs. Lead the loading and validation of membership and claims data into the
Posted 2 days ago | Updated 8 hours ago