ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT
Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.
Senior QNXT Analyst - Benefits/ Contract Configuration
Molina Healthcare Omaha, Nebraska; San Antonio, Texas; Detroit, Michigan; Yonkers, New York; Grand Rapids, Michigan; Meridian, Idaho; Milwaukee, Wisconsin; Scottsdale, Arizona; Utah; Lincoln, Nebraska; Nampa, Idaho; St. Petersburg, Florida; Columbus, Ohio; Augusta, Georgia; Kenosha, Wisconsin; Vancouver, Washington; Austin, Texas; Nebraska; Iowa City, Iowa; Kearney, Nebraska; Jacksonville, Florida; Layton, Utah; Orem, Utah; Mesa, Arizona; Grand Island, Nebraska; Fort Worth, Texas; Houston, Texas; Albany, New York; New Mexico; Texas; West Valley City, Utah; Racine, Wisconsin; Las Cruces, New Mexico; Buffalo, New York; Idaho Falls, Idaho; Provo, Utah; Louisville, Kentucky; Spokane, Washington; Everett, Washington; Bellevue, Washington; Wisconsin; Michigan; Tacoma, Washington; Cleveland, Ohio; Albuquerque, New Mexico; Syracuse, New York; Madison, Wisconsin; Lexington-Fayette, Kentucky; Des Moines, Iowa; Washington; Kentucky; Sioux City, Iowa; Green Bay, Wisconsin; Roswell, New Mexico; Miami, Florida; Orlando, Florida; Macon, Georgia; Cincinnati, Ohio; Ohio; Florida; Caldwell, Idaho; Covington, Kentucky; Davenport, Iowa; Phoenix, Arizona; Dallas, Texas; Warren, Michigan; Chandler, Arizona; Tampa, Florida; New York; Owensboro, Kentucky; Savannah, Georgia; Ann Arbor, Michigan; Dayton, Ohio; Akron, Ohio; Columbus, Georgia; Tucson, Arizona; Cedar Rapids, Iowa; Bowling Green, Kentucky; Rochester, New York; Atlanta, Georgia; Santa Fe, New Mexico; Salt Lake City, Utah; Sterling Heights, Michigan; Rio Rancho, New Mexico; Bellevue, Nebraska; Georgia; Iowa; Idaho; Boise, Idaho Job ID 2033870JOB DESCRIPTION
Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.
KNOWLEDGE/SKILLS/ABILITIES
- Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems.
- Participates in defect resolution for assigned component
- Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
- Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans.
- Participates in the implementation and conversion of new and existing health plans.
- Must have experience in Contracts and Benefits configuration in QNXT or Networx
- Must have knowledge on Medicare payment methods
- Experience on Hospital payment methodology & processing is essential
- Understanding on hospital claims processing and configuration works
- Medicare fee schedule knowledge is required
- Medicaid and Duals experience is highly preferred
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims payment method.
Preferred Education
Graduate Degree or equivalent experience
Medicaid and Duals expeirence is preferred.
Preferred Experience
7-9 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type Full Time Posting Date 09/29/2025Job Alerts
Sign up to receive automatic notices when jobs that match your interests are posted.
OPEN FORM