Remote Pricing Config Consultant — Payer NetworX FACETS

Cognizant; Rancho Cordova (CA); Remote; USD 113,000 - 130,000; Full time

Benefits offered by this job

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

Job summary

Cognizant is seeking a NetworX Pricing Configuration Consultant to support provider contracts, reimbursement configuration, and claims adjudication for healthcare payers. This remote role is open to qualified applicants in the United States, with collaboration across Contracting, Claims, Business, and IT teams.

You will configure contracts and fee schedules, analyze requirements, validate pricing, and ensure accurate adjudication. Strong SQL, and experience with NetworX tools are essential.

Qualifications

• Experience supporting healthcare payer organizations with provider contract pricing and reimbursement configuration.
• Hands-on experience with NetworX Pricer and NetworX Modeler.
• Experience with FACETS configuration and claims adjudication processes.
• Knowledge of provider contract configuration, fee schedules, reimbursement methodologies, and pricing validation.
• Strong SQL skills for data analysis, validation, and troubleshooting.
• Experience supporting Commercial, Medicare, and Medicaid lines of business.
• Experience with testing, production releases, implementation support, and post-production validation.
• Excellent verbal and written communication skills with the ability to collaborate across business and technical teams.

Responsibilities

• Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies within the NetworX Pricing platform.
• Analyze business and contractual requirements and translate them into effective pricing and reimbursement configurations.
• Perform pricing validation, claims analysis, testing, and production support to ensure accurate claims adjudication and reimbursement outcomes.
• Partner with Provider Contracting, Claims Operations, Business, and IT teams to implement and support configuration enhancements.
• Investigate and resolve pricing, reimbursement, and claims adjudication issues while maintaining configuration documentation and testing evidence.

Skills

SQL

NetworX Pricer

NetworX Modeler

FACETS configuration

Pricing validation

Claims adjudication

Provider contract pricing

Data analysis

Communication skills

Team collaboration

Job description

Cognizant is seeking a NetworX Pricing Configuration Consultant to support provider contracts, reimbursement configuration, and claims adjudication for healthcare payers. This remote role is open to qualified applicants in the United States, with collaboration across Contracting, Claims, Business, and IT teams.

You will configure contracts and fee schedules, analyze requirements, validate pricing, and ensure accurate adjudication. Strong SQL, and experience with NetworX tools are essential.