Remote Healthcare Payer UM/A&G Consultant (QNXT)

Cognizant; Dover (DE); A distancia; USD 113.000 - 132.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

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

Descripción de la vacante

Cognizant is hiring a Healthcare Payer Consultant - QNXT to help payers optimize member and provider communications through UM and A&G workflows. You will configure and analyze correspondence solutions, consult on Medicare and commercial letter requirements, and translate business needs into scalable, compliant communications.

The role offers a remote work model in the United States and requires strong analytics, cross-functional collaboration, and proficiency with XML, Word, Excel, and design

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

QNXT UM/A&G

Microsoft Word

Microsoft Excel

XML design

Adobe Illustrator

Herramientas

SQL

Oracle

TriZetto product suite

Descripción del empleo

Cognizant is hiring a Healthcare Payer Consultant - QNXT to help payers optimize member and provider communications through UM and A&G workflows. You will configure and analyze correspondence solutions, consult on Medicare and commercial letter requirements, and translate business needs into scalable, compliant communications.

The role offers a remote work model in the United States and requires strong analytics, cross-functional collaboration, and proficiency with XML, Word, Excel, and design