Sr. Benefit Configuration Analyst

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. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. 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.