Qnxt Claims Processing Jobs in Wisconsin (NOW HIRING)

The IS Configuration Lead directly manages activities for end-to-end systems configuration. This individual collaborates with the operational departments for supporting the core business functions, develops the annual lifecycle tasks with the operations and product areas, works with the Development and Architecture team to define scope within projects and utilizes new system functionality. This role serves as a key role in conducting and managing complex analytical projects affecting decisions, activities, and processes involving all areas of the organization.

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both with our hybrid workplace model.

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Collaborate in the planning, development, and deployment of new applications, and enhancements to existing applications
• Build, coordinate and perform in-depth test plans, test cases and functional testing, including end-user reviews, for modified and new systems, assuring proper user acceptance testing of completed projects and other post-implementation support
• Maintain effective communication with software vendors to ensure that Network Health’s specifications for new functionality, identified system defects and system implementation schedules are met.
• Provide orientation and training to end users, along with coaching, mentoring and work direction to other IT staff members for all modified and new systems
• Support department leader by preparing and delivering reports, recommendations, or alternatives that address existing and potential trouble areas in operating systems across the organization.
• Provide feedback to leader relating to individual staff performance
• Establish, monitor, measure and report on key quality and productivity metrics. Based on trend analysis, identify action plans to optimize performance. Monitor productivity and efficiency of operations
• Coach and educate the team on best practices in configuration, requirements gathering process, business/functional requirements management, and configuration implementations
• Monitor team standards on appropriate testing scenarios and documentation, automated system processes and SQL validations, and custom configuration scripting development with IS
• Identify, determine root cause and resolve operational problems and inefficiencies to ensure continued high-quality service to customers, and achieve required operational results
• Document processes and identify and adopt best practices to promote accuracy and efficiency
• Participate in planning, configuring, testing and implementing of system enhancements and assigned projects
• Comply with and apply standard practices in QNXT, EAM, NetworX Optum PPS and Rate Manager systems. Maintain data accuracy to ensure service level agreements are met for the systems and customers being supported.
• Represent company on user groups and at conferences and develops requirements for submission to vendors for system enhancements

Job Requirements:

• Bachelor’s degree or 8 years of equivalent experience required
• 4+ years of direct configuration experience in Cognizant products or Optum Products- or similarly structured insurance / health care platforms (eg Epic, VBA) (depending on role area), including participation on user groups and attendance at release meetings for software with shared accountability with business partners/training for translating release information to users to apply correct changes/developments in software.
• Minimum of 4 years’ experience in a health insurance or health care related field, with alternative educational requirements acceptable as more than 6 years of experience in health insurance with 4 years of experience in business analysis, EDI or configuration of systems from Cognizant, Optum or other claims processing systems.
• Depending on functional team the role will be supporting, position may require:
  • 4+ years’ experience as a coder or 4+ years experience working with provider contracts or payment.
• SQL knowledge is preferred

Network Health is an Equal Opportunity Employer