The Role
Configure and maintain QNXT benefit plans and hierarchies; perform data formatting, validation, unit testing, and error remediation; analyze claims and data to identify configuration gaps; create/maintain UM authorization templates; write intermediate SQL queries; lead stakeholder communications; identify automation opportunities using automation tools/GenAI; support performance tuning and system optimization.
Summary Generated by Built In
QNXT Benefit Automation Specialist with emphasis on commercial plans and Member, Claims, Provider, Sponsor, Benefit modules and related reference Tables.
Scope of the Need:
- The resources will support Benefit Configuration, data formatting, validation, unit testing, and error remediation.
- The Benefit Configuration Analyst SME would be collaborating with stakeholders to gather, assess, interpret, and design/document Benefit configuration needs and coverage requirements.
- Analysts must lead communications and facilitation efforts to present the documented findings and results from an analytical engagement.
- The analysts must have the ability to independently analyze or mine data, draw sound conclusions, and is able to interpret detail plan benefit summaries
- Analysts must diligently follow written instructions, oral instructions, and policy.
Experience Necessary:
- 3-5 Years of QNXT Benefit Configuration Implementation and Support Experience (Design, configuration, front/back-end load configuration, resolution/update)
- Independently design, configure and build benefit plans and various benefit components in QNXT
- Expertise in setting up and maintaining benefit plan hierarchies, including base plans, riders, and their attributes. This includes understanding the financial impact of benefit configurations on plan costs and premiums.
- Deep knowledge of Claims Processing Lifecycle - Including the upstream/downstream processes that impact claims payment
- Independently research claims issues to determine benefit configuration gaps, update configuration as applicable.
- Exposure and demonstrated ability to create / maintain UM Authorization Templates
- 3-5 Years experience of a demonstrated ability to independently create intermediate SQL queries - above and beyond basic.
- Ability to rapidly interpret and understand current data schemas that are new an unfamiliar
- Proven ability to operate in complex projects related to benefit configuration, including the ability to lead cross-functional teams and manage timelines, resources, and deliverables effectively.
- Demonstrated experience in identifying, diagnosing, and resolving complex issues related to benefit configuration in QNXT, including performance tuning and system optimization.
- Demonstrated experience in identifying manual steps/process that can be automated using automation tools/GenAI.
Compensation, Benefits and Duration
Minimum Compensation: USD 40,000
Maximum Compensation: USD 163,000
Compensation is based on actual experience and qualifications of the candidate. The above is a reasonable and a good faith estimate for the role.
Medical, vision, and dental benefits, 401k retirement plan, variable pay/incentives, paid time off, and paid holidays are available for full time employees.
This position is also available for independent contractors
No applications will be considered if received more than 120 days after the date of this post
Skills Required
- 3-5 years QNXT benefit configuration implementation and support experience (design, configuration, front/back-end load configuration, resolution/update)
- Ability to independently design, configure, and build benefit plans and components in QNXT
- Expertise in setting up and maintaining benefit plan hierarchies including base plans, riders, and attributes
- Deep knowledge of the claims processing lifecycle and upstream/downstream processes impacting claims payment
- Ability to research claims issues, determine benefit configuration gaps, and update configurations
- Exposure to and demonstrated ability to create and maintain UM authorization templates
- 3-5 years experience creating intermediate SQL queries independently (beyond basic SQL)
- Ability to rapidly interpret and understand unfamiliar data schemas
- Proven ability to operate in complex benefit configuration projects, lead cross-functional teams, and manage timelines/resources
- Experience diagnosing and resolving complex QNXT configuration issues, including performance tuning and system optimization
- Demonstrated experience identifying manual processes that can be automated using automation tools or GenAI
- Strong written and oral communication skills; ability to lead communications and present documented findings
- Ability to diligently follow written and oral instructions and policy
Am I A Good Fit?
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.
Success! Refresh the page to see how your skills align with this role.
The Company