15 Qnxt jobs available for remote work from home. Apply for positions such as RN, Supervisor- Preauthorization Imagining Team, Consultant - Payer Services - QNXT Developer, Sr. Benefit Configuration Analyst, and more! Discover the best work-from-home or hybrid, full- and part-time jobs.
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The RN Supervisor oversees daily operations, coordinates team workflows, and ensures quality service within the Medical Care Management department. They also facilitate team activities, provide leadership in utilization management, and deliver educational support to staff.
The QNXT Developer will design, develop, test, and implement complex healthcare payer technology solutions. They will collaborate with business and IT partners to resolve system issues and ensure high-quality delivery of technical specifications.
The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform. This role collaborates with cross-functional teams to ensure benefit plans are implemented accurately and in compliance with regulatory and contractual requirements.
The Lead Analyst is responsible for interpreting regulatory and contractual requirements to document system configuration parameters for claims processing. They also coordinate with cross-functional teams to ensure compliant, timely claim payments and support system upgrades and defect resolution.
The Program Manager will lead the end-to-end implementation and migration of the QNXT Claims workstream, ensuring alignment across cross-functional teams. They are responsible for managing project governance, vendor relationships, and operational readiness for go-live.
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The Credentialing Coordinator I is responsible for processing, reviewing, and maintaining provider and facility credentialing files while ensuring compliance with department and NCQA standards. They also assist with workflow management and provide guidance on the credentialing process during committee meetings.
The Senior Program Manager oversees Medicare Advantage operational work streams to ensure regulatory compliance and product integrity. They manage cross-functional initiatives, vendor relationships, and product implementations while driving continuous improvement and performance reporting.
The Payment Integrity Analyst executes claims investigation and recovery strategies to identify cost containment opportunities and ensure payment accuracy. They collaborate with internal departments and external vendors to audit claims, document root causes of overpayments, and manage provider disputes.
The Claims Review Specialist is responsible for reviewing and processing medical claims that require manual intervention to ensure accuracy and compliance with clinical guidelines. They must also collaborate with external departments to resolve claims errors and maintain performance goals regarding productivity and accuracy.
The Benefit Configuration Manager leads the strategic oversight and execution of benefit configuration operations within the QNXT platform. This role manages the end-to-end lifecycle of benefit plans, ensuring compliance with regulatory standards and supporting claims adjudication across various product lines.
The Principal Data & Analytics Delivery Leader will oversee the delivery of MMIS data and analytics solutions for state and local government clients. This role involves managing a team of analysts and developers while collaborating with cross-functional leaders to drive integrated reporting initiatives and ensure compliance.
The Senior Program Manager will lead business-side execution for core admin transformation, coordinating between business leaders, IT, and system integrators. They are responsible for driving integrated business planning, managing cross-functional risks, and overseeing business readiness activities such as training and cutover planning.
The analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform. They work cross-functionally to ensure benefit plans are implemented accurately and in compliance with regulatory requirements.
Responsible for supporting, enhancing, and implementing software applications and overseeing intermediate to large-scale projects. Acts as a liaison between customers, IT personnel, and vendors to align technology functionality with operational business processes.
The Senior Configuration Analyst provides business and technical expertise to identify, develop, and implement system configuration solutions that enhance and support business operations. This role involves performing complex analysis and configuration functions, ranging from high-level functional analysis to detailed technical system configuration.
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