Healthcare Transformation Lead - Remote

Cognizant; Charleston (WV); Remote; USD 81,000 - 130,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Life Insurance

Paid holidays + PTO

401(k) plan and contributions

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Job summary

Cognizant is seeking a Consulting Manager, Healthcare Business Transformation, to lead LTSS assessments across authorization, claims, provider, member, and financial workflows. You will analyze Pega and QNXT integrations, identify data gaps, and collaborate with stakeholders to design remediation roadmaps and transformation strategies.

You will facilitate workshops and executive sessions, develop business cases, and drive improvements in operational performance and risk reduction for healthcare

Qualifications

• Bachelor's degree or equivalent in Healthcare Administration, Information Systems, Business, or related field.
• 8+ years of experience in healthcare consulting, business transformation, program management, or healthcare operations.
• Strong experience with QNXT and healthcare payer platforms, including claims, benefits, enrollments, and authorization workflows.
• Experience working with Pega-based healthcare workflows, care management, or authorization management processes.
• Proven expertise in healthcare process analysis, stakeholder management, business requirements, and current-state/future-state process mapping.
• Experience conducting system integration reviews, data lineage assessments, reconciliation analysis, and business impact evaluations.
• Strong communication and executive presentation skills with the ability to influence stakeholders across business and technology organizations.
• Experience creating executive-level deliverables, recommendations, remediation roadmaps, and transformation strategies.

Responsibilities

• Lead end-to-end assessment and documentation of LTSS business processes across authorization, claims, provider, member, and financial workflows.
• Analyze interactions between Pega, QNXT, and related healthcare platforms to identify process, integration, and data flow gaps.
• Evaluate authorization-to-claims transaction integrity, data mappings, and operational controls to identify root causes of processing issues and financial leakage.
• Facilitate stakeholder workshops, discovery sessions, and executive presentations to align business and technology teams on findings and recommendations.
• Develop actionable remediation roadmaps, business cases, risk assessments, and transformation strategies that improve operational performance and reduce business risk.

Skills

QNXT experience

Pega workflows

Healthcare payer platforms

Stakeholder management

Executive presentations

Transformation strategies

Process mapping

Cross-functional collaboration

Education

Bachelor's degree or equivalent in Healthcare Administration, Information Systems, Business, or related field

Job description

Cognizant is seeking a Consulting Manager, Healthcare Business Transformation, to lead LTSS assessments across authorization, claims, provider, member, and financial workflows. You will analyze Pega and QNXT integrations, identify data gaps, and collaborate with stakeholders to design remediation roadmaps and transformation strategies.

You will facilitate workshops and executive sessions, develop business cases, and drive improvements in operational performance and risk reduction for healthcare