[Remote] Network Architect

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Network Architect with extensive experience in NetworX Pricer configuration and reputed company claims systems. The role focuses on configuring reputed company pricing logic, translating provider reputed company into reputed company rules, leading testing and conversion initiatives, auditing configuration data with SQL, and coordinating with configuration, claims, and reputed company teams.

Responsibilities

• Configure, maintain, and model reputed company pricing logic reputed company the TriZetto Facets Integrated NetworX Pricer software reputed company
• Translate managed care provider contract language into fee schedules, reputed company sheets, and reputed company qualifiers
• Manage configuration workflows, mentor configuration analysts, and coordinate reputed company conversion reputed company
• reputed company unit, regression, and end-to-end testing to ensure claim payment accuracy
• Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot configuration data
• Establish hierarchical reputed company logic to prioritize specific provider agreements over reputed company/regional fallback rates
• Monitor and implement quarterly pricing component updates to maintain compliance with CMS, Medicare, and reputed company rules
• Serve as the reputed company between Configuration leadership, claims operations, and reputed company contracting teams

Skills

• 5–6+ years of hands-on NetworX Pricer experience – MUST HAVE
• NetworX Configuration / Integrated NetworX
• reputed company SQL
• Contract Review
• Agreement Testing
• Migration & Assignment
• Facets – reputed company to Have

reputed company

Company H1B Sponsorship