Note: The job is a remote job and is open to candidates in USA. Cognizant is a leading technology company seeking a Senior Manager - NetworX Config Analyst. In this role, you will configure and optimize pricing and reimbursement solutions to support accurate claims adjudication for healthcare payer organizations, collaborating with various teams to ensure pricing accuracy and compliance.
Responsibilities
- Configure, maintain, and optimize pricing models within the TriZetto Facets Integrated NetworX Pricer platform
- Translate provider contract language into accurate fee schedules, pricing rules, rate sheets, and system qualifiers
- Lead and support configuration initiatives, contract migrations, and system conversion activities
- Perform and coordinate unit, regression, and end-to-end testing to validate pricing accuracy and claims outcomes
- Utilize Oracle SQL and relational database tools to audit, validate, and troubleshoot configuration data
- Implement pricing hierarchy and business rules to ensure correct application of provider agreements and reimbursement methodologies
- Support compliance with CMS, Medicare, and Medicaid guidelines through ongoing pricing updates and system maintenance
- Partner with configuration leadership, claims operations, and contracting teams to resolve issues and deliver effective solutions
Skills
- Experience configuring TriZetto Facets Integrated NetworX Pricer solutions
- Strong knowledge of healthcare provider reimbursement methodologies and managed care contract interpretation
- Proficiency with Oracle SQL and relational databases for analysis, validation, and troubleshooting
- Experience reviewing provider contracts and translating business requirements into pricing configurations
- Hands-on experience with configuration testing, migration activities, and claims validation
- Strong analytical, organizational, and problem-solving skills
- Excellent communication and stakeholder management abilities
- Experience supporting Medicare, Medicaid, and commercial healthcare payer environments
- Knowledge of provider contract loading, fee schedules, and reimbursement modeling
- Experience leading configuration projects or mentoring junior analysts
- Familiarity with Facets claims processing and pricing workflows
- Experience working within cross-functional teams supporting healthcare operations and technology initiatives
Benefits
- Medical/Dental/Vision/Life Insurance
- Paid holidays plus Paid Time Off
- 401(k) plan and contributions
- Long-term/Short-term Disability
- Paid Parental Leave
- Employee Stock Purchase Plan
- A remote position open to qualified applicants in the UnitedStates
Company Overview