Senior Facets Claims & Customer Service Workflow Consultant

Cognizant is a leading technology company, and they are seeking a Senior Facets Claims & Customer Service Workflow Consultant. In this role, you will design and deliver scalable Facets Claims and Customer Service Workflow solutions, collaborating with various stakeholders to enhance healthcare payer operations.

Responsibilities:

• Lead configuration design and implementation activities for Facets Claims, PCA, and Customer Service Workflow solutions
• Collaborate with business and operational stakeholders to translate requirements into scalable and reusable configuration solutions
• Facilitate global and detailed design sessions while providing subject matter expertise on Facets functionality and best practices
• Guide configuration activities throughout the project lifecycle, ensuring quality, compliance, and alignment with business objectives
• Develop, maintain, and review configuration documentation and design deliverables
• Support requirements gathering, business process improvement, and workflow optimization initiatives
• Lead configuration testing efforts, including test strategy development, quality assurance, and user acceptance testing support
• Provide technical leadership and mentorship to project teams while driving configuration excellence

Requirements:

• Undergraduate degree or equivalent combination of education and professional experience
• 6+ years of hands-on experience with TriZetto Facets Claims, PCA, and Customer Service Workflow configuration
• 6+ years of healthcare payer industry experience
• Strong understanding of healthcare claims processing, workflow management, and customer service operations
• Experience translating business requirements into effective configuration designs and solutions
• Experience supporting testing, quality assurance, and user acceptance testing activities
• Strong analytical, problem-solving, and decision-making skills
• Excellent written, verbal, and interpersonal communication skills
• Experience leading enterprise Facets implementation, modernization, or transformation initiatives
• Knowledge of Commercial, Medicare, and Medicaid healthcare payer operations
• Experience facilitating design workshops and client-facing requirements sessions
• Familiarity with Agile, Scrum, or hybrid delivery methodologies
• Proven ability to mentor team members and provide configuration leadership across large programs
• Experience driving process improvement and workflow automation initiatives