Senior NetworX/Facets Configuration Consultant

Location: Remote
Employment Type: Full-Time

Job ID: 00068008731

About the role:

As a Senior NetworX/Facets Configuration Consultant, you will make an impact by configuring, optimizing, and supporting Facets and Optum NetworX (Pricer and Modeler) to enable accurate, efficient claims adjudication for a fast‑growing health plan. You will be a valued member of our Healthcare Technology & Operations team, partnering with IT, claims, provider services, business operations, and solution architects to translate complex reimbursement policies and regulatory guidance into high‑quality system configurations, robust testing, and smooth production outcomes.

In this role, you will:

• 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.

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 support a healthy work‑life balance through our wellbeing programs. The working arrangements for this role are accurate as of the date of posting and may change based on business or client needs; we will always communicate expectations clearly.

What you need to have to be considered:

• 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.

These will help you stand out:

• 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.

Salary and Other Compensation:

Applicants will be accepted till 3/20/2026

Cognizant will only consider applicants for this position who are legally authorized to work in the United States without company sponsorship.

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

The annual salary for this position will be in the range of $132K-$150K 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.

Our strength is built on our ability to work together. Our diverse backgrounds offer different perspectives and new ways of thinking. It encourages lively discussions, creativity, productivity, and helps us build better solutions for our clients. We want someone who thrives in this setting and is inspired to craft meaningful solutions through true collaboration.

If you are content with ambiguity, excited by change, and excel through autonomy, we’d love to hear from you!

Apply Now!

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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.