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, perk 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