Networks Configuration Analyst

Our Client, an IT Services and Consultant company, is looking for a Networks Configuration Analyst for their Remote location.

Responsibilities:

• Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated Networks 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 Networks Pricer (5-6 yrs)
• Facets is not required, but nice to have
• Networks Configuration (Integrated Networks)
• Oracle SQL
• Review contract, Agreement testing, migration, assignment
• Years of Experience: 13.00 Years of Experience

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities