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.