Healthcare Payer Consultant - QNXT
Location: Remote
Employment Type: Full-Time
Job ID: 00070835941
Healthcare Payer Consultant - QNXT
About the role
As a QNXT UM/A&G Consultant, you will make an impact by helping healthcare payers optimize member and provider communications through effective utilization management and appeals & grievances correspondence solutions. You will be a valued member of the healthcare consulting team and work collaboratively with clients, delivery teams, product teams, and cross-functional stakeholders.
In this role, you will:
- Serve as a subject matter expert for Utilization Management (UM) and/or Appeals & Grievances (A&G) workflows within healthcare payer organizations.
- Configure, analyze, and support correspondence and communication solutions leveraging QNXT UM and/or A&G functionality.
- Consult with clients on complex Medicare and commercial letter requirements, including triggering mechanisms, business rules, and communication design.
- Gather, analyze, and document business requirements and translate them into scalable communication solutions.
- Manage multiple project timelines while collaborating with offshore teams and cross-functional stakeholders to achieve project objectives.
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
- Strong experience supporting healthcare payer operations, including Utilization Management and/or Appeals & Grievances processes.
- Advanced knowledge of QNXT UM and/or A&G.
- Advanced proficiency in Microsoft Word and Excel.
- Experience gathering business requirements and translating them into client solutions.
- Working knowledge of XML design and content development.
- Intermediate proficiency with Adobe Illustrator, Photoshop, and InDesign.
- Strong analytical, troubleshooting, and problem-solving skills.
- Experience managing multiple priorities and collaborating with both onsite and offshore teams.
- Strong verbal, written, and presentation communication skills.
These will help you stand out
- Deep understanding of healthcare payer operations, including Commercial, HMO, PPO, Medicare, Medicaid, and other government-sponsored programs.
- Experience with healthcare correspondence, document publishing, or communications management solutions.
- Experience with graphic design, content publishing, and editing.
- Knowledge of the TriZetto product suite.
- Ability to write clear, concise explanations of complex business and technical concepts.
- Strong proofreading, organizational, and attention-to-detail skills.
- Basic knowledge of SQL and/or Oracle.
- Self-motivated with strong research and investigative capabilities.
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 $113,000 - $132,000 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.
