Why This Role Stands Out
This hybrid role offers a valuable opportunity to advance your expertise in NetworX configuration and pricing with a reputable company, potentially leading to extended engagement. You'll thrive here if you possess strong NetworX Pricer and Oracle SQL skills, enjoy translating complex contracts into system logic, and are eager to contribute to critical pricing configurations. We encourage you to apply and explore this exciting career growth prospect.
Quick Overview
Job Description
NetworX Configuration Analyst
Remote
Must Have’s:
- NetworX Pricer and NetworX Modeler experience.
- Provider contract and reimbursement configuration experience. Experience with fee schedules, pricing methodologies, and network reimbursement.
- FACETS configuration and claims adjudication knowledge.
Job Summary
We are seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform. The ideal candidate will have strong healthcare payer experience, expertise in NetworX and FACETS, and the ability to translate provider contract requirements into accurate pricing configurations.
Key Responsibilities
- Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
- Analyze business and contractual requirements and convert them into system configurations.
- Perform pricing validation, claims analysis, testing, and production support.
- Investigate and resolve pricing, reimbursement, and claims adjudication issues.
- Collaborate with Provider Contracting, Claims, Business, and IT teams to implement configuration changes.
- Support UAT, production releases, and post-implementation validation activities.
- Create and maintain configuration documentation and testing evidence.
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