NetworX Configuration Analyst

Job Title:NetworX Configuration Analyst

Location:Remote EST (HM is flexible for strong candidates)

Tax Term:W2

Job Type:Contract

Duration:Long-Term Contract with potential for extension

Job Description:

We are seeking an experienced NetworX Configuration Analyst with strong hands-on expertise in NetworX Pricer and Integrated NetworX. The ideal candidate will have experience configuring complex pricing logic, translating managed care provider contract language into precise system configurations, performing agreement testing and migration, and utilizing Oracle SQL for configuration data validation and troubleshooting. Facets experience is not required but is nice to have.

Roles & 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.
• Review contracts and perform agreement testing, migration, and assignment activities.

Required Skills

• NetworX Pricer
• Integrated NetworX
• NetworX Configuration
• Oracle SQL
• Healthcare Claims / Pricing
• Managed Care Provider Contracts
• Contract Review
• Agreement Testing
• Configuration Migration
• Assignment
• Fee Schedules
• Rate Sheets
• System Qualifiers
• Unit Testing
• Regression Testing
• End-to-End Testing
• Claims Payment Validation
• Relational Databases
• SQL Queries
• CMS
• Medicare
• Medicaid

Preferred Skills

• Facets
• TriZetto Facets
• Facets Claims
• System Conversion
• Configuration Analyst Mentoring
• Managed Care

Qualifications

• 12+ years of overall experience.
• 5 6+ years of hands-on experience with NetworX Pricer is mandatory.
• Strong hands-on experience with Integrated NetworX and NetworX Configuration.
• Strong Oracle SQL experience for auditing, validating, and troubleshooting configuration data.
• Experience translating managed care provider contract language into system pricing configurations.
• Experience with contract review, agreement testing, migration, and assignment.
• Experience with unit, regression, and end-to-end testing.
• Strong understanding of healthcare claims pricing, provider agreements, and payment accuracy.
• Facets experience is preferred but not required.
• Strong analytical, communication, and stakeholder management skills.