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Senior Facets Claims & Customer Service Workflow Consultant

00069625641

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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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.

If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email [email protected] with your request and contact information.

 

Benefits that help you thrive and grow

Our benefits program is built with you in mind—so you can enjoy a fulfilling, balanced and healthy life.

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We regularly review market data to ensure compensation reflects the value you bring. Your benefits extend beyond pay and may include retirement plans, financial education, etc.

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Physical and mental health

We empower you to prioritize your wellbeing through paid time off, flexible working where possible, healthcare plans, counselling, our Mental Health Allyship program and more. 

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