NetworX Architect

TechDigital Group; New Jersey; Hybrid; USD 100,000 - 160,000; Full time

Job summary

TechDigital Group is seeking a pricing configuration expert with hands-on NetworX Pricer experience. The role involves translating managed care contracts into precise fee schedules and maintaining complex pricing logic within the Facets-Integrated NetworX Pricer system.

You will manage configuration workflows, mentor analysts, and coordinate system conversion projects, ensuring payment accuracy and CMS/Medicare/Medicaid compliance.

Qualifications

• Hands-on experience with NetworX Pricer (5–6 yrs).
• Translate managed care provider contracts into precise fee schedules and system qualifiers.
• Experience configuring pricing logic within pricing software systems.

Responsibilities

• Configure and maintain complex pricing logic in NetworX Integrated Pricer.
• Translate contracts into fee schedules and rate sheets.
• Lead configuration workflows and coordinate system migrations.

Skills

NetworX Pricer

Facets

Oracle SQL

CMS/Medicare/Medicaid rules

Pricing configuration

Data analysis

Tools

SQL

Relational databases

Job description

Design work. Must have hands on experience in NetworX Pricer (5-6 yrs). Facets is not required, but nice to have. NetworX Configuration (Integrated NetworX). Oracle SQL. Review contract, Agreement testing, migration, assignment.

• 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 of leadership, claims operations, and the legal contracting team.