QNXT & NetworX or HealthRules Configuration Analyst / SME

• H1-B sponsorship is NOT available
  
• No 3rd party/C2C vendors

MUST HAVE HEALTHCARE  AND NETWORX CONFIGURATION EXPERIENCE TO BE CONSIDERED. 

AXIOM Systems, Inc. is the premier healthcare IT and business solutions provider specializing in support for the system integration, implementation, enterprise reporting, HIPAA and EDI needs of healthcare organizations. AXIOM is unique in its ability to develop and implement practical, effective solutions based on its deep knowledge of the healthcare industry.

To support its clients AXIOM is looking for QNXT & NetworX or HealthRules Configuration Analyst / SME. The ideal candidate will have expert (SME) level experience configuring/integrating and testing various contracts within Cognizant/TriZetto NetworX Pricer including experience with Pricing, Fee Schedules, DRG tables and Providers.

 RESPONSIBILITIES:

• Interpret provider contracts and configure NetworX Pricer (creating new agreements if needed or updating existing) for the following types of agreements: Professional, ASC, SNF, Hospital (including DRG, APC, CAH, per diems, case rates etc.).
• Update existing agreements to add in new terms for Medicare and Medicaid.
• Update existing agreements to add in new gap fill pricing terms.
• Update existing agreements to move to “current year†fee schedules, DRG tables etc.
• Add network/agreement rows to providers as needed based on contract, providers etc.

 QUALIFICATIONS:

• Demonstrated SME/EXPERT level skills with QNXT & NetworX or QNXT & HealthRules Configuration.
• 5+ years experience configuring Benefits within QNXT, NetworX and/or HealthRules. 
• Experience with Medicare/Medicaid a plus, but not required.
• Ability to adequately test terms being added to assure we are achieving intended results.
• Ability to interpret contracts and translate into HealthRules or NetworX agreements. 
• Proven ability to quickly integrate existing knowledge to QNXT, HealthRules or NetworX configuration.
• Bachelor's degree or equivalent experience in relevant field required.