NetworX Architect - remote
About The Position
This role involves designing and configuring complex pricing logic within the TriZetto Facets Integrated NetworX Pricer software system. The architect will translate managed care provider contract language into fee schedules and rate sheets, manage configuration workflows, and lead testing processes to ensure claim payment accuracy. The position requires advanced SQL skills for data auditing and validation, establishing hierarchical system logic, and implementing pricing updates for compliance. The architect will also serve as a liaison between various teams, including leadership, claims operations, and legal contracting.
Requirements
- Hands-on experience in NetworX Pricer (5-6 years)
- NetworX Configuration (Integrated NetworX)
- Oracle SQL
- Review contract
- Agreement testing
- Migration
- Assignment
Nice To Haves
- Facets
Responsibilities
- 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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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
