About the role

The NetworX Consultant will work with Facets and NetworX (both Pricer and Modeler) to support the implementation, enhancement, maintenance, and resolution of issues. This role requires extensive communication, technical configuration, system testing, and collaboration with technical and business teams to ensure alignment with business objectives. The NetworX Consultant is responsible for configuring, maintaining, and optimizing system software and tools to meet the needs of a fast-growing Health Plan. This role involves analyzing business user requirements, implementing system configurations, troubleshooting issues, and ensuring that system performance aligns with business goals. The ideal candidate combines technical expertise with strong problem-solving, documentation, and communication skills.

In this role, you will:

• Lead and manage the implementation and configuration of NetworX pricing agreements to support health plan operations, including assessment and understanding of provider data.
• Serve as a subject matter expert, providing guidance on best practices, troubleshooting, and issue resolution.
• Comprehend contracts, regulations, provider bulletins, and other provider reimbursement-related policies.
• Collaborate with cross-functional teams, including IT, claims, provider services, and business operations, to implement and enhance system configurations.
• Develop, document, and maintain configuration standards, policies, and procedures.
• Analyze and validate system configurations to ensure accurate claim adjudication and provider reimbursement.
• Identify opportunities for system enhancements and automation to improve efficiency and reduce errors.
• Support system testing, upgrades, and implementations to ensure seamless transitions and minimal disruption.
• Conduct system testing and troubleshoot issues to ensure smooth functionality.
• Collaborate with solution architects and technical teams to ensure integration and alignment with business goals.
• Lead and participate in design and configuration review sessions to ensure adherence to standards and best practices.
• Provide clear communication on implementation status, risks, and solutions.
• Provide training and knowledge transfer to internal teams and stakeholders.
• Provide a deep understanding of Agile Scrum processes and working methodology.

Work model

We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.

What you need to have to be considered

• Over 10 years of active and hands-on experience with Facets, NetworX Pricer & Modeler, OPTUM Grouper Pricer products, Claims processing, and US Healthcare.
• Over 10 years of experience in a project leadership role, operating in an onsite-offshore model.
• Over 10 years of experience in building tools and strategies for automation, optimization, and digital transformation.
• Proven experience in configuring and managing implementations, enhancements, and maintenance.
• Expertise in New LOB implementations.
• Expertise in system configuration and strong understanding of the healthcare industry and managed care concepts.
• Proficiency in writing and optimizing SQL queries for data manipulation, extraction, and reporting.
• Proficiency in reimbursement methodologies and the ability to interpret these through requirements and design.
• Demonstrated ability to research, analyze, design, and build Facets Provider configuration.
• Demonstrated ability to understand and use Optum PPS configuration.
• Demonstrated ability to understand and interpret payer-provider contract terms, develop technical design, and implement them in configuration.
• Demonstrated ability to manage system-related projects from inception to closure.
• Excellent written and verbal communication skills.
• Strong understanding of healthcare claims processing, provider contracts, fee schedules, and benefits configuration.
• Knowledge of health plan operations for Medicare, Medicaid, Marketplace, LTSS, DSNP (duals) is mandatory.
• Proficiency in troubleshooting system and configuration issues, with a focus on root cause analysis.
• Configuration expertise on Facets Version 25.R1 (or higher) on an SQL platform.
• Knowledge of Windows, Microsoft Excel, PowerPoint, and Word, as well as Project Management Tools, Query Tools (SQL, Cognos, etc.), and the administration of Packaged Claims Processing Applications.
• Ability to adapt to a constantly changing environment and handle pressure situations.
• Experience with large configuration projects is preferred.
• Understanding of technical languages such as C#, Python, HTML, JavaScript, and CSS.
• Experience with version control and managing source code repositories using Azure DevOps, Jira, GitHub, etc.
• Ability to work in a fast-paced environment, both independently and collaboratively.
• Familiarity with MS Excel, CoPilot, Power Automate, and ChatGPT for data analysis and reporting.

These will help you stand out

• Bachelor’s degree in Business, Finance, Mathematics, Operations Research, Computer Science, Data Science, or a related field.

We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.

*Please note, this role is not able to offer visa transfer or sponsorship now or in the future*

#LI-NC1

Salary and Other Compensation:

Applicants will be accepted till 3/16/2026

The annual salary for this position will be in the range of $113K-$132K depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

• 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

Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

The Cognizant community:
We are a high caliber team who appreciate and support one another. Our people uphold an energetic, collaborative and inclusive workplace where everyone can thrive.

• Cognizant is a global community with more than 300,000 associates around the world.
• We don’t just dream of a better way – we make it happen.
• We take care of our people, clients, company, communities and climate by doing what’s right.
• We foster an innovative environment where you can build the career path that’s right for you.

About us:
Cognizant is one of the world's leading professional services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build, and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant (a member of the NASDAQ-100 and one of Forbes World’s Best Employers 2025) is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com

Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.

Disclaimer:
Compensation information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.