Remote Facets Provider SME - Payer Transformation Lead

Cognizant; Pleasanton (CA); On-site; USD 150,000 - 170,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance

Paid holidays and PTO

401(k) plan

Job summary

Cognizant is seeking a Facets Provider Functional SME to support healthcare payer transformation initiatives across provider configuration, networks, contracting, pricing integration, and claims adjudication on the TriZetto Facets platform. You will collaborate with business stakeholders and implementation teams to deliver successful Facets migration and modernization programs.

Based in the United States and remote-friendly, this role emphasizes strong analytical skills, stakeholder management,

Qualifications

• 8+ years in healthcare payer industry.
• 5+ years hands-on experience with TriZetto Facets Provider modules.
• Strong expertise in provider configuration, networks, contracting, and relationships.
• Knowledge of Medicare, Medicaid, and Commercial products.
• Experience supporting Facets implementations, migrations, or transformations.
• Proven ability in business analysis, impact assessments, testing support, and defect triage.
• Strong communication, stakeholder management, and problem-solving skills.

Responsibilities

• Lead provider-focused requirements sessions and design workshops with business and technical stakeholders.
• Configure and analyze provider structures within Facets (practitioners, facilities, provider groups, taxonomies, and relationships).
• Support provider network, participation, and contract configuration for accurate claims processing.
• Partner with claims, pricing, and business teams to validate provider setup and optimize adjudication outcomes.
• Drive provider data migration, testing, reconciliation, defect resolution, and production support throughout the project lifecycle.

Skills

Provider configuration

Provider networks

Provider contracting

Provider relationship management

Claims adjudication processes

Communication & stakeholder management

Tools

TriZetto Facets

Job description

Cognizant is seeking a Facets Provider Functional SME to support healthcare payer transformation initiatives across provider configuration, networks, contracting, pricing integration, and claims adjudication on the TriZetto Facets platform. You will collaborate with business stakeholders and implementation teams to deliver successful Facets migration and modernization programs.

Based in the United States and remote-friendly, this role emphasizes strong analytical skills, stakeholder management,