NetworX Pricing Configuration Lead Consultant - Healthcare Payer
Location: Remote
Employment Type: Full-Time
Job ID: 00070634953
NetworX Pricing Configuration Lead Consultant - Healthcare Payer
About the role
As a NetworX Pricing Configuration Lead Consultant, you will make an impact by designing, configuring, and optimizing provider reimbursement solutions that support accurate claims adjudication and contract pricing for healthcare payer organizations. You will be a valued member of the healthcare consulting team and work collaboratively with Provider Contracting, Claims, Business, and IT stakeholders to deliver scalable pricing and reimbursement solutions.
In this role, you will:
- Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies within the NetworX Pricing platform.
- Analyze business and contractual requirements and translate them into accurate pricing and reimbursement configurations.
- Perform pricing validation, claims analysis, testing, and production support to ensure configuration accuracy and operational excellence.
- Partner with Provider Contracting, Claims Operations, Business, and Technology teams to implement, validate, and support pricing solutions.
- Investigate and resolve pricing, reimbursement, and claims adjudication issues while maintaining configuration documentation and testing artifacts.
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 within the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
What you need to have to be considered
- Extensive experience supporting healthcare payer organizations with provider contract pricing and reimbursement configuration.
- Strong experience with NetworX Pricer and NetworX Modeler.
- Experience configuring and supporting FACETS claims adjudication and related business processes.
- Expertise in provider contract configuration, fee schedules, reimbursement methodologies, and pricing validation.
- Strong SQL skills for data analysis, validation, and troubleshooting.
- Deep knowledge of Commercial, Medicare, and Medicaid healthcare payer operations.
- Experience supporting testing, production implementations, and post-deployment validation activities.
- Strong analytical, problem-solving, and communication skills.
- Ability to work effectively with cross-functional business and technical teams.
These will help you stand out
- Experience with complex provider reimbursement methodologies and network pricing strategies.
- Knowledge of CMU migrations and production support activities.
- Experience partnering with Provider Contracting and Claims Operations teams.
- Understanding of healthcare EDI transactions, including 837 and 835 formats.
- Experience supporting large-scale healthcare transformation, modernization, or migration initiatives.
- Ability to lead client discussions and provide configuration recommendations for complex pricing requirements.
- Strong documentation, organization, and stakeholder management skills.
Salary and Other Compensation:
Applicants will be accepted till 11/15/2026
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 cannot offer visa transfer or sponsorship now or in the future*
The annual salary for this position will be in the range of $130,000 - $150,000 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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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.
Renseignments suppplémentaires sur l'emploi
Les informations relatives à la rémunération du poste à pourvoir dépendent de la date de publication de l’offre de poste. Cognizant se réserve le droit de modifier ces informations à tout moment, sous réserve des lois applicables.
Cognizant est un employeur soucieux de l'égalité des chances entre candidats. Votre candidature sera étudiée indépendamment de votre race, couleur, sexe, religion, croyances, orientation sexuelle, identité de genre, origine, handicap, informations génétiques, grossesse, statut d'ancien militaire ou de toute autre critère jugé discriminant par les lois européennes ou françaises.
Vous êtes porteur d'un handicap, vous pouvez-nous contacter par courriel [email protected] si vous souhaitez préciser les aménagements nécessaires pour le poste ou les entretiens à venir.
Les candidats peuvent être invités à participer à des entretiens en face à face ou par vidéoconférence. En outre, les candidats peuvent être amenés à présenter une carte d'identité valide lors de chaque entretien.
