About Cognizant Consulting:
Cognizant Consulting is more than Cognizant’s consulting practice—we’re a global community of 6,000+ experts dedicated to helping clients reimagine their business. Blending our deep industry and technology advisory capability, we create innovative business solutions for Fortune 500 clients. And now, we’re looking for our next colleague who’ll join us in shaping the future of business. Could it be you?
About the role:
As a Consulting Manager, Healthcare Business Transformation, you will make an impact by leading a comprehensive assessment of enterprise Long-Term Services and Supports (LTSS) operations, identifying opportunities to improve process efficiency, system interoperability, data integrity, and financial performance. You will be a valued member of the Healthcare Consulting team and work collaboratively with business stakeholders, LTSS operations teams, product owners, IT teams, architects, data analysts, finance leaders, and executive sponsors.
In this role, you will:
• Lead end-to-end assessment and documentation of LTSS business processes across authorization, claims, provider, member, and financial workflows.
• Analyze interactions between Pega, QNXT, and related healthcare platforms to identify process, integration, and data flow gaps.
• Evaluate authorization-to-claims transaction integrity, data mappings, and operational controls to identify root causes of processing issues and financial leakage.
• Facilitate stakeholder workshops, discovery sessions, and executive presentations to align business and technology teams on findings and recommendations.
• Develop actionable remediation roadmaps, business cases, risk assessments, and transformation strategies that improve operational performance and reduce business risk.
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 though 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:
• Bachelor's degree or equivalent professional experience in Healthcare Administration, Information Systems, Business, or a related field.
• 8+ years of experience in healthcare consulting, business transformation, program management, or healthcare operations.
• Strong experience with QNXT and healthcare payer platforms, including claims, benefits, enrollments, and authorization workflows.
• Experience working with Pega-based healthcare workflows, care management, or authorization management processes.
• Proven expertise in healthcare process analysis, stakeholder management, business requirements, and current-state/future-state process mapping.
• Experience conducting system integration reviews, data lineage assessments, reconciliation analysis, and business impact evaluations.
• Strong communication and executive presentation skills with the ability to influence stakeholders across business and technology organizations.
• Experience creating executive-level deliverables, recommendations, remediation roadmaps, and transformation strategies.
These will help you stand out:
• Experience supporting Molina Healthcare or other Medicaid and LTSS-focused healthcare organizations.
• Knowledge of healthcare claims processing, financial workflows, payment integrity, and leakage analysis.
• Experience leading enterprise assessments involving interoperability, data governance, and technology modernization initiatives.
• Familiarity with healthcare regulatory requirements, managed care operations, and value-based care environments.
• Experience with business architecture, process mining, workflow optimization, or healthcare transformation consulting engagements.
We're excited to meet people who share our mission and can make an impact in a variety of ways. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role.
Total Compensation:
The annual salary for this position is between $81,450 - $129,500 depending on experience and other qualifications of the successful candidate.
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
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
Os candidatos podem ser obrigados a comparecer a entrevistas presenciais ou por videoconferência. Além disso, os candidatos podem ser obrigados a apresentar seu documento de identificação emitido pelo estado ou governo atual durante cada entrevista.
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.
