• Lead Analyst, Technical Configuration Information…

    Molina Healthcare (Tampa, FL)
    …+ Mentors junior analysts + Participates in or leads project meetings + Understands QNXT , AutoQ, and MCG functionality and schema + Determines if a project is AutoQ, ... to deployment, including work assignment, prioritization, issue triage etc. + Understands QNXT , AutoQ, and MCG functionality and schema + Determines if a project… more
    Molina Healthcare (08/27/25)
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  • Lead Analyst, Configuration Oversight - Payment…

    Molina Healthcare (St. Petersburg, FL)
    …guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed ... identify trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. +… more
    Molina Healthcare (07/24/25)
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  • Specialist, Configuration Oversight (Healthcare…

    Molina Healthcare (Orlando, FL)
    …as applied to the appropriate modules within the core processing system ( QNXT ). * Conducts focal audits on samples of processed transactions impacted by ... claims processing system . + Experience using claims processing system ( QNXT ). **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and… more
    Molina Healthcare (08/16/25)
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  • Manager, Enrollment - REMOTE

    Molina Healthcare (St. Petersburg, FL)
    …automated process and manual input + Ensure quality control of data entered into QNXT and sent to external vendors + Oversees and participates in state, federal, and ... State, Federal, and business regulatory requirements and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. +… more
    Molina Healthcare (08/01/25)
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  • Representative, Customer Experience

    Molina Healthcare (Tampa, FL)
    …years + Preferred Systems Training: + Microsoft Office + Genesys + Salesforce + Pega + QNXT + CRM + Verint + Kronos + Microsoft Teams + Video Conferencing + CVS ... Caremark + Availity 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… more
    Molina Healthcare (08/30/25)
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  • Lead Adjudicator, Provider Claims

    Molina Healthcare (Miami, FL)
    …6+ years previous claims adjusting and customer services experience Experience in QNXT , Salesforce, Claims Viewer, Claim Shark, PEGA, Cotiviti, ECHO, CEMs Edifecs ... **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must… more
    Molina Healthcare (08/28/25)
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  • Adjudicator, Provider Claims (LTSS Call Center)

    Molina Healthcare (Miami, FL)
    …special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + ... Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating… more
    Molina Healthcare (08/27/25)
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  • Adjuster, Claims (Remote)

    Molina Healthcare (Jacksonville, FL)
    …and production standards. + Other duties as assigned. + QNXT -preferred **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination ... of education and experience **Required Experience** 1-3 Years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 years To all current Molina employees: If you are interested in applying… more
    Molina Healthcare (08/27/25)
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  • Sr Engineer, Applications- PowerBI

    Molina Healthcare (Orlando, FL)
    …verbal communication skills. + Experience with healthcare data and systems, + QNXT experience a plus **Education:** + Bachelor's Degree in Computer Science, ... Information Systems, or a related field - or an equivalent combination of education and experience. 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… more
    Molina Healthcare (08/27/25)
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  • Examiner, Claims (Remote)

    Molina Healthcare (Miami, FL)
    …quality and production standards. + Other duties as assigned. + QNXT -Preferred **JOB QUALIFICATIONS** **Required Education** HS Diploma or GED **Required ... Experience** 1-3 years **Preferred Education** Associate degree or equivalent combination of education and experience **Preferred Experience** 3-5 years To all current Molina employees: If you are interested in applying for this position, please apply through… more
    Molina Healthcare (08/27/25)
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