Healthcare Payer Consultant - QNXT

Cognizant

Lansing (MI)

A distancia

USD 113.000 - 132.000

Jornada completa

Hace 9 días

Una candidatura completa en un minuto

Currículum y carta de presentación personalizados, listos para enviar.

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Ventajas ofrecidas por este puesto de trabajo

Medical/Dental/Vision/Life Insurance
Paid holidays plus PTO
401(k) plan
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan

Descripción de la vacante

Cognizant is seeking a Healthcare Payer Consultant with QNXT UM/A&G expertise to help payers optimize member and provider communications. You will collaborate with clients, delivery teams, product teams, and cross-functional stakeholders to implement utilization management and appeals workflows.

Remote work within the United States is supported. The role requires UM/A&G expertise, strong communication, and the ability to translate complex requirements into scalable, compliant communication

Formación

  • Experience supporting healthcare payer UM and/or A&G workflows.
  • Advanced knowledge of QNXT UM/A&G functionalities.
  • Proficiency with Microsoft Word and Excel.
  • Ability to gather requirements and translate into client solutions.
  • Familiarity with XML design and content development.
  • Experience with Adobe Illustrator, Photoshop, and InDesign.
  • Strong analytical, troubleshooting, and problem-solving skills.
  • Experience coordinating with onsite and offshore teams.
  • Excellent verbal, written, and presentation communication skills.

Responsabilidades

  • Serve as SME for UM and/or A&G workflows.
  • Configure and support correspondence solutions in QNXT.
  • Consult on Medicare and commercial letter requirements.
  • Document business requirements and translate into scalable communications.
  • Manage multiple project timelines with cross-functional stakeholders.

Conocimientos

UM/A&G experience
QNXT UM/A&G
Word/Excel proficiency
Requirements gathering
XML design
Adobe Suite
SQL/Oracle basics
Verbal & written communication
Project coordination

Herramientas

Adobe Illustrator
Photoshop
InDesign

Descripción del empleo

Healthcare Payer Consultant - QNXT
Location: Remote
Employment Type: Full-Time
Job ID: 00070835941
About the role

As a QNXT UM/A&G Consultant , you will make an impact by helping healthcare payers optimize member and provider communications through effective utilization management and appeals & grievances correspondence solutions. You will be a valued member of the healthcare consulting team and work collaboratively with clients, delivery teams, product teams, and cross-functional stakeholders.

In this role, you will:

  • Serve as a subject matter expert for Utilization Management (UM) and/or Appeals & Grievances (A&G) workflows within healthcare payer organizations.

  • Configure, analyze, and support correspondence and communication solutions leveraging QNXT UM and/or A&G functionality.

  • Consult with clients on complex Medicare and commercial letter requirements, including triggering mechanisms, business rules, and communication design.

  • Gather, analyze, and document business requirements and translate them into scalable communication solutions.

  • Manage multiple project timelines while collaborating with offshore teams and cross-functional stakeholders to achieve project objectives.

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 within the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

What you need to have to be considered
  • Strong experience supporting healthcare payer operations, including Utilization Management and/or Appeals & Grievances processes.

  • Advanced knowledge of QNXT UM and/or A&G.

  • Advanced proficiency in Microsoft Word and Excel.

  • Experience gathering business requirements and translating them into client solutions.

  • Working knowledge of XML design and content development.

  • Intermediate proficiency with Adobe Illustrator, Photoshop, and InDesign.

  • Strong analytical, troubleshooting, and problem-solving skills.

  • Experience managing multiple priorities and collaborating with both onsite and offshore teams.

  • Strong verbal, written, and presentation communication skills.

These will help you stand out
  • Deep understanding of healthcare payer operations, including Commercial, HMO, PPO, Medicare, Medicaid, and other government-sponsored programs.

  • Experience with healthcare correspondence, document publishing, or communications management solutions.

  • Experience with graphic design, content publishing, and editing.

  • Knowledge of the TriZetto product suite.

  • Ability to write clear, concise explanations of complex business and technical concepts.

  • Strong proofreading, organizational, and attention-to-detail skills.

  • Basic knowledge of SQL and/or Oracle.

  • Self-motivated with strong research and investigative capabilities.

Salary and Other Compensation

Applicants will be accepted till 11/15/2026

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 cannot offer visa transfer or sponsorship now or in the future

The annual salary for this position will be in the range of $113,000 - $132,000 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!

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

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