CoSourcing Partners
NetworX Product Consultant - Facets Integration
CoSourcing Partners, Chicago, Illinois, United States, 60290
NetworX Product Consultant - Facets Integration (Remote)
Position Type:
Contract | Remote | Healthcare Domain
Overview:
We are seeking an experienced
NetworX Product Consultant
to join a healthcare product consulting engagement. This role focuses on configuring, enhancing, and supporting
TriZetto NetworX
applications with strong integration knowledge of
Facets . The ideal candidate will have deep domain expertise in provider reimbursement, pricing methodologies, and healthcare claims processing, particularly across Medicare, Medicaid, and Marketplace lines of business.
Key Responsibilities: Lead client-facing discovery and design sessions to define NetworX configurations aligned to business and contract requirements. Configure NetworX Modeler and Facets Integrated NetworX Pricer to support custom provider reimbursement methodologies. Translate paper contracts into system configurations with an understanding of fee schedules, cost shares, and agreement structures. Work cross-functionally with business, IT, and offshore/onshore teams to support implementation and testing. Validate Facets configurations, ensuring integration accuracy with NetworX modules. Provide hands-on support for issue analysis, root cause identification, and resolution. Maintain and optimize SQL queries used for data extraction, transformation, and reporting from NetworX and Facets data models. Mentor junior consultants and contribute to knowledge transfer and best practices documentation. Required Skills & Experience:
10+ years of healthcare experience
with at least
5 years of recent TriZetto NetworX pricing configuration experience . Hands-on experience with
Facets ,
NetworX Modeler , and
Integrated NetworX Pricer . Strong knowledge of
NetworX data structures , contract loading, and grouping/pricing logic. Demonstrated expertise in
SQL
for query development and performance tuning. Ability to interpret and implement
payer-provider contract terms
within the system. Understanding of
Facets agreements integration points
and configuration dependencies. Familiarity with
Optum PPS
configurations and pricing methodologies is a plus. Solid grasp of
Medicare, Medicaid, LTSS, DSNP, and Marketplace plan requirements . Preferred Qualifications:
Strong consulting background with the ability to communicate technical concepts clearly to non-technical stakeholders. Experience operating in hybrid resource models (onshore/offshore). Ability to manage competing priorities in a fast-paced, dynamic project environment. Comprehensive documentation skills for technical and operational handoffs.
Position Type:
Contract | Remote | Healthcare Domain
Overview:
We are seeking an experienced
NetworX Product Consultant
to join a healthcare product consulting engagement. This role focuses on configuring, enhancing, and supporting
TriZetto NetworX
applications with strong integration knowledge of
Facets . The ideal candidate will have deep domain expertise in provider reimbursement, pricing methodologies, and healthcare claims processing, particularly across Medicare, Medicaid, and Marketplace lines of business.
Key Responsibilities: Lead client-facing discovery and design sessions to define NetworX configurations aligned to business and contract requirements. Configure NetworX Modeler and Facets Integrated NetworX Pricer to support custom provider reimbursement methodologies. Translate paper contracts into system configurations with an understanding of fee schedules, cost shares, and agreement structures. Work cross-functionally with business, IT, and offshore/onshore teams to support implementation and testing. Validate Facets configurations, ensuring integration accuracy with NetworX modules. Provide hands-on support for issue analysis, root cause identification, and resolution. Maintain and optimize SQL queries used for data extraction, transformation, and reporting from NetworX and Facets data models. Mentor junior consultants and contribute to knowledge transfer and best practices documentation. Required Skills & Experience:
10+ years of healthcare experience
with at least
5 years of recent TriZetto NetworX pricing configuration experience . Hands-on experience with
Facets ,
NetworX Modeler , and
Integrated NetworX Pricer . Strong knowledge of
NetworX data structures , contract loading, and grouping/pricing logic. Demonstrated expertise in
SQL
for query development and performance tuning. Ability to interpret and implement
payer-provider contract terms
within the system. Understanding of
Facets agreements integration points
and configuration dependencies. Familiarity with
Optum PPS
configurations and pricing methodologies is a plus. Solid grasp of
Medicare, Medicaid, LTSS, DSNP, and Marketplace plan requirements . Preferred Qualifications:
Strong consulting background with the ability to communicate technical concepts clearly to non-technical stakeholders. Experience operating in hybrid resource models (onshore/offshore). Ability to manage competing priorities in a fast-paced, dynamic project environment. Comprehensive documentation skills for technical and operational handoffs.