Facets Configuration Specialist
Core
Lead configuration and maintenance of complex, business-critical Facets system tables and data elements across multiple environments.
Role type
Senior Facets configuration specialist
Builds
Facets system configurations for group and member enrollment, provider networks, and claims
Domain
Health insurance technology
Required skills
Facets medical product configuration, group and member enrollment, provider networks, claims, Microsoft SQL, Microsoft Excel
Preferred skills
DevOps, Network
Technologies
Excel, SQL, DevOps, Network
Responsibilities
Lead configuration and maintenance of complex, business-critical Facets system tables and data elements across multiple environments; Analyze, develop, and implement configuration changes to improve system performance and user efficiency; Coordinate configuration accuracy and compliance with change control processes; Provide technical and business expertise to develop proactive configuration solutions for complex issues; Serve as a domain subject matter expert on IT projects, mapping data needs to Facets applications; Review and develop solutions for critical business systems that may affect multiple business areas or applications; Review test scenarios and claims test results, provide feedback to testers, and conduct shadow testing when needed; Lead issue assessment and resolution, including initial severity and business-impact triage, root-cause analysis, process and solution development, claims remediation support, impact analysis, and process updates; Document detailed Facets product configuration requirements, including benefit codes, exceptions, provider tiering, and benefit administration rules; Create design documents that translate business requirements into Facets system setup specifications, and maintain requirements-to-test traceability; Work with Claims, UM, Care Management, and Service teams to gather requirements for claims routing, exception handling, and manual review workflows; Develop workflow designs and configurations, and support claims and service testing