Sentara Healthcare

Sr. Benefit Configuration Analyst

Sentara Healthcare$69K — $116K *
US-AnywhereRemote in Coral Springs, FL
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor’s Degree required.
  • 7+ years of hands-on QNXT benefit configuration experience in a managed care or health plan environment.
  • Strong knowledge of QNXT system architecture, configuration tables, benefit logic, and claims integration.
  • Proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting.
  • Experience with CMT and QCS tools for version management and configuration migrations.
  • Understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans.
  • Strong analytical, organizational, and problem-solving skills with excellent communication capabilities.

Responsibilities

  • Analyze, design, build, and validate complex benefit configurations in QNXT.
  • Collaborate with product, compliance, IT, network, and claims teams for accurate implementation of benefit plans.
  • Support new plan implementations and annual updates for benefit configurations.
  • Maintain ongoing configuration and ensure compliance with regulatory requirements.
  • Serve as a business and technical expert in QNXT benefit build.

Benefits

  • Medical, dental, and vision plans.
  • Adoption, fertility, and surrogacy reimbursement up to $10,000.
  • Paid time off and sick leave.
  • Paid parental and family caregiver leave.
  • Emergency backup care services.
  • Long-term and short-term disability plans, critical illness plans, and life insurance.
  • 401k/403B plan with employer match.
  • Tuition assistance up to $5,250/year and discounted educational opportunities.
  • Student debt pay down assistance of $10,000.
  • Pet insurance and legal resources plan.
  • Annual discretionary bonus eligibility based on established criteria.
Full Job Description

City/State

Doral, FL

Work Shift

First (Days)

Overview:

Overview

The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform to support accurate claims adjudication and compliance. This role works closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements.

The senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance.

Education
  • Bachelor’s Degree (Required)

Certification/Licensure
  • No specific certification or licensure requirements

Experience
  • Required to have 7+ years of hands-on QNXT benefit configuration experience, preferably in a managed care or health plan environment.
  • Required to have strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration.
  • Required to have proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting.
  • Required to have experience with CMT and QCS tools for version management, configuration migrations, and build monitoring.
  • Required to have strong understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans.
  • Required to have excellent analytical, organizational, and problem-solving skills, strong written and verbal communication including technical documentation. Excellent interpersonal skills and team oriented.

Preferred Qualifications

  • Familiarity with implementation methodologies for new products or market launches.
  • Knowledge of healthcare claims lifecycle, pricing, and accumulators.
  • Lean Six Sigma or process improvement background is a plus.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $ 69,867.20 - $ 116,438.40.  Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Keywords: QNXT, Benefit Configuration, SQL Server, CMT, QCS tools, Medicare, Medicaid, ACA, Commercial plans, lean six sigma, LSS, process improvement, QNXT system architecture, QNXT benefit configuration


Benefits: Caring For Your Family and Your Career

Medical, Dental, Vision plans

• Adoption, Fertility and Surrogacy Reimbursement up to $10,000

• Paid Time Off and Sick Leave

• Paid Parental & Family Caregiver Leave

• Emergency Backup Care

• Long-Term, Short-Term Disability, and Critical Illness plans

• Life Insurance

• 401k/403B with Employer Match

• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education

• Student Debt Pay Down – $10,000

•Pet Insurance 
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

For positions that are available as remote work,Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

About Sentara Healthcare

Sentara Healthcare is a not-for-profit healthcare system that operates hospitals, outpatient care centers, imaging centers, and other healthcare facilities in Virginia and North Carolina. The system provides a range of medical services, including cancer care, heart and vascular care, orthopedics, pediatrics, and women's health. Sentara Healthcare also offers health plans and wellness programs. The system is committed to providing high-quality, patient-centered care and has received numerous awards and recognitions for its clinical outcomes and patient satisfaction.
Learn more about Sentara Healthcare
Size
30,000 employees
Industry

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