NetworX Configuration Analyst Role
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AI Summary
The NetworX Configuration Analyst will configure and maintain complex pricing logic within the TriZetto Facets Integrated NetworX Pricer system. They will also translate provider contract language into accurate fee schedules and lead testing initiatives to ensure precise claim payments.
Hiring: NetworX Configuration Analyst
Location: Remote – EST Time Zone
Employment: Only W2
NO OPT/CPT
Experience: 12+ years overall relevant experience; 5-6 years of hands-on NetworX Pricer experience (MANDATORY)
Location: Remote – EST Time Zone
Employment: Only W2
NO OPT/CPT
Experience: 12+ years overall relevant experience; 5-6 years of hands-on NetworX Pricer experience (MANDATORY)
Job Summary
We are looking for an experienced NetworX Configuration Analyst with strong hands-on expertise in TriZetto Facets Integrated NetworX Pricer and healthcare/managed care pricing configuration.
The ideal candidate will have extensive experience translating provider contract language into accurate pricing configurations, fee schedules, rate sheets, and system qualifiers. This role will also support configuration testing, data migration, pricing updates, and collaboration with claims, contracting, legal, and configuration teams.
Key Responsibilities
- Configure, maintain, and model complex pricing logic within the TriZetto Facets Integrated NetworX Pricer system.
- Translate managed care provider contract language into accurate fee schedules, rate sheets, and system qualifiers.
- Perform day-to-day NetworX configuration and configuration workflow management.
- Mentor configuration analysts and coordinate system conversion and migration initiatives.
- Review provider contracts and perform agreement testing and configuration validation.
- Lead unit, regression, and end-to-end testing to ensure accurate claim payment.
- Develop and use advanced Oracle SQL queries to audit, validate, and troubleshoot configuration data.
- Establish hierarchical pricing logic to prioritize specific provider agreements over standard and regional fallback rates.
- Monitor and implement quarterly pricing component updates.
- Ensure pricing configurations align with CMS, Medicare, and Medicaid requirements.
- Collaborate with configuration leadership, claims operations, legal, and contracting teams.
- Support data migration, system conversion, and configuration validation activities.
Mandatory Skills
- NetworX Pricer
- Integrated NetworX / TriZetto Facets NetworX
- NetworX Configuration
- 5–6 years of hands-on NetworX Pricer experience
- Advanced Oracle SQL
- Contract Review
- Agreement Testing
- Configuration Testing
- Data Migration
- Unit, Regression, and End-to-End Testing
- Healthcare / Managed Care Pricing Configuration
Nice-to-Have Skills
- TriZetto Facets
- Claims Operations experience
- CMS, Medicare, and Medicaid pricing rules
- Configuration team mentoring
- System conversion projects
- Relational database auditing
Candidate Requirements
- 10+ years of overall relevant experience.
- 5–6 years of hands-on NetworX Pricer experience is required.
- Strong healthcare/managed care pricing configuration background.
- Must be comfortable working remotely within the EST time zone.
- Strong analytical, testing, troubleshooting, and communication skills.
- Only W2 candidates.
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