Senior Facets Claims & Customer Service Workflow Consultant
Location: Remote
Employment Type: Full-Time
Job ID: 00069625641
Senior Facets Claims & Customer Service Workflow Consultant
About the Role
As a Senior Facets Claims & Customer Service Workflow Consultant, you will make an impact by designing and delivering scalable Facets Claims, PCA, and Customer Service Workflow solutions that support critical healthcare payer operations. You will be a valued member of the Healthcare Platform Consulting team and work collaboratively with business stakeholders, operations teams, product teams, care management, and technology partners to implement innovative solutions that improve efficiency, accuracy, and member experiences. The Global Job Posting template recommends focusing on the most important responsibilities and qualifications in a concise, external-facing format.
In this role, you will:
- Lead configuration design and implementation activities for Facets Claims, PCA, and Customer Service Workflow solutions.
- Collaborate with business and operational stakeholders to translate requirements into scalable and reusable configuration solutions.
- Facilitate global and detailed design sessions while providing subject matter expertise on Facets functionality and best practices.
- Guide configuration activities throughout the project lifecycle, ensuring quality, compliance, and alignment with business objectives.
- Develop, maintain, and review configuration documentation and design deliverables.
- Support requirements gathering, business process improvement, and workflow optimization initiatives.
- Lead configuration testing efforts, including test strategy development, quality assurance, and user acceptance testing support.
- Provide technical leadership and mentorship to project teams while driving configuration excellence.
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 in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.
The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.
What You Need to Have to Be Considered
- Undergraduate degree or equivalent combination of education and professional experience.
- 6+ years of hands-on experience with TriZetto Facets Claims, PCA, and Customer Service Workflow configuration.
- 6+ years of healthcare payer industry experience.
- Strong understanding of healthcare claims processing, workflow management, and customer service operations.
- Experience translating business requirements into effective configuration designs and solutions.
- Experience supporting testing, quality assurance, and user acceptance testing activities.
- Strong analytical, problem-solving, and decision-making skills.
- Excellent written, verbal, and interpersonal communication skills.
These Will Help You Stand Out
- Experience leading enterprise Facets implementation, modernization, or transformation initiatives.
- Knowledge of Commercial, Medicare, and Medicaid healthcare payer operations.
- Experience facilitating design workshops and client-facing requirements sessions.
- Familiarity with Agile, Scrum, or hybrid delivery methodologies.
- Proven ability to mentor team members and provide configuration leadership across large programs.
- Experience driving process improvement and workflow automation initiatives.
Salary and Other Compensation:
Applicants will be accepted till 8/14/2026
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 is not able to offer visa transfer or sponsorship now or in the future*
The annual salary for this position will be in the range of $113,000 - $130,000 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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Sobre a Cognizant
Cognizant (NASDAQ: CTSH) é uma construtora de IA e fornecedora de serviços de tecnologia, criando a ponte entre o investimento em IA e o valor para as empresas por meio do desenvolvimento de soluções de IA completas para nossos clientes. Nossa profunda experiência em setores, processos e engenharia nos permite incorporar o contexto único de cada organização em sistemas tecnológicos que potencializam a capacidade humana, geram resultados tangíveis e mantêm empresas globais à frente em um mundo em rápida transformação. Saiba mais em cognizant.ai ou @cognizant.
A Cognizant é uma empregadora que investe em equidade. Sua candidatura não será pautada em raça, cor, gênero, sexualidade, credo, origem, deficiência, gravidez ou qualquer outra característica protegida pelas leis brasileiras.
Informações adicionais de emprego
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Embora nosso sistema permita a candidatura em todos os idiomas, o(s) idioma(s) e o(s) nível(is) de proficiência exigidos para o trabalho variam. No entanto, é necessário um nível básico de inglês para fins de comunicação em toda a empresa.
A Cognizant é uma empregadora que investe em equidade. Sua candidatura não será pautada em raça, cor, gênero, sexualidade, credo, origem, deficiência, gravidez ou qualquer outra característica protegida pelas leis brasileiras.
Se você tem uma deficiência que requer adaptações razoáveis para procurar uma vaga de emprego ou enviar uma candidatura, envie um e-mail para [email protected] com sua solicitação e informações de contato.
