NetworX Pricing Configuration Lead Consultant - Healthcare Payer
Location: Remote
Employment Type: Full-Time
Job ID: 00070634952
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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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.
