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.
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
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.
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.
