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Senior Business Systems Analyst QNXT- Operations (Remote)

Company: Sentara Health
Location: Richmond
Posted on: July 9, 2024

Job Description:

City/State
Richmond, VA

Overview

Work Shift
First (Days) (United States of America)

Sentara is hiring a Senior Business Systems Analyst QNXT - Operations!

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

This is a Full-Time position with day shift hours and great benefits!

Work Location: 100% Remote

Candidates must have a current residence in one of the follow states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming

Job Summary:

This position is responsible for the implementation and support of quality initiatives within assigned areas. Provides subject matter expertise related to quality initiative implementation, reporting and analysis. It is a liaison between internal/external customers and Information Technology for business definition, scope, testing and implementation to ensure quality, efficiency, effectiveness, and customer knowledge to improve business practices. Possesses a high degree of operational knowledge as it relates to customer operations in claims, system administration, expansion business, and member enrollment.

The Sr. Business Systems Analyst perform activities that provide business solutions to complex organizational initiatives and should demonstrate an extensive expertise in the claim s platform and all interfacing applications, both customized and packaged. This individual should possess a high degree of expertise in the business requirements that support reimbursement policies and methodologies of the organization, as well as perform complex data analysis and draw business conclusions for decision making. The analyst will coordinate the maintenance of assigned Claims Department systems for the program and play a key role in the configuration and implementation of new markets and products. The analyst should consider interdepartmental impact when recommending and implementing solutions. Responsibilities include but are not limited to claim analysis, root cause analysis, interpretation of configuration requirements, coordinating configuration, ad- hoc reporting and documentation. In addition, the Sr. Business Systems Analyst will be responsible for managing configuration projects. He or she will work with peers in the department to establish realistic project scope, project plans and timelines.They will perform as a SME for the System Configuration team and provide appropriate onboarding training as needed.

Job Requirements:

  • Bachelor's level degree
  • Experience with SQL data analysis (Ability to write SQL Queries)
  • Looking for someone who is a NetworX Pricer SME
  • Claims Adjudication Life Cycle experience
  • Claims Configuration triage support experience
  • Experience with QNXT Claims Configuration or any other claims application configuration experience (Facets experience will qualify).
  • Have experience training new team members - highly preferred.
  • Knowledge & understanding of Member Enrollment, Provider Contracts, Benefits and Authorization and Claims workflow

    About the Company:

    As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:

    Medical, Dental, and Vision Insurance

    Paid Annual Leave, Sick Leave

    Flexible Spending Accounts

    Retirement funds with matching contribution

    Supplemental insurance policies, including legal, Life Insurance and AD&D among others

    Work Perks program including discounted movie and theme park tickets among other great deals.

    Opportunities for further advancement within our organization

    For more information about our employee benefits,

    Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)

    Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!

    For applicants within Maryland, Nevada, Ohio and Washington States, the following hiring range will be applied:$69,320.16 - $95,659.20.

    To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-54153

    #Indeed

    #Dice

    Monster

    Talroo-IT

    Indeed

    Monster

    Talroo

    Keywords: Health plan, QNXT, Facets, NetworX, NetworX Pricer, System Configuration, Provider pricing, Insurance, SQL MS SQL Server, SQL Server Analysis Services, SQL Server Reporting Services, SQL Server Integration Services, SSAS, SSRS, SSIS, Medicaid, Medicare, Commercial, NetworX, Remote, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming

    Job Summary

    This position is responsible for the implementation and support of quality initiatives within assigned areas. Provides subject matter expertise related to quality initiative implementation, reporting and analysis. Is a liaison between internal/external customers and Information Technology for business definition, scope, testing and implementation to ensure quality, efficiency, effectiveness, and customer knowledge to improve business practices. Possesses a high degree of operational knowledge as it relates to customer operations in claims, system administration, expansion business, and member enrollment.

    Related experience will be in one of the following areas, operations, IT, or reporting.

    Minimum requirements:
    Bachelor's level degree
    Experience with SQL data analysis (Ability to write SQL Queries)
    Claims Adjudication Life Cycle experience
    Claims Configuration triage support experience
    Experience with QNXT Claims Configuration or any other claims application configuration experience
    Knowledge & understanding of Member Enrollment, Provider Contracts, Benefits and Authorization and Claims workflow

    Qualifications:

    BLD - Bachelor's Level Degree (Required)

    Information Technology

    Skills

    Communication, Complex Problem Solving, Critical Thinking, Judgment and Decision Making, Microsoft Excel, Operations Analysis, Systems Analysis

    Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

    Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

    In support of our mission to improve health every day, this is a tobacco-free environment.

Keywords: Sentara Health, Richmond , Senior Business Systems Analyst QNXT- Operations (Remote), Professions , Richmond, Virginia

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