Network Architect

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Configure, sustain, and model intricate pricing logic within the TriZetto Facets Integrated NetworX Pricer software system.

• Convert managed care provider contract language into accurate fee schedules, rate sheets, and system qualifiers.

• Oversee daily configuration workflows, mentor configuration analysts, and manage system conversion projects across various platforms.

• Lead extensive unit, regression, and end-to-end testing processes to guarantee claim payment accuracy.

• Employ advanced SQL queries and relational databases to audit, validate, and troubleshoot configuration data batches.

• Create hierarchical system logic to prioritize particular provider agreements over standard, regional fallback rates.

• Monitor and apply quarterly pricing component updates to ensure compliance with CMS, Medicare, and Medicaid regulations.

• Serve as the main point of contact between Configuration leadership, claims operations, and the legal contracting team.

⛳️ Requirements

• Hands-on experience with NetworX Pricer (5–6 years).

• Familiarity with NetworX Configuration (Integrated NetworX).

• Proficiency in Oracle SQL.

• Facets experience is preferred but not mandatory.

• Experience in reviewing contracts, testing agreements, migration, and assignment.

• Capability to work remotely during EST hours, with hiring manager flexibility for exceptional candidates.

🏝️ Benefits

• (Add benefits here if applicable)