NetworX Configuration Analyst

Remote • Posted 6 hours ago • Updated 6 hours ago
Contract W2
12 Months
No Travel Required
Remote
Depends on Experience
Fitment

Dice Job Match Score™

🛠️ Calibrating flux capacitors...

Job Details

Skills

  • Facets
  • Claims Management
  • Auditing
  • Leadership
  • Legal
  • Management
  • Medicaid
  • Medicare
  • Mentorship
  • Migration

Summary

Description:

Must have hands on experience in NetworX Pricer (5-6 yrs)

Facets is not required, but nice to have

NetworX Configuration (Integrated NetworX)

Oracle SQL

Review contract, Agreement testing, migration, assignment

 

Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system.

Translate managed care provider contract language into precise fee schedules, rate sheets, and system qualifiers.

Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion projects across platforms.

Direct comprehensive unit, regression, and end-to-end testing processes to ensure absolute claim payment accuracy.

Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot massive configuration data batches.

Establish hierarchical system logic to correctly prioritize specific provider agreements over standard, regional fallback rates.

Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and Medicaid rules.

Act as the primary liaison between Configuration of leadership, claims operations, and the legal contracting team.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 90975901
  • Position Id: 9033841
  • Posted 6 hours ago
Contact the job poster
RS

Raj Sharma

Recruiter @ Voluble Systems LLC
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