Role Summary:

We are seeking experienced TriZetto Clinical CareAdvance (CCA) Configuration SMEs to support a large-scale Utilization Management (UM) and Prior Authorization (PA) modernization program for a leading US Healthcare payer. The role involves hands-on configuration of CCA workflows, business rules, authorizations, correspondence, and integrations.

Key Responsibilities

- Configure CCA workflows and business processes.
- Configure ABRE (Advanced Business Rules Engine) for Prior Authorization and auto-authorization.
- Configure Utilization Management (UM), Appeals & Grievances (A&G;), and clinical workflows.
- Configure TCS correspondence and RightFax integrations.
- Support FACETS integration, benefit mapping, pharmacy,



and provider-administered drug workflows.
- Configure automated case creation, routing, and closure rules.
- Prepare configuration documentation and support CCA platform modernization.

Required Skills

- 5+ years of hands-on TriZetto Clinical CareAdvance (CCA) configuration experience.
- Solid experience with ABRE, Prior Authorization (PA), and Utilization Management (UM).
- Experience with US Healthcare Payer, Medicare, and Medicaid.
- Knowledge of TCS, RightFax, FACETS integration, and clinical workflow configuration is preferred.

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📌 CCA Analyst (Noida)
🏢 Emids Technologies
📍 Noida