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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Over Cognizant
Cognizant (NASDAQ: CTSH) is een bouwer van AI-oplossingen en een leverancier van technologiediensten. Wij slaan de brug tussen AI-investeringen en ondernemingswaarde door het bouwen van full-stack AI-oplossingen voor onze klanten. Onze diepgaande kennis van sectoren, processen en engineering stelt ons in staat om de unieke context van een organisatie te verankeren in technologische systemen. Deze systemen versterken het menselijk potentieel, realiseren tastbare resultaten en geven wereldwijde ondernemingen een voorsprong in een snel veranderende wereld. Ontdek hoe op cognizant.ai of @cognizant.
Aanvullende arbeidsinformatie
De informatie over de beloning is correct op de datum van deze vacature. Cognizant behoudt zich het recht voor om deze informatie op elk moment te wijzigen, met inachtneming van de toepasselijke wetgeving.
Van sollicitanten kan worden verwacht dat zij gesprekken bijwonen, persoonlijk of via een videogesprek. Daarnaast kan van kandidaten worden gevraagd om tijdens elk gesprek een geldig, door de overheid uitgegeven identiteitsbewijs (zoals een identiteitskaart of paspoort) te tonen.
Cognizant is een werkgever die gelijke kansen biedt. Je sollicitatie en kandidatuur worden niet beoordeeld op basis van ras, huidskleur, geslacht, religie, levensovertuiging, seksuele geaardheid, genderidentiteit, nationale afkomst, handicap, genetische informatie, zwangerschap, veteranenstatus of enige andere eigenschap die wordt beschermd door federale, regionale of lokale wetgeving.
