QNXT Claims Data Quality Assurance

Essential Functions

Provides claims data QA oversight.

Examines complex data to optimize the data's efficiency and quality.

Develop data quality metrics and standards for different types of claims data to ensure high quality and error-free.

Develops data quality models to identify issues with the data and recommend solutions to improve the data quality.

Conducts and tracks routine audits on claims data collection/reports and reports results to claims leadership.

Collaborates with database developers and Claims Data Analysts to improve systems and data scripts.

Must Have

3 years experience working with QNXT 5.9 or higher

In-depth knowledge of QNXT data tables/ schema, claims data structures

Knowledge of the Agile development methodology- Azure Dev Ops

Knowledge of .net, SQL Server, Python, JAVA, SSIS, Excel and SSRS.

In-depth knowledge of SQL, ability to construct moderately complex SQL queries- create/modify SQL queries

Strong knowledge of quality assurance processes and standards, including developing and using test metrics.

Strong knowledge of audit processes and the ability to effectively implement and maintain them.

Experience in Medi-Cal or Managed Care Environment is a plus