Apex Systems · 1 week ago
QNXT Benefit Configuration Supervisor
United States
Full-time
Remote
Senior Level
$50/hr - $70/hr
7+ years expApex Systems is a world-class IT services company that serves thousands of clients across the globe. The Supervisor, QNXT Benefit Configuration, 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 to support claims processing and member eligibility systems.
Human ResourcesInformation TechnologyRecruiting
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
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
Life
Disability
Employee stock purchase program
401K program
Health Savings Account on the HDHP plan
SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions
Corporate discount savings program
Discounts
On-demand training program
Access to certification prep
Library of technical and leadership courses/books/seminars once you have 6+ months of tenure
Certification discounts and other perks to associations that include CompTIA and IIBA
Dedicated customer service team for our Consultants
Certified Career Coach
Company
Apex Systems
Apex Systems, a division of On Assignment, provides organizations with IT staffing solutions to address gaps in their current workforce.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Roger Wahman
Chief Technology Officer - SVP
Andrea Schiola
Global Head of Technology Partnerships, SVP, Principal
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