Remote Benefit Configuration Lead

Sentara Health; United States; À distance; USD 106 000 - 177 000; Plein temps

Avantages offerts par ce poste

Medical benefits

401k with match

Paid time off

Résumé du poste

Sentara Health is seeking a Benefit Configuration Manager to lead strategic configuration operations within the QNXT platform. The role supports Medicare, Medicaid, Commercial, and Exchange products, and collaborates with business and IT teams to implement new products and regulatory changes.

The position emphasizes governance, quality, and operational excellence, with responsibility for UAT, defect management, and performance reporting across enterprise initiatives.

Qualifications

• Bachelor’s degree or relevant experience in health plan configuration.
• 8+ years in health plan benefit configuration using QNXT or equivalent.
• 5+ years leading configuration teams or supervisors.
• Experience with Commercial, Exchange, Medicare, and Medicaid benefits and regulatory rules.
• Strong analytical, organizational, project management, and communication skills.
• Proven ability to lead cross-functional teams and drive initiatives.
• Ability to create SQL queries for validation of configuration and claims analysis.

Responsabilités

• Oversee analysis, design, configuration, implementation, and maintenance of benefit plans in QNXT.
• Ensure accurate configuration of products, plans, service codes, accumulators, limitations, and cost-share structures per regulations.
• Direct annual benefit changes, new product implementations, and market expansion efforts.
• Establish governance for configuration requests, prioritization, approvals, and deployments.
• Monitor configuration quality via KPIs, SLAs, and QA programs.
• Act as escalation point for regulatory interpretation and configuration decisions.
• Lead UAT, validation, defect management, and production readiness activities.
• Drive process improvements to enhance quality, efficiency, and scalability.
• Collaborate with IT to identify automation opportunities for configuration management.
• Provide executive reporting on configuration activities, risks, and capacity.
• Coach and manage configuration staff and establish team goals.

Connaissances

QNXT experience

Leadership of configuration teams

SQL validation

Regulatory knowledge

Formation

Bachelor's degree or equivalent experience

Outils

QNXT tools (CMT/QCS)

SQL Server

Description du poste

Sentara Health is seeking a Benefit Configuration Manager to lead strategic configuration operations within the QNXT platform. The role supports Medicare, Medicaid, Commercial, and Exchange products, and collaborates with business and IT teams to implement new products and regulatory changes.

The position emphasizes governance, quality, and operational excellence, with responsibility for UAT, defect management, and performance reporting across enterprise initiatives.