Job Summary
Serve as a senior consultant contributing deep payer domain expertise to complex client engagements in a hybrid day shift model with no travel expectations. Apply analytical and advisory skills to optimize payer operations improve member and provider experiences and support compliant efficient healthcare ecosystems. Collaborate across multidisciplinary teams to deliver measurable business outcomes and sustainable value.
Responsibilities
- Drive end to end consulting engagements for payer clients by analyzing current processes and systems to identify gaps in efficiency compliance and member satisfaction while proposing actionable improvements aligned with business goals.
- Provide expert guidance on payer operations including claims adjudication benefit configuration utilization management provider contracting and member services to help clients streamline workflows and reduce operational risk.
- Lead the design and documentation of future state payer process models and business requirements ensuring clear traceability from client objectives to implementable solutions that enhance service quality and cost effectiveness.
- Collaborate with product technology and operations teams in a hybrid work environment to translate complex payer business needs into practical configuration data and reporting solutions that can be executed within agreed timelines.
- Conduct detailed data analysis on claims enrollment and provider datasets to uncover patterns performance issues and opportunities for cost savings that directly contribute to better health outcomes and financial sustainability.
- Guide stakeholders through regulatory and compliance considerations relevant to payer organizations such as policy updates and audit readiness while ensuring recommendations adhere to industry standards and internal governance.
- Facilitate structured workshops and working sessions with client subject matter experts to validate assumptions refine solution options and gain alignment on prioritized initiatives that will deliver measurable impact for members and providers.
- Mentor junior consultants and team members on payer domain concepts analytical approaches and consulting best practices to build a strong internal capability and ensure consistent high quality delivery across projects.
- Coordinate day to day project activities including status reporting risk and issue tracking and dependency management to keep stakeholders informed and ensure deliverables remain on schedule and within scope.
- Develop clear and concise client ready documentation such as process maps requirement specifications impact assessments and value realization summaries that demonstrate how proposed changes advance organizational goals.
- Support change management activities by crafting communication plans and training materials that help client teams adopt new payer processes and tools smoothly while maintaining focus on member and provider experience.
- Contribute to internal thought leadership by capturing lessons learned from payer engagements and turning them into reusable frameworks accelerators and reference materials that strengthen the company consulting offerings.
- Align consulting solutions with the company larger purpose by focusing on payer strategies that enable better access to care improved affordability and transparent interactions for members providers and communities.
Qualifications
- Bring strong experience working in payer environments with hands on exposure to claims platforms benefit administration and provider networks enabling practical and context aware consulting recommendations.
- Demonstrate advanced analytical and problem solving skills using spreadsheets or business intelligence tools to evaluate payer performance metrics and convert findings into clear insights and prioritized actions.
- Apply solid knowledge of healthcare regulations and payer compliance practices to ensure that all proposed process and system changes support regulatory adherence and minimize operational risk.
- Utilize excellent communication and stakeholder management skills to interact confidently with client business teams technology teams and senior decision makers in a hybrid work setting.
- Show proven capability in structured consulting delivery including requirement elicitation documentation and presentation of solution options enabling smooth progress through the project lifecycle.
- Exhibit ability to work independently within the day shift model while coordinating effectively with global and local team members to maintain continuity of service for payer clients.
关于高知特 (Cognizant)
高知特(Cognizant)（纳斯达克代码：CTSH）作为一家AI Builder和相关技术服务提供商，致力于通过打造全栈AI解决方案，帮助企业将人工智能投资转化为实际价值。公司凭借深厚的行业经验、流程优化和工程技术专长，将企业独特的业务场景融入科技系统，赋能组织释放人才潜能，推动切实成果，并帮助全球企业在瞬息万变的环境中保持领先。如需了解更多详情，敬请访问 cognizant.ai 或关注@cognizant。
补充雇佣信息
薪酬信息截至本职位发布之日为准。Cognizant 保留在适用法律允许的范围内随时修改该信息的权利。
申请人可能需要通过现场面试或视频会议的方式参加面试。此外，候选人在每次面试时可能需要出示其当前所在州或政府签发的有效身份证件。
Cognizant 是一家提供平等就业机会的雇主。在招聘过程中，您的申请和候选资格不会因种族、肤色、性别、宗教、信仰、性取向、性别认同、国籍、残疾、遗传信息、怀孕、退伍军人身份或任何其他受联邦、州或地方法律保护的特征而受到影响。
