Facets Workflow Consultant

As a Facets Workflow Consultant you'll analyze and optimize claims and benefits workflows within the Facets platform.

Location: Remote (PST)

Summary:

A Facets Workflow Consultant analyzes and optimizes claims and benefits workflows within the Facets platform. The role involves reviewing existing workflow rules, identifying customizations, understanding business outcomes, and supporting clients in improving claims and benefits operations. The consultant must have strong Facets knowledge, analytical skills, and the ability to work with cross functional teams-often remotely.

Skills:

• Facets Workflow Rules Configuration
• SQL for rule impact analysis
• Facets Data Model & Operations
• Knowledge of state/regulatory variations
• Critical thinking & problem solving
• Leadership & collaboration
• Ability to manage large rule inventories

Duties:

• Review 4000+ Facets workflow rules and identify state specific and group specific customizations.
• Map rule dependencies and evaluate downstream impact across claims, membership, billing, and provider modules.
• Document differences between baseline and client specific configurations.
• Work with business, configuration, and QA teams to validate rule behavior.
• Recommend optimizations, including consolidation of redundant rules.

Required:

• 7 8 years as a Business or System Analyst working with Facets.
• Strong understanding of claims workflows, provider validation, and benefits administration.
• Experience reviewing large rule/configuration repositories.
• Solid knowledge of US healthcare payer operations.
• Ability to interpret and analyze complex rules and configurations.
• Strong documentation and communication skills.

Qualifications:

• BE/ME, BTech/MTech, B.Sc./M.Sc. in Engineering or related fields.
• Technical certifications preferred.