Molina Healthcare · 3 months ago
Senior QNXT Analyst - Contract Configuration
United States
Full-time, Contract
Remote
Senior Level
$80K/yr - $141K/yr
5+ years expMolina Healthcare is a company focused on providing quality healthcare services. They are seeking a Senior QNXT Analyst to ensure accurate implementation and maintenance of claims databases and to support the configuration of contracts and benefits.
Health CareHospitalMedical
Responsibilities
Responsible for accurate and timely implementation and maintenance of critical information on claims databases
Maintains critical information on claims databases
Synchronizes data among operational and claims systems and application of business rules as they apply to each database
Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements
Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems
Participates in defect resolution for assigned component
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality
Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans
Participates in the implementation and conversion of new and existing health plans
Qualification
Required
Responsible for accurate and timely implementation and maintenance of critical information on claims databases
Maintains critical information on claims databases
Synchronizes data among operational and claims systems and application of business rules as they apply to each database
Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements
Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems
Participates in defect resolution for assigned component
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality
Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans
Participates in the implementation and conversion of new and existing health plans
Must have experience in Contracts configuration in QNXT or Networx
Experience in DOFR (division of financial responsibility) or CA DOFR, DME, capitation, Physician pricing is required
Must have knowledge on Medicare payment methods
Experience on Hospital payment methodology & processing is essential
Understanding on hospital claims processing and configuration works
Medicare fee schedule knowledge is required
Bachelor's Degree or equivalent combination of education and experience
5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims payment method
Preferred
Graduate Degree or equivalent experience
Medicaid and Duals experience is preferred
7-9 years
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
2026-01-17
Company data provided by crunchbase