Job Description
Our Client, an IT Services and Consultant company, is looking for a NetworX Configuration Analyst for their Remote location.
Responsibilities:
- Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system.
- Translate managed care provider contract language into precise fee schedules, rate sheets, and system qualifiers.
- Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion projects across platforms.
- Direct comprehensive unit, regression, and end-to-end testing processes to ensure absolute claim payment accuracy.
- Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot massive configuration data batches.
- Establish hierarchical system logic to correctly prioritize specific provider agreements over standard, regional fallback rates.
- Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and Medicaid rules.
- Act as the primary liaison between Configuration of leadership, claims operations, and the legal contracting team.
Requirements:
- Must have hands on experience in NetworX Pricer (5-6 yrs)
- NetworX Configuration (Integrated NetworX)
- Oracle SQL
- Review contract, Agreement testing, migration, assignment
- Facets is not required, but nice to have
- 10.00 Years of Experience
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Skills
Analysis Skillsunmatched
Centers for Medicare and Medicaid Services (CMS)unmatched
Contract Reviewunmatched
Establish Prioritiesunmatched
Fee Scheduleunmatched
Health Planunmatched
Information Technology Consultingunmatched
Leadershipunmatched
Legalunmatched
Maintain Complianceunmatched
Managed Careunmatched
Medicaidunmatched
Medicareunmatched
Mentoringunmatched
Multiplatform/Cross-Platformunmatched
Oracle Databaseunmatched
Pricingunmatched
Product Pricingunmatched
Project/Program Coordinationunmatched
Provider Contractingunmatched
Quality Assurance Methodologyunmatched
Relational Databases (RDBMS)unmatched
SQL (Structured Query Language)unmatched
Testingunmatched
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