SME-Configuration HC

Job Summary

Serve as a subject matter expert in health care benefit configuration with a primary focus on Facets benefit configuration for a multinational organization. Apply four to seven years of hands on experience to design configure validate and optimize benefit solutions that enhance member experience and operational accuracy. Operate in a night shift work from office model ensuring stable production support and continuous improvement of benefit configuration outcomes.

Responsibilities

• Configure complex health care benefits in Facets benefit configuration to ensure accurate enrollment processing and claims adjudication that align with client contractual requirements and regulatory guidelines.
• Analyze benefit requirements and source documentation to translate business rules into precise configuration specifications that reduce defects and rework across downstream administrative processes.
• Validate existing and newly configured benefits through detailed scenario based testing and impact analysis to confirm that calculated results align with expected outcomes and organizational quality standards.
• Collaborate with business analysts and operations teams to clarify benefit intent and configuration rules so that benefit designs are implemented consistently and support a seamless member and provider experience.
• Document configuration design decisions benefit rules and exception handling in a clear and reusable format to support future maintenance knowledge transfer and audit readiness.
• Perform root cause analysis for configuration related issues reported by stakeholders to identify defects or gaps and implement targeted corrections that prevent recurrence and stabilize production performance.
• Optimize benefit configuration structures by simplifying rules removing redundancies and aligning configuration patterns with enterprise standards to improve system maintainability and processing efficiency.
• Coordinate and execute configuration migration activities across non production and production environments while following change control procedures to minimize risk and ensure traceability.
• Provide subject matter guidance to peers and partner teams on Facets benefit configuration capabilities limitations and best practices to improve solution design quality and reduce implementation cycles.
• Engage in periodic regression testing of benefit configurations during system upgrades and patch deployments to detect configuration impacts early and safeguard critical business functions.
• Prepare and review configuration related metrics such as defect trends turnaround times and accuracy rates to identify opportunities for continuous improvement and to demonstrate value delivered to the organization.
• Support night shift operational activities by monitoring critical configuration driven processes addressing incidents promptly and communicating status updates to relevant stakeholders when required.
• Contribute to initiatives that enhance member and provider satisfaction by configuring benefits that are transparent predictable and aligned with the company purpose of improving health care outcomes for communities.

Qualifications

• Apply four to seven years of practical experience in Facets benefit configuration and health care benefits configuration to independently handle end to end configuration tasks with minimal supervision.
• Utilize strong knowledge of health plan products cost sharing structures and benefit accumulators to design configurations that accurately represent complex benefit designs.
• Use working knowledge of claims processing enrollment processing and eligibility concepts to anticipate configuration impacts and proactively prevent operational issues.
• Communicate in English at a novice professional level in both spoken and written form to collaborate effectively with team members and accurately document configuration assets.
• Leverage analytical thinking attention to detail and problem solving skills to interpret business rules validate edge cases and deliver reliable configuration outcomes.
• Demonstrate familiarity with testing practices such as test case creation defect documentation and result reconciliation related to benefit configuration validation.
• Adapt successfully to a work from office night shift environment by maintaining consistent productivity focus and responsiveness to time sensitive configuration requests.

Certifications Required

Preferred certification in health care administration or Facets configuration training completion

À propos de Cognizant
Cognizant (NASDAQ: CTSH) est un AI Builder et une entreprise de services numériques (ESN) élaborant des solutions complètes d’IA maximisant les investissements pour des résultats concrets. Sa profonde expertise des métiers, des processus et des technologies lui permet d’intégrer dans les systèmes technologiques le contexte unique de chaque organisation de l’ingénierie à la production à l’échelle. Son objectif: améliorer l’efficacité des équipes, créer de la valeur et permettre aux grandes entreprises de rester performantes dans un monde qui évolue rapidement. Pour en savoir plus: cognizant.ai ou @cognizant. 

À savoir avant de postuler

• Autorisation de travail: Cognizant ne prendra en considération que les candidats à ce poste qui sont légalement autorisés à travailler au Canada sans avoir besoin d'un parrainage de l'employeur, aujourd'hui ou à l'avenir.
• Mesures d’adaptation: Si vous avez un handicap qui nécessite des mesures d’adaptation raisonnable pour effectuer une recherche d’emploi ou poser une candidature, veuillez envoyer un courriel à [email protected] avec votre demande et vos coordonnées.
• L’IA dans notre processus de recrutement: Nous utilisons des outils d'intelligence artificielle (IA) pour trier et évaluer les candidatures efficacement. Notre équipe examine ensuite les candidatures et décide qui passe à l’étape suivante.
• Poste à pourvoir: Sauf indication contraire, ce poste est actuellement vacant et nous cherchons à le pourvoir.
• Exigences linguistiques: Nous demandons à tous les candidats de posséder une connaissance de base de l’anglais afin de faciliter les communications internes. Pour les postes au Québec, la capacité à communiquer efficacement en anglais est requise car vous fournirez des services à et collaborerez avec des parties prenantes anglophones situées hors de la province.
• Inclusion: Cognizant est un employeur souscrivant au principe de l’égalité d’accès à l’emploi. Votre candidature et votre dossier ne seront pas examinés en fonction de la race, de la couleur, du sexe, de la religion, des croyances, de l'orientation sexuelle, de l'identité de genre, de l'origine nationale, du handicap, des renseignements génétiques, de la grossesse, du statut d'ancien combattant ou de toute autre caractéristique protégée par les lois fédérales, provinciales ou locales.