Responsibilities: Design, develop, and test applications using the QNXT Framework. Implement and configure QNXT claims workflow, with a strong understanding of commercial and Medicare aspects. Write and optimize SQL queries for data access and manipulation. Collaborate with vendors and cross-functional teams to understand requirements, assist with design, and deliver solutions. Design and build reports and dashboards. Build auditing functionality and reports on agency custom solution. Troubl

The Senior QNXT Configuration Analyst is responsible for planning, designing, testing, and implementing configuration, business applications, including the Cognizant QNXT product suite. This role ensures system configurations align with business needs and regulatory requirements by collaborating with various departments and external vendor partners. Knowledge/Skills/Abilities: Strong understanding of healthcare IT systems, electronic health records (EHR), and health information exchanges (HIE).

Responsibilities: Design, develop, and test applications using the QNXT Framework. Implement and configure QNXT claims workflow, with a strong understanding of commercial and Medicare aspects. Write and optimize SQL queries for data access and manipulation. Collaborate with vendors and cross-functional teams to understand requirements, assist with design, and deliver solutions. Design and build reports and dashboards. Build auditing functionality and reports on HMSA's custom solution. Trouble

Role: TriZetto QNXT Developer Location: Remote- Must work Hawaiian time Duration: 12+ Months Responsibilities: Design, develop, and test applications using the QNXT Framework. Implement and configure QNXT claims workflow, with a strong understanding of commercial and Medicare aspects. Write and optimize SQL queries for data access and manipulation. Collaborate with vendors and cross-functional teams to understand requirements, assist with design, and deliver solutions. Design and build rep

Job Description JOB DESCRIPTION Job Summary Responsible for accurate and timely review of production support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains understanding of solution functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received on claims to identify billing issues that will impact claims processing and payment. Monitor ne

Job Description JOB DESCRIPTION Designs and builds company specific enterprise application systems and technology expertise across multiple disciplines. Applies and promotes key principles (e.g., stability, scalability, performance, security, compatibility, re-use), helping ensure a balance between tactical and strategic technology solutions. Considers business problems "end-to-end": including people, process, and technology, both within and outside the enterprise, as part of any design solut

Job Title: Senior QNXT Developer Location: Remote Duration : 6-12 Months Experience Level: Senior (8+ years) Job Overview We are seeking highly skilled and experienced Senior QNXT Developers to join our growing team. The ideal candidates will have a strong background in the QNXT Framework and a comprehensive understanding of Healthcare IT systems, particularly in Medicaid and payer systems. This is an exciting opportunity to support mission-critical healthcare technology initiatives, including c

Position : QNXT Commercial Benefits Configuration SME Location : Remote Job Duration: 6-12 Months Strong QNXT Benefit Configuration SME's on the Commercial side Technical QNXT Benefit Configuration, Commercial LOB Must Haves: Need to know QNXT benefits configuration (NOT JUST QNXT CLAIM NEEDS TO BE SPECIFC TO QNXT BENEFITS and know the ins and outs. will dive deep there in interviews.) Need to know commercial side (Ideal is 75% commercial; 25% Medicare) Knowledge of SQL. **writing SQL Querie

Job Description JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Oversees receipt of and coordinates data from the provider network for entry into t

Pay & Benefits Estimated hiring range $90,225 - $110,275 / year, 5% bonus target, full benefits. ;br> Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title IS Application Systems Administrator II Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title IS Application Support Manager Department Business Intelligence Requisition 25000 Pay & Benefits Estimated hiring range

Job Description JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. This multifaceted role supports both operational efficiency and strategic project delivery for process improvement initiatives as it pertains to other provider network management areas. KNOWLEDGE/SKILLS/ABILITIES Bridge communication and collaboration between IT, PMO, provider n

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w

Job Description JOB DESCRIPTION Job Summary The Azure ETL Developer is tasked with designing and developing Azure Data Factory solutions, covering projects of moderate to high complexity. This position also necessitates proficiency in Microsoft SSIS ETL solutions to support the architecture, development, and migration of legacy solutions to Azure Data Factory. Candidates should possess three to five years of experience with the Microsoft ETL stack, including experience in SSIS, SSRS, T-SQL, a

Note : GCEAD, L2EAD, consultant can apply for this position who can work on W2. Job Descriptions : We are looking for an experienced Senior QA Healthcare Manager/QA Leader to lead the quality assurance team in ensuring the reliability, security, and compliance of healthcare applications. The ideal candidate should have a strong background in healthcare software testing, regulatory compliance (HIPAA, CMS, FDA), test automation, and team leadership. Key Responsibilities: Lead and manage the QA t

Role: Azure Data Architect with Healthcare domain exp Location: REMOTE Duration: Long-term/Fulltime/Permanent Roles and Responsibilities: Key Responsibilities: Establish data policies and standards to ensure data quality, security, and compliance. Design and optimize database models to store and retrieve information. Contribute to data architecture design for migration to Azure Data bricks from Synapse, SQL ServerIntegrate data from various claims systems such as QNXT and home grown claim system

We are trying to source Sr. EvolveNXT consultant for our direct client for a Long Term Remote project. We need Senior Consultant with strong background in Healthcare industry. It is a long - term remote position.Required Skills Experience leading the end-to-end deployment of the EvolveNXT software platform (CRM) from requirements gathering to go-live.Experience in ensuring that all requirements gathered are contained in the BRD.UAT testing experience of EvolveNXT capabilities. EvolveNXT engageme

MuleSoft Developer Experience Required: 5+ years Location: Remote Required Skills: MuleSoft, DataWeave, Healthcare What's in It for You? As a MuleSoft Developer, you'll be part of an Agile team focused on building and enhancing healthcare applications. This role offers the opportunity to implement new features and integrations while following best practices and industry coding standards. Key Responsibilities: Design, develop, and deploy integration solutions using the MuleSoft platform, in