Cognizant · 21 hours ago
Sr. NetworX/Facets Configuration Consultant
United States
Full-time
Remote
Senior Level, Lead/Staff
$132K/yr - $150K/yr
10+ years expCognizant is seeking a Senior NetworX/Facets Configuration Consultant who will configure, optimize, and support Facets and Optum NetworX to ensure efficient claims adjudication for a growing health plan. The role involves collaborating with various teams to translate complex policies into system configurations and leading projects related to healthcare technology and operations.
IndustrialConsultingSoftwareInformation TechnologyIndustrial AutomationSoftware Engineering
No H1B
Responsibilities
Lead and manage NetworX pricing agreement implementation and configuration; assess and utilize provider data to support health plan operations
Serve as a subject matter expert on Facets, NetworX (Pricer/Modeler), and reimbursement best practices; troubleshoot complex issues and drive root‑cause resolutions
Interpret contracts, regulations, provider bulletins, and reimbursement policies; translate CMS/agency guidance and industry feedback into actionable configuration updates
Collaborate with cross‑functional teams (IT, claims, provider services, business operations) to implement and enhance system configurations and integrations
Develop, document, and maintain configuration standards, policies, and procedures; lead/participate in design and configuration reviews
Analyze and validate configurations to ensure accurate claim adjudication and provider reimbursement; identify automation and enhancement opportunities
Plan and execute system testing, upgrades, and implementations to minimize disruption; provide clear communication on status, risks, and mitigation
Deliver training and knowledge transfer to internal teams; operate within Agile/Scrum ways of working
Qualification
Required
10+ years of hands‑on experience across Facets, NetworX Pricer, Optum Grouper/Pricer, claims processing, and U.S. healthcare
5+ years leading projects in an onsite–offshore model; proven success delivering implementations, enhancements, and maintenance at scale
Expertise in new line‑of‑business (LOB) implementations and end‑to‑end system configuration
Strong knowledge of managed care concepts, provider contracts, fee schedules, and benefit configuration
Proficiency writing and optimizing SQL queries for data validation, analysis, and reporting
Demonstrated ability to analyze, design, and build Facets Provider configuration; working knowledge of Optum PPS configuration
Ability to interpret payer–provider contract terms, produce technical designs, and implement them via configuration
Deep understanding of health plan operations for Medicare, Medicaid, Marketplace, LTSS, and DSNP (duals)
Configuration experience on Facets v25.R1 or higher on an SQL platform
Excellent written and verbal communication skills; strong root‑cause analysis and issue‑resolution abilities
Preferred
Experience delivering large configuration programs and complex production cutovers
Hands‑on use of project/portfolio tools and query/reporting tools (e.g., Cognos), with working knowledge of Windows, Excel, PowerPoint, Word
Familiarity with Power Automate, Copilot, and ChatGPT to streamline analysis, documentation, or reporting workflows
Ability to thrive in a fast‑paced, changing environment, working both independently and collaboratively
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
Company
Cognizant
Cognizant is a professional services company that helps clients alter their business, operating, and technology models for the digital era.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$0.24MKey Investors
Summit Financial Wealth Advisors
2025-03-08Post Ipo Equity
2016-11-18Post Ipo Equity· $0.24M
1998-06-19IPO
Leadership Team
Ravi Kumar S
Chief Executive Officer
Anil Cheriyan
CTO / EVP Strategy & Technology
Recent News
Deccan Chronicle
2026-02-08
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