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PURPOSE: Contribute as an experienced team member on client or internal assignments and projects such as product configuration implementation, design, configuration support and maintenance and staff augmentation. Utilizes professional concepts, company objectives, and business rule requirements to develop configuration solutions and resolve configuration issues in core product systems. Provides design, knowledge and expertise on core system functionality as it applies to the client's business, drawing on the analyst's managed care, application system technology and business experience.
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ESSENTIAL RESPONSIBILITIES:
- Perform systems configuration analysis, design, coding, unit testing on customer specific solutions during the client product implementation stage and ongoing support and maintenance of quality custom solutions
- Identifying gaps between external expectations and system limitations and suggests configuration improvements or streamlined maintenance processes and techniques if applicable
- Follow established processes, standards and procedures designed to minimize service level agreement violations
- Analyze complex customer business requirements and software/product objectives; designs, configures, supports and maintains complex application designs to meet the customer needs
- Estimate time frames, quality and quantity of resources required to successfully complete activities; develops project plan incorporating all project variables
- Provide periodic status checks with clients and and internal teams on all project activities in order to assess progress against project plan; provides regular and concise status reports to direct manager
- Address and resolve escalated issues in the appropriate manner within the appropriate timeframe and escalates as appropriate
- Other duties as assigned
TRAINING & EXPERIENCE:
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- Bachelor's Degree in Health Care Management, Computer Science, or other related field required; Equivalent work experience will be taken into consideration in leiu of degree
- 3-5 years of business experience in system configuration
- Experience with TriZetto processing platforms, FACETS and/or QNXT and/or QicLink, NetworX Pricer
- Experience with Excel
- Experience with query building using Rapid SQL, MS Access and/or other technical analysis tools
- Strong technical and mathematical aptitudes
- Healthcare industry knowledge a plus
- Experience with Third Party apps a plus, i.e. Optum CES Clinical Editing System, Optum Pricer, Microdyn, etc.
Skill Set Preferred:
- Multi-task and organize work effectively
- Conduct root cause analysis to determine issues related to basic system configuration
- Evaluate adequacy of test plans compared to business requirements
- Understand relationship and dependencies among contract, benefit, adjudication, claims and payment systems
- Knowledge of CMS/State Guidelines and Billing Codes
- Develop, share, and incorporate organizational best practices into business applications
- Diagnose problems and identify opportunities for process redesign and improvement
- Serve as the subject matter expert on the assigned function product to ensure operational performance
WORKING CONDITIONS (Location, travel, etc.):
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- This position is remote; The ability to stage a remote office is required
- Minimal travel may be requested
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Employee Status : Full Time Employee Shift : Day Job Travel : No Job Posting : May 09 2023 About Cognizant Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, transforming clients' business, operating and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant is ranked 185 on the Fortune 500 and is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at or follow us
Applicants may be required to attend interviews in person or by video conference. In addition, candidates may be required to present their current state or government issued ID during each interview. Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. If you have a disability that requires a reasonable accommodation to search for a job opening or submit an application, please email with your request and contact information.
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Cognizant North America
May 10, 2023