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Qnxt Jobs (NOW HIRING)

Techvilla Solutions

  • Medical

Position Overview We are seeking an experienced QNXT Benefit Configuration Analyst to support the implementation, enhancement, and maintenance of benefit plans within the TriZetto QNXT platform. The ...

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What is a Qnxt?

A Qnxt job typically involves working with the QNXT platform, a healthcare claims and benefits management system used by payers to process claims, manage memberships, and ensure regulatory compliance. Roles can vary, including analysts, developers, testers, or support specialists who configure, maintain, or troubleshoot the system. Professionals in these roles often work with databases, reports, and system integrations to optimize healthcare operations.

What are the typical responsibilities of a Qnxt analyst or administrator?

A QNXT Analyst or Administrator is primarily responsible for configuring and maintaining the QNXT platform, ensuring accurate processing of healthcare claims and member data. Daily tasks may include troubleshooting system issues, performing data validation, generating ad hoc reports, and providing support to end-users such as claims examiners or customer service teams. The role often requires regular collaboration with IT, operations, and compliance departments to implement system upgrades and support organizational goals. By playing a key part in optimizing claims processing workflows, QNXT professionals help ensure efficient and compliant healthcare administration.

What are the key skills and qualifications needed to thrive in the Qnxt position, and why are they important?

To thrive as a QNXT Analyst or Administrator, you need solid experience in healthcare claims processing, data analysis, and system configuration, typically supported by a background in health information technology or business administration. Familiarity with QNXT software (a Trizetto claims management platform), SQL, and industry certifications like Certified Professional Coder (CPC) are often required. Strong problem-solving skills, attention to detail, and effective communication help professionals excel when supporting internal users and collaborating across teams. These skills are vital for ensuring accurate claims adjudication, maintaining regulatory compliance, and optimizing healthcare operations.

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Qnxt jobs near you
Infographic showing various Qnxt job openings in the United States as of August 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 82% In-person, and 18% Remote job distribution.

QNXT Benefit Configuration Analyst

Techvilla Solutions

Lyndhurst, NJ • Remote

Full-time

Medical

Posted 9 days ago

Job description

Position Overview

We are seeking an experienced  QNXT Benefit Configuration Analyst  to support the implementation, enhancement, and maintenance of benefit plans within the  TriZetto QNXT  platform. The ideal candidate will have extensive experience configuring commercial and/or government healthcare products, translating business requirements into system configurations, and collaborating with cross-functional teams to deliver high-quality healthcare solutions.  

The candidate should possess strong knowledge of healthcare payer operations, benefit plan design, claims processing, SQL, and end-to-end testing.

Roles and Responsibilities
  • Configure and maintain benefit plans within the QNXT platform based on business and regulatory requirements. 
  • Configure Service Groups, Restriction Groups, Copay Groups, Coinsurance, Deductibles, Out-of-Pocket Maximums (MOOP), Accumulators, Visit Limits, Authorization Rules, and Benefit Limits. 
  • Configure benefits for Commercial, Medicare Advantage, Medicaid, Exchange, PPO, HMO, POS, EPO, and ASO products. 
  • Analyze business requirements and translate them into detailed configuration specifications. 
  • Collaborate with Business Analysts, Product Owners, Configuration Analysts, Developers, QA, and Business Stakeholders. 
  • Perform impact analysis for new benefit changes, regulatory updates, and annual benefit plan implementations. 
  • Support annual benefit rollovers and Open Enrollment implementations. 
  • Validate benefit configurations using the QNXT Claims module to ensure claims adjudicate correctly. 
  • Develop configuration documentation, design documents, mapping documents, and implementation guides. 
  • Troubleshoot benefit configuration issues and identify root causes. 
  • Support production incidents and resolve benefit configuration defects. 
  • Participate in requirements gathering sessions, JAD sessions, backlog grooming, sprint planning, and release planning. 
  • Work closely with QA teams during SIT, UAT, and regression testing. 
  • Perform SQL queries to validate configuration data, troubleshoot issues, and analyze claim outcomes. 
  • Participate in release deployments and post-production validation activities. 
  • Collaborate with downstream teams supporting Claims, Enrollment, Provider, Finance, EDI, and Customer Service. 
  • Maintain configuration version control using QCS, CMT, or other migration tools. 
  • Ensure compliance with CMS, State Medicaid, and Commercial regulatory requirements. 
Required Qualifications
  • 5+ years of Healthcare Payer experience. 
  • 5+ years of hands-on TriZetto QNXT Benefit Configuration experience. 
  • Strong understanding of healthcare benefit design and claims adjudication. 
  • Experience configuring: 
    • Service Groups 
    • Restriction Groups 
    • Copay Groups 
    • Coinsurance 
    • Deductibles 
    • Accumulators 
    • MOOP 
    • Visit Limits 
    • Prior Authorization Rules 
    • In-Network / Out-of-Network Benefits 
  • Experience with Commercial, Medicare, and Medicaid benefit plans. 
  • Strong SQL skills including: 
  • Experience troubleshooting claims adjudication issues. 
  • Experience validating benefit configurations using test claims. 
  • Ability to read and interpret business requirements and technical documentation. 
  • Strong analytical and problem-solving skills. 
  • Excellent communication and stakeholder management skills. 
Preferred Qualifications
  • Experience with QCS (QNXT Configuration Studio). 
  • Experience with CMT (Configuration Migration Tool). 
  • Experience supporting annual benefit implementations. 
  • Experience with Medicare Advantage and Medicaid Managed Care plans. 
  • Experience with CMS regulations. 
  • Experience working in Agile/Scrum environments. 
  • Experience using Jira, Azure DevOps, or Rally. 
  • Experience supporting large healthcare payer organizations. 

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