Sr. NetworX​/Facets Configuration Consultant

Senior Networ

X/Facets Configuration Consultant

Location: Remote

Employment Type: Full-Time

Job :

As a Senior Networ

X/Facets Configuration Consultant, you will make an impact by configuring, optimizing, and supporting Facets and Optum Networ

X (Pricer and Modeler) to enable accurate, efficient claims adjudication for a fast‑growing health plan. You will be a valued member of our Healthcare Technology & Operations team, partnering with IT, claims, provider services, business operations, and solution architects to translate complex reimbursement policies and regulatory guidance into high‑quality system configurations, robust testing, and smooth production outcomes.

• Lead and manage Networ
  
  X pricing agreement implementation and configuration; assess and utilize provider data to support health plan operations.

• Serve as a subject matter expert on Facets, Networ
  
  X (Pricer/Modeler), and reimbursement best practices; troubleshoot complex issues and drive root‑cause resolutions.

• Interpret contracts, regulations, provider bulletins, and reimbursement policies; translate CMS/agency guidance and industry feedback into actionable configuration updates.

• Collaborate with cross‑functional teams (IT, claims, provider services, business operations) to implement and enhance system configurations and integrations.

• Develop, document, and maintain configuration standards, policies, and procedures; lead/participate in design and configuration reviews.

• Analyze and validate configurations to ensure accurate claim adjudication and provider reimbursement; identify automation and enhancement opportunities.

• Plan and execute system testing, upgrades, and implementations to minimize disruption; provide clear communication on status, risks, and mitigation.

• Deliver training and knowledge transfer to internal teams; operate within Agile/Scrum ways of working.

We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we support a healthy work‑life balance through our wellbeing programs. The working arrangements for this role are accurate as of the date of posting and may change based on business or client needs;

we will always communicate expectations clearly.

• 10+ years of hands‑on experience across Facets, Networ
  
  X Pricer, Optum Grouper/Pricer, claims processing, and U.S. healthcare.

• 5+ years leading projects in an onsite–offshore model; proven success delivering implementations, enhancements, and maintenance at scale.

• Expertise in new line‑of‑business (LOB) implementations and end‑to‑end system configuration.

• Strong knowledge of managed care concepts, provider contracts, fee schedules, and benefit configuration.

• Proficiency writing and optimizing SQL queries for data validation, analysis, and reporting.

• Demonstrated ability to analyze, design, and build Facets Provider configuration; working knowledge of Optum PPS configuration.

• Ability to interpret payer–provider contract terms, produce technical designs, and implement them via configuration.

• Deep understanding of health plan operations for Medicare, Medicaid, Marketplace, LTSS, and DSNP (duals).

• Configuration experience on Facets v25.R1 or higher on an SQL platform.

• Excellent written and verbal communication skills; strong root‑cause analysis and issue‑resolution abilities.

• Experience delivering large configuration programs and complex production cutovers.

• Hands‑on use of project/portfolio tools and query/reporting tools (e.g., Cognos), with working knowledge of Windows, Excel, PowerPoint, Word.

• Familiarity with Power Automate, Copilot, and ChatGPT to streamline analysis, documentation, or reporting workflows.

• Ability to thrive in a fast‑paced, changing environment, working both independently and collaboratively.

Applicants will be accepted till 2/23/2026

Cognizant will only consider applicants for this position who are legally authorized to work in the United States without company sponsorship.

* Please note,…