Senior Business Analyst, Benefit Configuration

City/State

Work Shift

Overview:

The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform to support accurate claims adjudication and compliance. This role works closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements.

The senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance.

• Bachelor’s degree in a relevant field such as Computer Science, Information Technology, Information Systems, Engineering, Business/Administration, Finance, Accounting, or Education, or a closely related discipline. 

• Minimum of 4 years of progressive, relevant professional experience required.

OR

• In lieu of a bachelor’s degree, an additional 2 years of directly related experience (for a total of 6 years) may be considered as equivalent. 

• No specific certification or licensure requirements

• Required to have 7+ years of hands-on QNXT benefit configuration experience, preferably in a managed care or health plan environment.

• Required to have strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration.

• Required to have proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting.

• Required to have experience with CMT and QCS tools for version management, configuration migrations, and build monitoring.

• Required to have strong understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans.

• Required to have excellent analytical, organizational, and problem-solving skills, strong written and verbal communication including technical documentation. Excellent interpersonal skills and team oriented.

Preferred Qualifications

• Familiarity with implementation methodologies for new products or market launches.

• Knowledge of healthcare claims lifecycle, pricing, and accumulators.

• Lean Six Sigma or process improvement background is a plus.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $ 69,867.20 - $ 116,438.40.  Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.