- Molina Healthcare (Long Beach, CA)
- …ensuring the technologies are being implemented. Coding experience a plus! Familiar with QNXT is a plus. Job Summary Responsible for internal business projects and ... programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May… more
- 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
- Cognizant (Honolulu, HI)
- **About the role** As a QNXT Config Analyst, you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... to add PBPs. + Troubleshoot and remediate/workaround for claim pend 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 (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
- 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
- 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
- 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
- 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
- Molina Healthcare (Green Bay, WI)
- …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
- 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
- Molina Healthcare (Mecca, 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
- Molina Healthcare (WA)
- …application changes. **Preferred Education** Master's Degree **Preferred Experience** + QNXT or QMACS knowledge or Centricity CPS knowledge. + SharePoint, ... MS Project experience. + AI technology 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… more
- Molina Healthcare (Cincinnati, OH)
- …special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + ... Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating… more
- Fallon Health (Worcester, MA)
- …for ensuring the integrity of information being entered & maintained within the QNXT system. Must have the ability to analyze various situations and be able ... to make independent decisions on best practices in the interest of the members and the health plan. The Enrollment & Billing Operations Representative III is considered the main resource person for all Regulatory staff for issues regarding the eligibility and… more
- TEKsystems (Brookfield, WI)
- …subrogation. PLUS: - Coding experience preferred. - Past experience using QNXT (TM) Claims Workflow a plus - Medicaid/Medicare Experience Level Intermediate ... Level Pay and Benefits The pay range for this position is $19.25 - $19.25/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific… more
