Job Summary
Serve as a senior product test consultant specializing in Facets claims and benefit configuration for healthcare payer and provider solutions in a hybrid work model. Apply deep hands on experience to validate complex configurations optimize claims processing accuracy and ensure system reliability and compliance. Collaborate closely with cross functional teams to deliver robust high quality Facets implementations that improve member and provider experiences while supporting enterprise scale o
Responsibilities
- Drive comprehensive test strategy planning for Facets modules focused on claims adjudication and benefit configuration to ensure end to end coverage across core healthcare payer and provider use cases.
- Design detailed test scenarios and data sets for Facets claims processing including complex benefit rules and provider contract variations to validate accurate outcomes in high volume production environments.
- Execute functional and integration testing on Facets claims workflows to verify proper configuration of benefits accumulators pricing logic and provider networks while minimizing defects reaching production.
- Analyze Facets configuration tables and rule sets to identify potential gaps or conflicts in benefit designs and claims edits and propose corrective changes that improve operational efficiency.
- Collaborate with business analysts configuration teams and operations stakeholders to translate payer and provider business requirements into testable Facets scenarios that reflect real world claim patterns.
- Perform root cause analysis on defects identified in Facets claims and benefit configuration and document findings in clear test artifacts that enable targeted remediation and future prevention.
- Validate interoperability between Facets and downstream systems such as financial reporting data warehouses and provider portals to ensure claims and benefit data integrity across the ecosystem.
- Apply healthcare payer and provider domain expertise to evaluate the impact of new benefit designs regulatory mandates and product changes on Facets test coverage and regression suites.
- Create and maintain reusable test assets including regression packs test data libraries and execution checklists tailored to Facets claims and benefits modules to support continuous delivery.
- Coordinate test execution in a hybrid work environment ensuring effective communication of progress risks and dependencies across onsite and remote stakeholders during day shift operations.
- Provide mentoring and guidance to peers and junior testers on Facets configuration concepts claims adjudication flows and best practices for healthcare product testing while promoting quality ownership.
- Contribute to continuous improvement initiatives by assessing test process performance proposing optimization opportunities and supporting adoption of automation where feasible in Facets testing.
- Document clear and concise test results and business impact summaries highlighting improvements in claim accuracy benefit interpretation and provider satisfaction driven by high quality configuration validation.
Qualifications
- Leverage extensive experience of nine to twelve years in product testing with a strong focus on healthcare payer and provider domains to interpret complex requirements and design robust Facets test approaches.
- Apply expert proficiency in Facets claims functionality to validate claim adjudication business rules pricing logic and edits ensuring alignment with contractual and regulatory expectations.
- Utilize advanced knowledge of Facets benefit configuration including benefit plans accumulators and eligibility constructs to verify that configured products support diverse member coverage scenarios.
- Demonstrate hands on experience across broader Facets platform capabilities such as membership billing and provider data to ensure holistic validation of integrated health plan operations.
- Use deep domain knowledge in provider networks reimbursement models and contract structures to assess how Facets configurations impact provider claim outcomes and operational workflows.
- Employ strong understanding of payer business processes including enrollment benefits administration and claims lifecycle management to design tests that reflect real health plan operations.
- Apply familiarity with hybrid work practices and day shift collaboration models to maintain effective stakeholder engagement clear communication and consistent delivery of test commitments.
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。
