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Healthcare Payer Consultant - QNXT

Location: Remote

Employment Type: Full-Time

Job ID: 00070835941

Healthcare Payer Consultant - QNXT

About the role

As a QNXT UM/A&G Consultant , you will make an impact by helping healthcare payers optimize member and provider communications through effective utilization management and appeals & grievances correspondence solutions. You will be a valued member of the healthcare consulting team and work collaboratively with clients, delivery teams, product teams, and cross-functional stakeholders.

In this role, you will:

+ Serve as a subject matter expert for Utilization Management (UM) and/or Appeals & Grievances (A&G) workflows within healthcare payer organizations.

+ Configure, analyze, and support correspondence and communication solutions leveraging QNXT UM and/or A&G functionality.

+ Consult with clients on complex Medicare and commercial letter requirements, including triggering mechanisms, business rules, and communication design.

+ Gather, analyze, and document business requirements and translate them into scalable communication solutions.

+ Manage multiple project timelines while collaborating with offshore teams and cross-functional stakeholders to achieve project objectives.

Work model

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants within the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

What you need to have to be considered

+ Strong experience supporting healthcare payer operations, including Utilization Management and/or Appeals & Grievances processes.

+ Advanced knowledge of QNXT UM and/or A&G.

+ Advanced proficiency in Microsoft Word and Excel.

+ Experience gathering business requirements and translating them into client solutions.

+ Working knowledge of XML design and content development.

+ Intermediate proficiency with Adobe Illustrator, Photoshop, and InDesign.

+ Strong analytical, troubleshooting, and problem-solving skills.

+ Experience managing multiple priorities and collaborating with both onsite and offshore teams.

+ Strong verbal, written, and presentation communication skills.

These will help you stand out

+ Deep understanding of healthcare payer operations, including Commercial, HMO, PPO, Medicare, Medicaid, and other government-sponsored programs.

+ Experience with healthcare correspondence, document publishing, or communications management solutions.

+ Experience with graphic design, content publishing, and editing.

+ Knowledge of the TriZetto product suite.

+ Ability to write clear, concise explanations of complex business and technical concepts.

+ Strong proofreading, organizational, and attention-to-detail skills.

+ Basic knowledge of SQL and/or Oracle.

+ Self-motivated with strong research and investigative capabilities.

Salary and Other Compensation:

Applicants will be accepted till 11/15/2026

Cognizant will only consider applicants for this position who are legally authorized to work in the United States without company sponsorship.

_*Please note, this role cannot offer visa transfer or sponsorship now or in the future*_

The annual salary for this position will be in the range of $113,000 - $132,000 depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

+ Medical/Dental/Vision/Life Insurance

+ Paid holidays plus Paid Time Off

+ 401(k) plan and contributions

+ Long-term/Short-term Disability

+ Paid Parental Leave

+ Employee Stock Purchase Plan

Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Our strength is built on our ability to work together. Our diverse backgrounds offer different perspectives and new ways of thinking. It encourages lively discussions, creativity, productivity, and helps us build better solutions for our clients. We want someone who thrives in this setting and is inspired to craft meaningful solutions through true collaboration.

If you are content with ambiguity, excited by change, and excel through autonomy, we'd love to hear from you!

Apply Now!

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Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

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Healthcare Payer Consultant - QNXT

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