Job Summary
Serve as a senior consultant contributing deep payer domain expertise to complex client engagements in a hybrid day shift model with no travel expectations. Apply analytical and advisory skills to optimize payer operations improve member and provider experiences and support compliant efficient healthcare ecosystems. Collaborate across multidisciplinary teams to deliver measurable business outcomes and sustainable value.
Responsibilities
- Drive end to end consulting engagements for payer clients by analyzing current processes and systems to identify gaps in efficiency compliance and member satisfaction while proposing actionable improvements aligned with business goals.
- Provide expert guidance on payer operations including claims adjudication benefit configuration utilization management provider contracting and member services to help clients streamline workflows and reduce operational risk.
- Lead the design and documentation of future state payer process models and business requirements ensuring clear traceability from client objectives to implementable solutions that enhance service quality and cost effectiveness.
- Collaborate with product technology and operations teams in a hybrid work environment to translate complex payer business needs into practical configuration data and reporting solutions that can be executed within agreed timelines.
- Conduct detailed data analysis on claims enrollment and provider datasets to uncover patterns performance issues and opportunities for cost savings that directly contribute to better health outcomes and financial sustainability.
- Guide stakeholders through regulatory and compliance considerations relevant to payer organizations such as policy updates and audit readiness while ensuring recommendations adhere to industry standards and internal governance.
- Facilitate structured workshops and working sessions with client subject matter experts to validate assumptions refine solution options and gain alignment on prioritized initiatives that will deliver measurable impact for members and providers.
- Mentor junior consultants and team members on payer domain concepts analytical approaches and consulting best practices to build a strong internal capability and ensure consistent high quality delivery across projects.
- Coordinate day to day project activities including status reporting risk and issue tracking and dependency management to keep stakeholders informed and ensure deliverables remain on schedule and within scope.
- Develop clear and concise client ready documentation such as process maps requirement specifications impact assessments and value realization summaries that demonstrate how proposed changes advance organizational goals.
- Support change management activities by crafting communication plans and training materials that help client teams adopt new payer processes and tools smoothly while maintaining focus on member and provider experience.
- Contribute to internal thought leadership by capturing lessons learned from payer engagements and turning them into reusable frameworks accelerators and reference materials that strengthen the company consulting offerings.
- Align consulting solutions with the company larger purpose by focusing on payer strategies that enable better access to care improved affordability and transparent interactions for members providers and communities.
Qualifications
- Bring strong experience working in payer environments with hands on exposure to claims platforms benefit administration and provider networks enabling practical and context aware consulting recommendations.
- Demonstrate advanced analytical and problem solving skills using spreadsheets or business intelligence tools to evaluate payer performance metrics and convert findings into clear insights and prioritized actions.
- Apply solid knowledge of healthcare regulations and payer compliance practices to ensure that all proposed process and system changes support regulatory adherence and minimize operational risk.
- Utilize excellent communication and stakeholder management skills to interact confidently with client business teams technology teams and senior decision makers in a hybrid work setting.
- Show proven capability in structured consulting delivery including requirement elicitation documentation and presentation of solution options enabling smooth progress through the project lifecycle.
- Exhibit ability to work independently within the day shift model while coordinating effectively with global and local team members to maintain continuity of service for payer clients.
About Cognizant:
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization’s unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.
Additional employment information
Compensation 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.
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview.
Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.
