Facets Claims & Utilization Management (UM) Configuration Lead - Remote

Remote – Full-Time

About the role

As a Facets Claims & Utilization Management (UM) Configuration Lead, you will design and deliver scalable configuration solutions that support critical healthcare payer operations. You will be a valued member of the Healthcare Platform Consulting team and work collaboratively with business stakeholders, operations teams, product leaders, care management teams, network teams, and technology partners to optimize and enhance the TriZetto Facets platform. This role is ideal for a healthcare configuration professional who enjoys solving complex business challenges, influencing platform strategy, and driving successful implementation outcomes across enterprise healthcare environments.

Responsibilities

• Lead the design, configuration, and implementation of Facets Claims and Utilization Management solutions based on approved business requirements.
• Partner with business and operational stakeholders to develop scalable, reusable configuration solutions that support organizational growth and efficiency.
• Provide configuration leadership and subject matter expertise during global and detailed design sessions.
• Guide configuration activities across the project lifecycle, ensuring adherence to quality standards, timelines, and business objectives.
• Develop and maintain configuration documentation, ensuring accuracy, completeness, and business approval.
• Collaborate with operations, product, network, care management, and technology teams to define and deliver configuration requirements.
• Support requirement gathering and business process improvement initiatives by providing expertise in Facets functionality and capabilities.
• Lead configuration testing efforts, including test strategy development, test case creation, quality assurance, and user acceptance testing activities.

Requirements

• Bachelor’s degree or equivalent combination of education and professional experience.
• 5+ years of hands-on experience configuring TriZetto Facets Claims and Utilization Management (UM) modules.
• 5+ years of healthcare payer industry experience.
• Strong understanding of healthcare claims processing, utilization management workflows, and healthcare operations.
• Experience translating business requirements into effective system configuration solutions.
• Proven ability to lead configuration design activities across complex healthcare implementations.
• Experience supporting quality assurance, configuration testing, and user acceptance testing initiatives.
• Strong verbal and written communication skills with the ability to engage effectively with both business and technical stakeholders.

Skills

• Experience leading enterprise-scale Facets implementation, enhancement, or modernization initiatives.
• Knowledge of healthcare payer functions including Claims, Care Management, Provider Operations, and Utilization Management.
• Experience facilitating design workshops and client-facing requirements sessions.
• Familiarity with Agile and hybrid delivery methodologies.
• Demonstrated ability to mentor team members and provide configuration thought leadership across large programs.

Pay

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

• 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