Healthcare Payer Consultant - QNXT

Cognizant Technology Solutions Corporation; Richmond (VA); A distancia; USD 113.000 - 132.000; Jornada completa

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 specialized in QNXT UM/A&G to help payers optimize member and provider communications through effective utilization management and appeals workflows.

You will configure QNXT UM/A&G functionality, gather business requirements, and collaborate with cross-functional teams—onsite and offshore—to deliver scalable communication solutions for Medicare and commercial lines.

Formación

• Experience with healthcare payer operations including UM and/or A&G.
• Advanced knowledge of QNXT UM and/or A&G.
• Advanced proficiency in Microsoft Word and Excel.
• Experience gathering business requirements and translating 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 with onsite and offshore teams.
• Strong verbal, written, and presentation communication skills.

Responsabilidades

• Serve as SME for UM/A&G workflows.
• Configure, analyze, and support correspondence solutions using QNXT UM/A&G.
• Consult with clients on Medicare and commercial letter requirements.
• Gather and document business requirements and translate them into scalable solutions.
• Manage multiple project timelines with offshore and cross-functional teams.

Conocimientos

UM workflows

A&G workflows

QNXT UM/A&G

Microsoft Word

Microsoft Excel

Requirements gathering

XML design

Analytical skills

Communication skills

Herramientas

TriZetto product suite

Adobe Illustrator

Adobe Photoshop

Adobe InDesign

SQL

Oracle

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.