- Cognizant (Plano, TX)
- **Sr. QNXT Config Analyst.** **About the role:** As a Sr. QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. ... add PBPs. + Troubleshoot and remediate/workaround for claim pending issues. + QNXT Configuration for different State implementation. + Ability to do back-end queries… more
- Cognizant (Plano, TX)
- **About the role:** As a Sr. QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... add PBPs. . Troubleshoot and remediate/workaround for claim pending issues. . QNXT Configuration for different State implementation. . Ability to do back-end queries… more
- Insight Global (Norfolk, VA)
- Job Description Insight Global is looking for QNXT Benefits Configuration Analyst SMEs to join a team of one of our large healthcare clients. This position will be a ... analysis to make decisions to resolve issues -Previous configuration experience within QNXT -Desire a Bachelor's degree -Ability to be coachable -Team player… more
- Molina Healthcare (Long Beach, CA)
- …to research and analyze data using SQL is required. + Experience with QNXT is preferred. + Medicare/ medicaid membership exp required Required soft skill include ... but are not limited to : + Excellent communication + Possess a team player attitude + Ability to work in a diverse environment. + Must be flexible and willing to learn new skills. **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent… more
- Molina Healthcare (ID)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to ... work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for… more
- Molina Healthcare (Milwaukee, WI)
- …**Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it… more
- Molina Healthcare (Fort Worth, TX)
- …**Job Summary** The Delivery Manager will be responsible in delivering various technical projects that involves in (Compute, Storage, Network, Data Management) ... migration to Azure. The incumbent in this role will be closely working with PMO, Project technical team in delivering our key initiatives. The Delivery Manager will drive the deliverables with technical knowledge in the below areas. * Manage delivery of… more
- CareOregon (Portland, OR)
- …is responsible for providing product support to provider data within the QNXT module. Primary tasks include adding, maintaining, and updating provider data records, ... and IPAs by investigating changes and validating information prior to updating QNXT ; consult with advanced Provider Data staff to clarify information. + Complete… more
- Molina Healthcare (Provo, UT)
- …guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed ... identify trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. +… more
- Fallon Health (Worcester, MA)
- …of the TruCare documentation system as well as Fallon Health's core system QNXT + In coordination with the Administrative Assistant, manages the supplies inventory ... in Outlook and communicates such to interdepartmental teams via QNXT Call Tracking + Receives requests for ACO member...approved materials and communicates such to interdepartmental teams via QNXT Call Tracking + Utilizes Smart Data for processing… more
- Molina Healthcare (Albany, NY)
- …and systems for Corporate Operations PMO + Implements Corporate Configuration of the QNXT system as well as the Care Management application for UM functions within ... QNXT and enables system to produce expected costs. +...state regulatory requirements are met, maximizes MASS Adjudication within QNXT , improves process quality, reduces G&A costs, and continues… more
- Molina Healthcare (Omaha, NE)
- …automated process and manual input + Ensure quality control of data entered into QNXT and sent to external vendors + Oversees and participates in state, federal, and ... State, Federal, and business regulatory requirements and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. +… more
- Insight Global (Virginia Beach, VA)
- …for both iOS and Android. Automate and validate EDI transactions and QNXT -based healthcare workflows. Write complex SQL queries for backend database validation. Use ... DevOps, and Maven. Experience in Agile/Scrum environments. Familiarity with EDI, QNXT systems, and healthcare domain workflows. Experience in writing Excel Macros.… more
- Robert Half Management Resources (Burbank, CA)
- …and regulatory compliance. + Assess current use and configuration of the QNXT system, focusing on eligibility and enrollment modules. + Collaborate with business ... Medicaid regulations and CMS requirements. + Proven hands-on experience with the QNXT system, particularly in the eligibility and enrollment components. + Excellent… more
- Molina Healthcare (NY)
- …as applied to the appropriate modules within the core processing system ( QNXT ). * Conducts focal audits on samples of processed transactions impacted by ... claims processing system . + Experience using claims processing system ( QNXT ). **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and… more
- LA Care Health Plan (Los Angeles, CA)
- …lead algorithm assignments. Enters Data accurately by following the Goldmine and QNXT guidelines. Responsible for maintaining the quality and integrity of the CRM ... of internal proprietary systems, including but not limited to: CISCO, QMEIS, MEIS, QNXT , PDM, MARx, Member360, and AEVS to pre-screen prospective members for all… more
- LA Care Health Plan (Los Angeles, CA)
- …and the configuration of the LA Care Health Plan Core System (ie, QNXT ) and the related surround systems, applications, and database (eg, Clinical CareAdvance (CCA), ... Process Communication Tracking (PCT), etc.). The Quality Configuration Assurance Analyst III collaborates closely with peers and management within the department as well as throughout the organization to facilitate the timely, accurate quality assurance of the… more
- CVS Health (Austin, TX)
- …in a production-based environment. + At least 1 year of experience with QNXT , specifically related to provider and claim module knowledge. + Must reside within ... the continental United States. **Preferred Qualifications** + Prior experience working with SQL. + Prior auditing experience. + Basic knowledge of Microsoft Excel. + Attention to detail. + Effective and professional written and verbal communication skills. +… more
- Molina Healthcare (Rancho Mirage, CA)
- …years + Preferred Systems Training: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS ... Caremark + Availity To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- CareOregon (Portland, OR)
- …strategy best practices, such as ETL o Claims processing technologies, such as QNXT and Facets o Electronic health record technologies such as EPIC and Allscripts ... o Document management and collaboration platforms, such as SharePoint and Office 365 o Scripting language technology, such as PowerShell and T-SQL o Compute environments, such as server hardware, storage and virtualization o Microsoft server operating systems… more