NetworX Architect - remote
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AI Summary
The Network Architect is responsible for designing and overseeing the implementation of complex network infrastructure solutions. They will ensure system scalability, security, and performance across the organization's remote and on-site environments.
Role: NetworX Architect
Remote – EST, but HM is flexible if candidate is strong
Potential for extension
Work type: W2
Design work
Must have hands on experience in NetworX Pricer (5-6 yrs)
Facets is not required, but nice to have
NetworX Configuration (Integrated NetworX)
Oracle SQL
Review contract, Agreement testing, migration, assignment
• Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system.
• Translate managed care provider contract language into precise fee schedules, rate sheets, and system qualifiers.
• Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion projects across platforms.
• Direct comprehensive unit, regression, and end-to-end testing processes to ensure absolute claim payment accuracy.
• Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot massive configuration data batches.
• Establish hierarchical system logic to correctly prioritize specific provider agreements over standard, regional fallback rates.
• Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and Medicaid rules.
• Act as the primary liaison between Configuration of leadership, claims operations, and the legal contracting team.
Remote – EST, but HM is flexible if candidate is strong
Potential for extension
Work type: W2
Design work
Must have hands on experience in NetworX Pricer (5-6 yrs)
Facets is not required, but nice to have
NetworX Configuration (Integrated NetworX)
Oracle SQL
Review contract, Agreement testing, migration, assignment
• Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system.
• Translate managed care provider contract language into precise fee schedules, rate sheets, and system qualifiers.
• Manage day-to-day configuration workflows, mentor configuration analysts, and coordinate system conversion projects across platforms.
• Direct comprehensive unit, regression, and end-to-end testing processes to ensure absolute claim payment accuracy.
• Utilize advanced SQL queries and relational databases to audit, validate, and troubleshoot massive configuration data batches.
• Establish hierarchical system logic to correctly prioritize specific provider agreements over standard, regional fallback rates.
• Monitor and implement quarterly pricing component updates to maintain strict compliance with CMS, Medicare, and Medicaid rules.
• Act as the primary liaison between Configuration of leadership, claims operations, and the legal contracting team.
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