Senior Configuration Specialist QNXT - SCAN Temp

SCAN Health Insurance • Long Beach, CA

3d • $34 - $50 • Remote

About The Position

The Senior Configurations Specialist QNXT - SCAN Temp will provide strategic guidance and support to the Configuration Department, fostering a collaborative environment and facilitating knowledge sharing. Will lead initiatives to improve processing accuracy by leveraging effective system configuration, automation, and process optimization across organizational departments. This role will oversee the end-to-end planning, development, testing, and implementation of system configuration changes, enhancements, and replacements to ensure alignment with operational goals. Will champion for IKA & QNXT claims processing improvement projects and maximize departmental effectiveness through cross-functional collaboration and ongoing process enhancements.

Requirements

• 4-6 years of related experience with QNXT in the health plan, health care or related industry is required.
• Performs work under direct supervision.
• Handles basic issues and problems, and refers more complex issues to higher-level staff.
• Possesses beginning to working knowledge of subject matter.
• Solid design expertise.
• Technical expertise - Advanced technical skills for functional area.
• Advanced Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams), and SQL experience is required.
• Debugging skills.
• Problem Solving - Basic problem-solving skills and conflict resolutions skills with strong critical thinking skills.
• Strong time management skills.
• Communication - Good written and verbal communication and interpersonal skills.
• A background check is required.

Nice To Haves

• Bachelor's Degree preferred or equivalent experience.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Responsibilities

• Perform software component configuration, analysis, monitoring, and performance optimization to maintain and improve Enrollment, Billing, Authorizations, Claims, Member Services, Customer Service, Capitation, Finance, and other core business systems.
• Represent the Configuration Unit effectively in both internal and external meetings.
• Apply strong analytical, critical thinking, and troubleshooting skills to resolve complex issues escalated from the department.
• Identify root causes, develop strategic solutions, and provide timely recommendations for improvements in partnership with business owners and Shared Services Management.
• Maintain accurate issue tracking logs and provide regular updates to management and stakeholders, demonstrating strong organizational and time management skills to ensure timely follow-up and resolution.
• Function as a Subject Matter Expert (SME) on system capabilities, including but not limited to benefits administration, code sets, fee schedules, coding, provider contracts, workflows, authorizations, billing, enrollment, and other business processing areas.
• Serve as an SME on CMS, DHCS, and other relevant regulatory agency requirements pertaining to system configuration.
• Address escalated issues with strategic judgment, proactively evaluate upstream and downstream impacts, and ensure adherence to all applicable regulatory guidelines and organizational standards.
• Provide guidance, training, and knowledge transfer to business partners and team members.
• Develop and deliver training materials, documentation, and job aids to support process consistency and system understanding.
• Conduct onboarding and ongoing training sessions to keep staff current on system changes and regulatory requirements.
• Lead the design, development, debugging, testing, maintenance, and enhancement of automated processes in collaboration with IT partners.
• Engage with stakeholders to facilitate the successful and timely implementation across all affected areas.
• Ensure that all system changes are accurately tracked, recorded, and compliant with established change control procedures.
• Develop and foster a customer-focused approach to strengthen relationships with internal and external stakeholders.
• Lead process improvement initiatives by reviewing objectives and specifications, evaluating proposed changes, making informed recommendations, and driving projects to successful completion.
• Identify opportunities for system redesign and enhancements, providing clear business requirements and test results for leadership consideration.
• Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing (UAT) to ensure operational effectiveness, timely execution, and continuous performance optimization.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Benefits

• Medical Benefits
• Paid Sick Time
• Excellent 401(k) Retirement Saving Plan
• Robust employee recognition program
• An opportunity to become part of a team that makes a difference to our members and our community every day!
• A competitive compensation and benefits program
• An annual employee bonus program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year
• Excellent Retirement Savings program
• A work-life balance
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

• Career Level: Senior
• Education Level: No Education Listed