Claims examiner Jobs in Chesapeake, VA

Facets Consulting Manager (Claims & Benefits)

As a Facets Consulting Manager, you will make an impact by helping healthcare payer organizations optimize claims and benefits operations through deep Facets expertise, business process transformation, and strategic consulting.

You will be a valued member of our Healthcare Consulting team, partnering with client stakeholders, operational leaders, business analysts, architects, and delivery teams to design and implement solutions that improve operational performance, claims outcomes, and member experiences.

In this role, you will:

• Lead requirements discovery workshops and consultative sessions to define business outcomes, key performance indicators (KPIs), and operational improvement opportunities across claims and benefits functions.
• Serve as a trusted advisor and subject matter expert on Facets claims and benefits capabilities, guiding clients on best practices, configuration approaches, and operational optimization strategies.
• Analyze business requirements and translate them into scalable solutions that improve efficiency, quality, and performance across healthcare payer operations.
• Provide advanced problem-solving, root cause analysis, and recommendations for complex claims processing, benefits configuration, and operational workflow challenges.
• Partner with business and technical teams to develop and implement end-to-end solutions across claims, benefits, enrollment, provider, and member service functions.
• Facilitate knowledge transfer and mentor client teams on Facets functionality, operational processes, and industry best practices.
• Collaborate effectively with onshore and offshore teams to deliver high-quality consulting services and successful client outcomes.

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 throughout the United States.

Regardless of your working arrangement, we are committed to supporting a healthy work-life balance through our wellbeing programs and flexible work environment.

What you need to have to be considered

• 8+ years of experience working with TriZetto Facets in healthcare payer environments.
• Proven experience leading business analysis, consulting, or solution design initiatives focused on claims and benefits operations.
• Deep understanding of healthcare payer business processes, including claims adjudication, benefits administration, enrollment, provider operations, and member services.
• Strong knowledge of Facets core functionality, configuration concepts, and data structures.
• Experience conducting requirements gathering, stakeholder workshops, process assessments, and solution design sessions.
• Demonstrated expertise in claims root cause analysis, operational problem-solving, and process optimization.
• Ability to communicate complex business and technical concepts to both executive and operational stakeholders.
• Strong leadership, consulting, facilitation, and stakeholder management skills.
• Experience working within global delivery environments utilizing both onshore and offshore teams.

These will help you stand out

• Experience with benefits cost-share configuration and claims processing optimization.
• Knowledge of PCA, Utilization Management (UM), Coordination of Benefits (COB), Provider, and Member Match workflows.
• Experience designing or optimizing end-to-end claims and benefits value chains.
• Prior healthcare payer consulting experience with large-scale transformation initiatives.
• Experience developing KPIs, operational metrics, and continuous improvement strategies.
• Familiarity with workflow-driven solutions that improve claims quality, accuracy, and auto-adjudication performance.

Salary and Other Compensation

Applicants will be accepted till 10/15/2026

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 $130,000 - $150,000 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

• 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!

About Cognizant

Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization's unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at cognizant.ai or @cognizant.

Things to know before you apply

• Work authorization: Cognizant will only consider applicants for this position who are legally authorized to work in Canada without requiring employer sponsorship, now or at any time in the future.
• Accommodations: If you have a disability that requires reasonable accommodation to search for a job opening or submit an application, please email CareersNA2@cognizant.com with your request and contact information.
• AI in hiring: We use artificial intelligence (AI) tools to help us screen and assess applications more efficiently. Our team performs additional human review and ultimately decides who moves forward in our hiring process.
• Open position: Unless otherwise stated, this job posting is for an open position on our team.
• Language proficiency: We ask that all candidates have basic English proficiency for company-wide communications purposes. For roles based in Quebec, professional English proficiency is required, as you'll deliver services to and collaborate with stakeholders outside the province who may not speak French.
• Inclusion: Cognizant is an equal opportunity employer. Your application and candidacy will not be considered based on race, color, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, provincial or local laws.