Medicaid Claims Configuration Analyst

Job Summary

Providing senior functional and technical expertise for Medicaid claims configuration in a fully remote capacity, the Advisor Business Analyst - Claims Configuration will lead a team of Configuration Business Analysts, translating client requirements and Medicaid policy into scalable QNXT solutions while managing complex claims issues and communicating effectively with stakeholders.

Key responsibilities

• Lead and mentor a team of Claims Configuration Business Analysts, ensuring quality and consistency in configuration practices
• Engage with clients and cross-functional teams to facilitate requirements discussions, configuration reviews, and issue resolution
• Configure and support QNXT claims solutions, translating Medicaid policy and operational needs into actionable specifications and business rules

Required qualifications

• 9+ years of hands-on QNXT configuration experience, including contracts, benefits, and payment methodologies
• Thorough understanding of relational database concepts and healthcare data models
• Demonstrated competency in writing complex SQL queries for claims analysis and troubleshooting
• Bachelor's degree in Computer Science, Information Systems, Health Informatics, Business Administration, or a related field, or equivalent experience
• Experience leading or mentoring Configuration Business Analysts and reviewing technical or functional work products