Remote Benefit Configuration Manager — Lead & Optimize

Sentara Healthcare Inc; Town of Florida, Northern (NY, KY); Hybrid; USD 106,000 - 177,000; Full time

Job summary

Sentara is seeking a Benefit Configuration Manager to lead the configuration of Medicare, Medicaid, Commercial, and Exchange products within QNXT. You will guide supervisors and analysts, establish standards, and partner with cross-functional teams to implement new products and regulatory changes.

The role focuses on governance, quality, and operational excellence in benefit configuration, with remote work options and strategic leadership responsibilities.

Qualifications

• Bachelor's degree or equivalent experience in healthcare administration, information systems, or business administration.
• 8+ years of progressive health plan benefit configuration experience (QNXT or equivalent).
• 5+ years leading configuration teams or operational functions.

Responsibilities

• Oversee analysis, design, configuration, implementation, and maintenance of benefit plans in QNXT.
• Ensure accurate configuration of products, plans, service codes, accumulators, limitations, and cost-shares per plan rules and CMS/ ACA requirements.
• Direct annual benefit changes, new product implementations, and regulatory updates.
• Establish governance for configuration requests, prioritization, approvals, and deployments.
• Monitor configuration quality and timeliness via KPIs, SLAs, and QA programs.
• Act as escalation point for complex regulatory interpretation and decisions.
• Lead configuration staff and project teams across enterprise initiatives.
• Oversee UAT, validation, defect management, and production readiness.

Skills

Bachelor's degree

8+ years experience

5+ years leading teams

QNXT / benefit configuration

Regulatory knowledge (CMS ACA Medicaid

SQL queries for validation

Education

Bachelor's degree in Healthcare Administration, Information Systems, Business Administration, or related field

Tools

SQL Server

QNXT CMT/QCS

Job description

Sentara is seeking a Benefit Configuration Manager to lead the configuration of Medicare, Medicaid, Commercial, and Exchange products within QNXT. You will guide supervisors and analysts, establish standards, and partner with cross-functional teams to implement new products and regulatory changes.

The role focuses on governance, quality, and operational excellence in benefit configuration, with remote work options and strategic leadership responsibilities.