Position Details
Qnxt Benefit Configuration Sme Apply
Title: QNXT Benefit Configuration SME
Duration: Long term,
Job Id: 20713
Job Id: 20713
Location: South Boston, Virginia
Description:
QNXT Benefit Configuration SMEs 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.
