NetworX Configuration Analyst

TechDigital Group; North Carolina; Hybrid; USD 120,000 - 150,000; Full time

Job summary

TechDigital Group in North Carolina seeks a pricing systems expert with hands-on NetworX Pricer and configuration experience to translate provider contracts into precise fee schedules and system qualifiers. You will manage daily configuration workflows and coordinate cross-platform system conversions.

You will lead comprehensive testing, audit large data batches with SQL, and ensure claim payment accuracy while applying CMS, Medicare, and Medicaid rules.

Qualifications

• Hands-on experience with NetworX Pricer (5-6 years).
• Experience configuring NetworX integrated components.
• Proficiency in Oracle SQL and data querying.
• Familiarity with CMS, Medicare and Medicaid rules is beneficial.

Responsibilities

• Configure, maintain, and model pricing logic within NetworX Pricer.
• Translate contract language into precise fee schedules and qualifiers.
• Lead configuration workflows and coordinate system conversion projects.
• Direct testing (unit, regression, end-to-end) to ensure payment accuracy.
• Use SQL queries to audit and troubleshoot large configuration data batches.
• Establish hierarchical logic to prioritize provider agreements.
• Monitor quarterly pricing updates for CMS/regulatory compliance.
• Serve as liaison between Configuration leadership, claims, and contracting.

Skills

NetworX Pricer

NetworX Configuration

Facets (nice to have)

Oracle SQL

Tools

Relational databases

Job description

• 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.