Hiring: Benefit Configuration Manager - Remote Company: Sentara Health Location: Doral, FL Job Posted Time: 2026-09-10 11:57:03 Employment Type: Full-time / Remote Target Skills & Keywords : Agile, Configuration Management, Medicaid, Medicare, Project Management, Quality Assurance, Regulatory Compliance, SQL, SQL Server, Six Sigma, Stakeholder Management About the job Experience: •3 years of related experience in one of the following areas, operations, IT, or reporting. (Required) •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 •Paid Time Off and Sick Leave •Paid Parental & Family Caregiver Leave Required Skills: •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. 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 •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 •Solid functional working knowledge of QNXT architecture and Benefit configuration QNXT Configuration Management Tool (CMT) and QNXT Configuration Console Suite (QCS) Compensation: •$106,080 - $176,820 / year •Flexible work environment (work from home / hybrid options) •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. •Adoption, Fertility and Surrogacy Reimbursement up to $10,000 Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!