Job ID: JOB_ID_6873
Role:
We are looking for skilled QNXT Medicaid Testers who thrive in validating complex business rules, benefit configurations, and state-specific Medicaid requirements. Join us as we support enterprise Medicaid programs powered by the TriZetto QNXT platform and drive high-quality, compliant healthcare solutions.
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.
Requirements:
- 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 Qualifications:
- 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.
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
Remote. US-Based (Full-Time). Employment Type: C2C.
Compensation & Location
Salary: $55 – $75 per year (Estimated)
Location: Remote
Recruiter / Company – Contact Information
Recruiter / Employer: Artigence Tech Solutions
Email: i@artigencetech.com
Recruiter Notice:
To remove this job posting, please send an email from
i@artigencetech.com with the subject:
DELETE_JOB_ID_6873