e QNXT Developer is responsible for designing, developing, maintaining, and supporting solutions within the QNXT platform to meet healthcare payer business requirements. This role works closely with business analysts, claims, enrollment, provider management, and IT teams to enhance system functionality, improve operational efficiency, and ensure compliance with healthcare regulations.
Key Responsibilities- Design, develop, test, and implement enhancements within the QNXT application.
- Configure and customize QNXT modules, including claims, membership, provider, benefits, and authorization processing.
- Develop and maintain stored procedures, SQL queries, interfaces, and system integrations.
- Analyze business requirements and translate them into technical solutions.
- Troubleshoot production issues and provide timely resolution.
- Support system upgrades, patches, and performance optimization initiatives.
- Develop and maintain EDI transactions, including 834, 835, 837, and other healthcare data exchanges.
- Collaborate with cross-functional teams to gather requirements and perform impact analysis.
- Create technical documentation, design specifications, and user support materials.
- Ensure compliance with HIPAA, CMS, state regulations, and organizational standards.
- Participate in code reviews, testing, deployment, and release management activities.
- Support data conversion, migration, and reporting initiatives.
- Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field (or equivalent experience).
- 3+ years of experience working with the QNXT platform.
- Strong knowledge of healthcare payer operations, including claims processing, enrollment, benefits, and provider management.
- Experience with Microsoft SQL Server, T-SQL, stored procedures, and database development.
- Experience developing system interfaces and healthcare EDI transactions.
- Strong analytical, troubleshooting, and problem-solving skills.
- Knowledge of SDLC methodologies and source control processes.
- Excellent written and verbal communication skills.
- Experience with TriZetto (Cognizant) QNXT implementations and upgrades.
- Knowledge of Medicare, Medicaid, and Commercial health plans.
- Experience with SSIS, SSRS, Power BI, or other reporting tools.
- Familiarity with APIs, web services, and integration technologies.
- Agile/Scrum experience.
- Healthcare industry certifications or technical certifications are a plus.
- QNXT Configuration and Development
- SQL Server / T-SQL
- EDI (834, 835, 837, 270/271, 276/277)
- SSIS / SSRS
- Data Analysis and Reporting
- System Integration
- Healthcare Claims Processing
- Provider and Member Management
- HIPAA Compliance
Salary Range
Now, a little about us …
At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first—both patients and those who dedicate their lives to delivering care.
And at the very core of this vital work is our incredibly talented people.
People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare.
Perks and benefits
Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career.
Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family.
Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more.
And everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way.
Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All qualified candidates are encouraged to apply.
Skills Required
- Bachelor's degree in Computer Science, Information Systems, Healthcare Informatics, or related field (or equivalent experience)
- 3+ years of experience working with the QNXT platform
- Strong knowledge of healthcare payer operations including claims processing, enrollment, benefits, and provider management
- Experience with Microsoft SQL Server, T-SQL, stored procedures, and database development
- Experience developing system interfaces and healthcare EDI transactions (834, 835, 837, 270/271, 276/277)
- Strong analytical, troubleshooting, and problem-solving skills
- Knowledge of SDLC methodologies and source control processes
- Excellent written and verbal communication skills
- Experience with TriZetto (Cognizant) QNXT implementations and upgrades
- Knowledge of Medicare, Medicaid, and Commercial health plans
- Experience with SSIS, SSRS, Power BI, or other reporting tools
- Familiarity with APIs, web services, and integration technologies
- Agile/Scrum experience
- Healthcare industry or technical certifications
What We Do
Tegria is a global healthcare consulting and services company delivering end-to-end solutions that help provider and payer organizations transform healthcare. To learn more, visit www.tegria.com
