NetworX Configuration Analyst

Why Consider this Job Opportunity

Competitive salary with opportunities for performance bonuses

Potential for career advancement and professional growth within the organization

Collaborative and supportive work environment

Engage in meaningful work that impacts the healthcare landscape

Opportunity to work with cross‑functional teams including Provider Contracting, Claims, Finance, and IT

• Configure and optimize provider pricing rules, fee schedules, and reimbursement logic using the Networ
  
  X Pricer platform
• Analyze contract terms and translate them into systematic pricing configuration requirements
• Validate pricing outcomes through test adjudication and reconcile any variances
• Monitor and troubleshoot pricing-related claims issues while leading root‑cause investigations
• Ensure compliance with regulatory requirements and maintain updated configuration documentation

• 4–7 years of hands‑on Networ
  
  X Pricer configuration experience in a health plan or TPA environment
• Expertise in provider pricing methodologies such as RBRVS, APC/DRG, and value‑based reimbursement models
• Strong knowledge of claims adjudication and provider contracting workflows
• Ability to analyze complex pricing rules and convert them into scalable configuration logic
• Excellent communication skills and attention to detail

• Experience in healthcare consulting or working directly with healthcare organizations
• Familiarity with regulatory requirements and CMS pricing standards
• Proven track record of successful collaboration with cross‑functional teams
• Additional certifications related to healthcare reimbursement or pricing methodologies

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top‑tier employer.