NetworX Configuration Analyst

Job Title:NetworX Configuration Analyst

Location:Remote (EST Preferred)

Tax Term (W2, C2C): W2

Job Type (Permanent/Contract):Contract

Duration:Potential for Extension

Description:

We are seeking an experienced NetworX Configuration Analyst with strong hands-on expertise in NetworX Pricer and Integrated NetworX Configuration. The ideal candidate will have experience configuring complex pricing logic, translating provider contracts, performing agreement testing, migration activities, and utilizing Oracle SQL to support healthcare claims pricing. Experience with TriZetto Facets is a plus but not required.

Role and 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 leadership, claims operations, and the legal contracting team.

Required Skills:

• NetworX Pricer (5 6+ years hands-on)
• Integrated NetworX Configuration
• Oracle SQL
• Contract Review
• Agreement Testing
• Migration
• Claims Pricing Configuration
• TriZetto Facets (Nice to Have)

Qualifications:

• 13+ years of experience in healthcare payer configuration or related roles.
• Strong hands-on experience with NetworX Pricer and Integrated NetworX Configuration.
• Experience translating provider contracts into pricing configurations.
• Proficiency with Oracle SQL for validation, auditing, and troubleshooting.
• Experience with agreement testing, migration, and pricing configuration.
• Knowledge of CMS, Medicare, and Medicaid pricing guidelines.
• Excellent analytical, communication, and stakeholder management skills.