Manager, Configuration - Marketplace Benefit Maintenance/QNXT - Remote

Molina Healthcare; Michigan; Remote; USD 80,000 - 189,000; Full time

Job summary

A leading healthcare company is seeking a remote Manager for Configuration. This role oversees a team focused on benefit maintenance and requires extensive knowledge in SQL, healthcare claims, and the QNXT schema. Candidates need a Bachelor's degree along with experience in marketplace configurations and management.

Qualifications

• Bachelor's degree or equivalent is required.
• 5-7 years of relevant experience is required, with a preference for 7-9 years.

Responsibilities

• Manages a team of Configuration Analysts to ensure timely implementations.
• Develops standard operating procedures for the team.
• Works with project teams to assess configuration needs.

Skills

SQL

Complex payment methodologies

Health care benefits

Healthcare claims processing

Business writing

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Office

QNXT

Job description

Join to apply for the Manager, Configuration - Marketplace Benefit Maintenance/QNXT - Remote role at Molina Healthcare

1 day ago Be among the first 25 applicants

Join to apply for the Manager, Configuration - Marketplace Benefit Maintenance/QNXT - Remote role at Molina Healthcare

Molina Healthcare is in search of a Manager, Configuration. This role is remote and can be worked from a variety of locations.

Highly Qualified Candidates Will Have The Following Experience-

• Marketplace implementation experience
• Marketplace benefit configuration experience
• Marketplace and/or Commercial experience
• Strong SQL skills
• Understanding of the QNXT Schema
  
  

Job Summary

Manages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure adherence to business and system requirements of Health Plans as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

Knowledge/Skills/Abilities

• Meet and exceed all performance metrics and department goals.
• Understand conflicts with teams and provide solutions.
• Ensure all team members comply with company and legal requirements.
• Ensure tasks are completed with accuracy and efficiency. Sets the right priorities and systematically identifies the root cause of challenges.
• Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions, and methodology for new and existing business.
• Develops standard operating procedures and guidelines for the Configuration team.
• Provides status reports and project updates to management and stakeholders.
• Ensure staff have all the resources they need to perform at a high level.
• Conduct performance reviews, training, and corrective action as appropriate.
• Understanding of complex payment methodologies
• Understanding of complex configuration solutions
• Advanced knowledge of health care benefits.
• Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission.
• Ability to adopt and utilize work tracking software
• Strong business writing skills; proficient user of Microsoft Products including Word, Excel, Outlooks, Teams, SharePoint, PowerPoint, and Visio
• Advanced knowledge of Excel preferred
• SQL knowledge preferred
• Coding certification preferred
• Knowledge of configuration in QNXT strongly preferred
  
  

Job Qualifications

Required Education: Bachelor's Degree or equivalent combination of education and experience

Preferred Education Graduate Degree or equivalent combination of education and experience

Required Experience 5-7 Years

Preferred Experience 7-9 years

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 Opportunity Employer (EOE) M/F/D/V

Pay Range: $80,412 - $188,164 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Engineering and Information Technology

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at Molina Healthcare by 2x

Get notified about new Configuration Manager jobs in Michigan, United States.

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.