Our client, a IT Services and Consulting company, is looking for a Senior Facets Product Consultant / Facets Solution Manager for their Bridgewater, NJ location.
Responsibilities:
The SME shall provide the client with advisory knowledge of configuration structure and provide leadership in implementing or optimizing configuration solutions to increase auto-adjudication rate and/or implement new lines of business.
The SME resource should also provide concrete project plan tasks to bring the current FACETS configuration architecture to an optimize future state, including best practice configuration, assessment of sub-modules not currently leveraged, and provide measurable metrics on configuration approaches.
The Facets Design Specialist will conduct requirements discovery sessions and lead design sessions to determine how best to design and configure applications within Facets to meet the defined requirements.
Understand business and technical requirements, consult customers to design and recommend solution architecture, manage mid and large-sized projects of the following nature( Product updates, Application Maintenance, etc., guide product specialists to ensure complete coverage of client’s requirements and product quality within the client and project specifications
The role requires excellent general consulting and Facets application skills to work with the client technical team to understand: the technical and functional ecosystem; analyze customer requirements; challenges from an IT and business process perspective by interacting with the customer architects / SMEs, and reviewing documentation.
Provide recommendations (e.g., product implementation, platform identification, architecture suitability, gap analysis, customization/bolt-on development and integration, product maintenance) to address the same;
Create the solution architecture; Present the benefits of the solution; Lead Proof of Concept for the business problem; Provide inputs on technical robustness and scalability of the product to the LPC.
Requirements:
Experience: 12–17+ years in healthcare payer systems with 5–10+ years of Facets consulting and implementation experience.
Domain: Health Insurance/Payer (Commercial, Medicare, Medicaid/Medi-Cal).
Critical Skills: Facets (Enrollment, Membership, Billing, Group/Class Plan, Accounting, Claims, UM, COB), Facets configuration, implementation, solution architecture, business consulting, claims analysis, data models, stakeholder management, and team leadership.
Facets product knowledge on enrollment, group class plan, billing, membership, accounting (resource 1) and for resource #2 need to have claims, UM, and COB
Ability to lead business discussions
Excellent communication skills across all levels of the project team, including client and internal teams
Proven track in implementations of Facets product
5-10 years Facets consulting experience
5-10 years of industry knowledge including all LOB (e.g., MediCal/Medicaid, Commercial, Medicare)
Remote Serve as a Consulting team lead and Subject Matter Expert (SME) for core applications and sub-modules.
Experience should include a strong understanding of core functionality, emphasizing Benefits, Providers, Enrollment, and Claims.
Experience with claims root cause analysis, benefits cost shares, PCA, and Workflow to solve UM, COB, Provider, and member match issues is preferred.
Ability to provide advanced analysis, problem-solving, and interpret application configuration.
Good knowledge of Facets data models.
Must be able to liaison effectively with business and technical groups and transfer Facets application knowledge to customer staff.
Clearly articulate (both verbal and written) issues and provide alternative solutions.
Excellent in working with onshore/offshore resource models.