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Healthcare Benefit Configuration Jobs (NOW HIRING)

Sentara Healthcare Inc

$106K - $176K/yr

Sentara is hiring a Benefit Configuration Manager! This position is fully remote. Overview The ... Bachelor\'s degree in Healthcare Administration, Information Systems, Business Administration, or ...

Capital Rx

Benefit Operations Specialist

Charlotte, NC · On-site

$95K - $100K/yr

... healthcare space. Position Responsibilities: * Responsible for all aspects of benefit configuration, including new plan setup, plan change setup, claims testing, and regular audits * Drives cross ...

Solis Health Plans, Inc.

$60K - $70K/yr

Minimum of 3-5 years of experience in health insurance, managed care, claims configuration, or benefit administration . * Experience working with benefit plan documents and claims adjudication ...

P3 Health Partners

Configuration Manager

Omaha, NE · On-site

EDI transactions, provider, health plan benefits and member eligibility data, encounters ... Understanding of the healthcare industry, including competitors, the regulatory environment, and ...

P3 Health Partners

Configuration Manager

Tucson, AZ · On-site

EDI transactions, provider, health plan benefits and member eligibility data, encounters ... Understanding of the healthcare industry, including competitors, the regulatory environment, and ...

Limagrain

Healthcare Benefits Supervisor

Davis, CA · On-site

$83K - $103K/yr

HM Clause Job Title: Healthcare Benefits Supervisor Job Location: Davis Contract type: Permanent ... You will be a great fit if you have experience similar to: • Manage health and welfare benefit ...

Guidehouse

Configuration Manager

Beavercreek, OH · On-site

$86K - $129K/yr

Configuration Control / Data Management (CME) Travel Required: Up to 10% Clearance Required ... Health Care & Dependent Care Flexible Spending Accounts * Transit and Parking Commuter Benefits

Guidehouse

Configuration Manager

Huntsville, AL · On-site

$86K - $129K/yr

Configuration Control / Data Management (CME) Travel Required: Up to 10% Clearance Required ... Health Care & Dependent Care Flexible Spending Accounts * Transit and Parking Commuter Benefits

Health Source MSO

Configuration Analyst

Alhambra, CA · On-site

Monday- Friday, 8am - 5pm Configuration Analyst is responsible for serving as the day-to-day liaison for our client contacts and their respective healthcare providers and vendors during ...

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Healthcare Benefit Configuration information

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$37.5K

$95.9K

$144.5K

How much do healthcare benefit configuration jobs pay per year?

As of Sep 14, 2026, the average yearly pay for healthcare benefit configuration in the United States is $95,935.00, according to ZipRecruiter salary data. Most workers in this role earn between $76,000.00 and $112,000.00 per year, depending on experience, location, and employer.
Infographic showing various Healthcare Benefit Configuration job openings in the United States as of June 2026, with employment types broken down into 3% As Needed, 82% Full Time, 14% Part Time, and 1% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $95,935 per year, or $46.1 per hour.

Benefit Configuration Manager - Remote

Doral, FL • On-site, Remote

Sentara Healthcare
Hospitals • 10K+ employees
Learn more about Sentara Healthcareexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

Job description

City/State
Doral, FL
Work Shift
First (Days)
Overview:
Sentara is hiring a Benefit Configuration Manager!
This position is fully remote.
Overview
The Benefit Configuration Manager is responsible for the strategic leadership, oversight, and execution of benefit configuration operations within the QNXT platform. This role manages the end-to-end benefit configuration lifecycle, ensuring accurate implementation and maintenance of Medicare, Medicaid, Commercial, and Exchange products in support of claims adjudication, regulatory compliance, and organizational objectives. The manager leads configuration supervisors and analysts, establishes operational standards, drives continuous improvement initiatives, and partners with cross-functional business and technology teams to implement new products, regulatory changes, and system enhancements. The Benefit Configuration Manager serves as a key leader and subject matter expert for benefit configuration strategy, governance, quality, and operational excellence.
Key Responsibilities
  • Oversee the analysis, design, configuration, implementation, and maintenance of benefit plans within QNXT.
  • Ensure accurate configuration of products, plans, service codes, accumulators, limitations, authorization requirements, and cost-share structures in compliance with plan contractual requirements, CMS, Medicaid, ACA regulations.
  • Direct annual benefit change activities, new product implementations, regulatory updates, and market expansion efforts.
  • Establish and maintain governance processes for configuration requests, prioritization, approvals, and production deployments.
  • Monitor configuration quality, accuracy, and timeliness through established KPIs, SLAs, and quality assurance programs.
  • Serve as an escalation point for complex regulatory interpretation and benefit implementation decisions.
  • Act as the business owner and primary configuration representative for enterprise projects and strategic initiatives.
  • Oversee User Acceptance Testing (UAT), configuration validation, defect management, and production readiness activities.
  • Drive continuous process improvement initiatives that improve quality, efficiency, scalability, and operational effectiveness.
  • Collaborate with IT to identify automation opportunities and enhance configuration management capabilities.
  • Analyze trends, identify root causes of configuration defects, and implement corrective action plans.
  • Provide executive-level reporting on configuration activities, risks, resource capacity, and strategic initiatives.
  • Provide leadership, coaching, and performance management for QNXT Benefit Configuration Supervisors and configuration staff.
  • Establish team goals, performance metrics, and productivity standards aligned with organizational objectives.

Required Qualifications
  • Bachelor's degree in Healthcare Administration, Information Systems, Business Administration, or related field; In lieu of degree, direct experience will be considered.
  • 8+ years of progressive experience in health plan benefit configuration using QNXT or a comparable claims administration platform.
  • 5+ years of experience leading configuration teams, supervisors, or operational functions.
  • Demonstrated expertise in Commercial, Exchange, Medicare, and Medicaid benefit designs and regulatory requirements.
  • Extensive knowledge of benefit configuration logic, claims adjudication, accumulators, authorization rules
  • Experience managing large-scale benefit implementations or annual benefit maintenance activities.
  • Strong analytical, organizational, project management, and problem-solving skills.
  • Excellent written, verbal, presentation, and stakeholder management skills.
  • Proven ability to lead cross-functional teams and drive organizational initiatives.
  • Proven ability to create SQL queries for validation of benefit configuration and claims analysis

Preferred Qualifications
  • Working knowledge of QNXT architecture and Benefit configuration QNXT Configuration Management Tool (CMT) and QNXT Configuration Console Suite (QCS)
  • Working knowledge of SQL Server and data validation techniques for QNXT.
  • Lean Six Sigma, PMP, Agile, or other process improvement/project management certifications.

Education:
  • No specific degree is required.

Experience:
  • 3 years of related experience in one of the following areas, operations, IT, or reporting. (Required)

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for full-time employment is: 106,080.00 - 176,820.80. Additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Talroo-IT, health plan, QNXT, benefit configuration, configuration management tool, CMT, QNXT configuration Console Suite, QCS, PMP, Agile, health plan, UAT, healthcare, benefit configuration, Medicaid, commercial, Medicare, governance, quality assurance
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
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.

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