Note: The job is a remote job and is open to candidates in USA. BrothersTech is seeking a Network Architect with extensive experience in NetworX Pricer configuration and healthcare claims systems. The role focuses on configuring complex pricing logic, translating provider contracts into system rules, leading testing and conversion initiatives, auditing configuration data with SQL, and coordinating with configuration, claims, and legal teams.
Responsibilities
- Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system
- Translate managed care provider contract language into fee schedules, rate sheets, and system qualifiers
- Manage configuration workflows, mentor configuration analysts, and coordinate system conversion projects
- Direct unit, regression, and end-to-end testing to ensure claim payment accuracy
- Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot configuration data
- Establish hierarchical system logic to prioritize specific provider agreements over standard/regional fallback rates
- Monitor and implement quarterly pricing component updates to maintain compliance with CMS, Medicare, and Medicaid rules
- Serve as the liaison between Configuration leadership, claims operations, and legal contracting teams
Skills
- 5–6+ years of hands-on NetworX Pricer experience – MUST HAVE
- NetworX Configuration / Integrated NetworX
- Oracle SQL
- Contract Review
- Agreement Testing
- Migration & Assignment
- Facets – Nice to Have
Company Overview
Company H1B Sponsorship