Job ID: JOB_ID_5790
Role Overview
Are you a QNXT expert with strong Medicaid testing experience? Ready to play a critical role in ensuring accurate claims adjudication, enrollment processing, and regulatory compliance within complex healthcare payer systems? Join us as we support enterprise Medicaid programs powered by the TriZetto QNXT platform and drive high-quality, compliant healthcare solutions.
We’re looking for skilled QNXT Medicaid Testers who thrive in validating complex business rules, benefit configurations, and state-specific Medicaid requirements.
Key Responsibilities
- Validate Medicaid-focused claims processing, enrollment, premium billing, and encounter reporting within QNXT.
- Test rules-driven claims adjudication, pricing logic, and benefit configurations.
- Support end-to-end testing cycles: functional, integration, regression, performance & data validation.
- Ensure compliance with state and federal Medicaid regulations.
- Collaborate with business analysts, QA teams, and project managers to resolve configuration gaps.
Required Skills and Experience
- 3-7 years of experience in QNXT testing within Medicaid environments.
- Strong understanding of Medicaid operations: UM, Prior Authorization, Capitation, PMPM, TPL/COB.
- Hands-on experience with 834, 820, NCPDP file formats and MMIS submissions.
- Experience with test planning, execution, defect tracking & validation within QNXT.
Preferred Skills and Experience
- Experience with large payer organizations or Medicaid agencies.
- Strong analytical mindset with excellent documentation & stakeholder communication skills.
- Experience supporting QNXT upgrades, releases, and audit readiness documentation.
Location: US-Based (Full-Time)
We value detail-oriented professionals who understand Medicaid compliance, enjoy solving complex claims scenarios, and can ensure accurate QNXT configurations in dynamic healthcare environments.
Special Requirements
QNXT expert with strong Medicaid testing experience. Experience with 834, 820, NCPDP file formats and MMIS submissions. Experience with large payer organizations or Medicaid agencies preferred. Experience supporting QNXT upgrades, releases, and audit readiness documentation preferred.
Compensation & Location
Salary: $80,000 – $120,000 per year
Location: Remote
Recruiter / Company – Contact Information
Email: i@artigencetech.com
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