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Sentara Health · 2 weeks ago

Supervisor, QNXT Benefit Configuration - Remote

United States

Full-time

Remote

Mid, Senior Level

$91K/yr - $152K/yr

7+ years exp

Sentara Health is hiring for a Supervisor, QNXT Benefit Configuration. The Supervisor is responsible for overseeing the daily operations of benefit configuration activities within the QNXT platform, ensuring accurate and compliant configuration of benefit plans and products.

Hospital & Health Care

Responsibilities

Supervise and lead a team of benefit configuration analysts working in QNXT

Oversee and ensure accurate benefit build and configuration for new and existing plans, benefit riders, and products

Validate system configurations for compliance with CMS, Medicaid, and state guidelines

Develop and maintain standard operating procedures (SOPs) and workflows

Manage timelines and deliverables for benefit setup during annual enrollment, new market launches, and regulatory changes

Collaborate with IT, Claims, Provider Relations, and Legal/Compliance to resolve configuration-related issues

Participate in system upgrades, testing (UAT), and implementation planning

Monitor quality assurance metrics to ensure high data integrity and adherence to SLAs

Provide training and mentoring to staff on benefit configuration best practices and QNXT functionality

Serve as the subject matter expert (SME) for benefit configuration policies, systems, and tools

Qualification

QNXTBenefit configurationClaims processingMedicare knowledgeAnalytical skillsProcess improvementLeadershipProblem-solvingInterpersonal skillsOrganizational skills

Required

Bachelor's degree or 7+ years of experience in benefit configuration within QNXT or a similar claims adjudication system

3+ Supervisor or Lead experience providing guidance to lower-level staff and managing tasks

In-depth knowledge of Medicare, Medicaid, ACA, and/or commercial plan benefit structures

Proficient in interpreting and implementing benefit grids, SBCs, and regulatory documents

Strong understanding of claims processing and eligibility systems

Excellent analytical and problem-solving skills

Strong interpersonal, organizational, and leadership abilities

Preferred

Experience with Trizetto's QNXT core administration system

Knowledge of CMS model benefits and Medicaid waiver programs

Process improvement or Lean Six Sigma background

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