Remote Healthcare Transformation Manager

Cognizant; Nashville (TN); On-site; USD 81,000 - 130,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Life Insurance

Paid holidays + PTO

401(k) plan

Long-term/Short-term Disability

Paid Parental Leave

Employee Stock Purchase Plan

Job summary

Cognizant Consulting is seeking a Consulting Manager, Healthcare Business Transformation, to lead LTSS operations assessment, identify efficiency gaps, and drive performance improvements across authorization, claims, provider, member, and financial workflows.

You will facilitate workshops with stakeholders and deliver actionable roadmaps and transformation strategies, coordinating with IT, data analysts, and executives. This role emphasizes strong communication and executive-level deliverables.

Qualifications

• Bachelor's degree or equivalent professional experience in Healthcare Administration, Information Systems, Business, or a 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.

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

Stakeholder management

Executive presentations

Process analysis

Healthcare IT experience

Pega workflows

QNXT

Education

Bachelor's degree in Healthcare Administration/Information Systems/Business

Tools

Pega

QNXT

Job description

Cognizant Consulting is seeking a Consulting Manager, Healthcare Business Transformation, to lead LTSS operations assessment, identify efficiency gaps, and drive performance improvements across authorization, claims, provider, member, and financial workflows.

You will facilitate workshops with stakeholders and deliver actionable roadmaps and transformation strategies, coordinating with IT, data analysts, and executives. This role emphasizes strong communication and executive-level deliverables.