
Merican Inc
Remote or Maryland • Today
Easy Apply
Contract, Third Party
$$70/Hr C2C
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Merican Inc
Remote or Maryland • Today
Easy Apply
Contract, Third Party
$$70/Hr C2C



Role: Clinical Care Advance (CCA) Configuration Analyst
Experience: 5 12 Years
Role Summary
We are seeking experienced TriZetto Clinical Care Advance (CCA) Configuration experts to support a large-scale Utilization Management (UM) and Prior Authorization (PA) modernization program for a leading US Healthcare payer. The role involves hands-on configuration of CCA workflows, business rules, authorizations, correspondence, and integrations.
Key Responsibilities
Configure CCA workflows and business processes
Configure ABRE (Advanced Business Rules Engine) for Prior Authorization and auto-authorization
Configure Utilization Management (UM), Appeals & Grievances (A&G), and clinical workflows
Configure TCS correspondence and RightFax integrations
Support FACETS integration, benefit mapping, pharmacy, and provider-administered drug workflows
Configure automated case creation, routing, and closure rules
Prepare configuration documentation and support CCA platform modernization
Required Skills
5+ years of hands-on TriZetto Clinical Care Advance (CCA) configuration experience.
Strong experience with ABRE, Prior Authorization (PA), and Utilization Management (UM)
Experience with US Healthcare Payer, Medicare, and Medicaid
Knowledge of TCS, RightFax, FACETS integration, and clinical workflow configuration is preferred
With our diverse collection of skilled and committed consultants, technology companies, businesses and digital experts, we provide our subject expertise and our unique client service approach, a best-in-class global model of delivery suited to the business demands of our clients. We ensure that we implement future-oriented solutions for our clients via investments in people, solutions, technologies, competencies and infrastructure.
Our full-service offering and flexible delivery choices that combine cost, quality, effort, and risk are focused on addressing future issues for our customers. Our worldwide delivery method enables our customers to select the optimal supply plan for them.
🔢 Crunching numbers...
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