QNXT Benefit Configuration SME - VA

Photon$85K — $110K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3-5 years of QNXT Benefit Configuration implementation and support experience.
  • Deep knowledge of the Claims Processing Lifecycle.
  • Experience in creating and maintaining UM Authorization Templates.
  • 3-5 years of experience in creating intermediate SQL queries.
  • Proficient in interpreting complex data schemas rapidly and effectively.

Responsibilities

  • Support Benefit Configuration including data formatting and validation.
  • Collaborate with stakeholders to gather and document Benefit configuration needs.
  • Lead communication efforts to present analytical findings to stakeholders.
  • Independently analyze data and draw conclusions related to benefit summaries.
  • Follow written and oral instructions to ensure compliance with policies.

Benefits

  • Opportunity to work with cross-functional teams.
  • Engage in complex projects with diverse stakeholders.
  • Enhance skills in data analysis and benefit configurations.
  • Involvement in significant process improvements.
  • Access to ongoing professional development in the healthcare domain.
Full Job Description
Job 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.

About Photon

Photon Careers

Joining Photon presents an unparalleled opportunity to advance one's career with a leader in digital innovation. Photon is actively seeking talented individuals to join its diverse team of professionals, dedicated to reshaping industries through technology and creativity.

Explore Job Opportunities

Photon offers a variety of job opportunities that cater to a range of skills and interests. Each position at Photon is designed to challenge team members while providing meaningful pathways for professional and personal growth.

Experience the Culture and Benefits

Photon is committed to fostering a workplace culture that promotes diversity and inclusion. The company provides comprehensive benefits designed to support the health, well-being, and financial security of each team member. At Photon, every professional enjoys access to career development programs and diversity training, ensuring they are equipped for leadership roles in an evolving marketplace.

Engage in Professional Growth

Photon believes in the power of innovation and leadership to drive success. The company supports its team members with resources for continuous learning and growth, including advanced training sessions and leadership workshops. Networking within Photon’s industry-leading community allows for unparalleled career advancement and skill enhancement.

Internship Programs

For those beginning their professional journey, Photon offers internship programs that provide a robust foundation in digital solutions. Internships at Photon are characterized by immersive projects and hands-on learning, guided by experts in various fields. These programs are a gateway to full-time employment and a promising career path.

Join the Team

Photon is hiring! Explore open positions that match your skills and interests. Photon looks for passionate, curious, creative, and solution-driven team players. Whether you are starting your career or looking to make a significant impact in your professional journey, Photon has a place for you.

Prepare for Your Interview

Photon values a thorough selection process. Prospective team members are encouraged to prepare by understanding the company’s mission and values. Tailoring your resume to highlight relevant experience and skills will make a significant difference. Engage actively during your interview, demonstrating your knowledge and enthusiasm for the role you are applying for.

Stay Connected

Keep up to date with the latest from Photon by following the company’s career blog. Gain insights from insiders, learn about new job openings, and get tips on preparing your resume and acing your interview.

Career Development at Photon

Photon is dedicated to the professional development of its team members. The company offers various tools and resources, including career coaching and performance feedback, to help individuals reach their full potential. With Photon, career aspirations are nurtured, encouraging every team member to excel and innovate in their respective roles.

Networking and Career Opportunities

Photon encourages its team members to engage in networking within the company and the broader industry. These connections can lead to myriad opportunities, from collaborative projects to mentorship. Networking at Photon is not just about building professional relationships; it's about fostering a community of innovation and mutual growth.

Conclusion

Photon is not just a company; it is a community of driven professionals committed to making a difference. With a focus on innovation, leadership, and diversity, Photon offers a dynamic environment where ambitious individuals can thrive. Explore the possibilities and join Photon’s team of leaders, innovators, and visionaries.
Learn more about Photon

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