Title: QNXT Benefit Configuration SME
Duration: Long term
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:
- 35 Years of QNXT Benefit Configuration Implementation and Support Experience (Design configuration front/backend 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
- 35 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 crossfunctional 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.