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Sentara Health · 4 days ago

Senior Benefit Configuration Analyst QNXT - Remote

United States

Full-time

Remote

Mid, Senior Level

$70K/yr - $116K/yr

7+ years exp

Sentara Health is a leading healthcare organization, and they are seeking a Senior Benefit Configuration Analyst to manage complex benefit configurations within the QNXT platform. This role involves collaborating with various teams to ensure accurate implementation of benefit plans and compliance with regulatory requirements.

Hospital & Health Care

Responsibilities

Responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform to support accurate claims adjudication and compliance

Work closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements

Serve as a business and technical expert in QNXT benefit build and support new plan implementations, annual updates, and ongoing configuration maintenance

Qualification

QNXT benefit configurationMicrosoft SQL ServerQNXT system architectureRegulatory requirements knowledgeCMTQCS toolsAnalytical skillsOrganizational skillsProblem-solving skillsCommunication skillsInterpersonal skills

Required

Bachelor's degree in a relevant field such as Computer Science, Information Technology, Information Systems, Engineering, Business/Administration, Finance, Accounting, or Education, or a closely related discipline

Minimum of 4 years of progressive, relevant professional experience required

In lieu of a bachelor's degree, an additional 2 years of directly related experience (for a total of 6 years) may be considered as equivalent

7+ years of hands-on QNXT benefit configuration experience, preferably in a managed care or health plan environment

Strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration

Proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting

Experience with CMT and QCS tools for version management, configuration migrations, and build monitoring

Strong understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans

Excellent analytical, organizational, and problem-solving skills, strong written and verbal communication including technical documentation

Excellent interpersonal skills and team oriented

Preferred

Familiarity with implementation methodologies for new products or market launches

Knowledge of healthcare claims lifecycle, pricing, and accumulators

Lean Six Sigma or process improvement background is a plus

Benefits

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reimbursement up to $10,000

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term, Short-Term Disability, and Critical Illness plans

Life Insurance

401k/403B with Employer Match

Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education

Student Debt Pay Down – $10,000

Reimbursement for certifications and free access to complete CEUs and professional development

Pet Insurance

Legal Resources Plan

Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Company

Sentara Health

Glassdoor3.7

Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission - "we improve health every day." Sentara is one of the largest health systems in the U.S.

Founded in 1988

Hampton Roads, VA, US

10001+ employees