Facets Process & Documentation Specialist

The Opportunity

At Huron, we're redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client's challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together.

Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.

Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.

Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Position Summary

Huron is a global consultancy that partners with healthcare organizations to optimize operations, improve financial performance, and drive sustainable transformation.

We are seeking a Facets Process & Documentation Specialist (DLP | Desk Level Procedures) with strong expertise in health plan operations, membership processing, claims processing system (i.e.: Facets). This role will focus on designing, documenting, and optimizing Desk Level Procedures (DLPs) that support critical payer workflows across membership, claims, benefits, and configuration processes.

This individual will play a key role in translating complex system workflows and business processes into clear, actionable step-by-step procedures that enable operational teams to resolve issues, maintain compliance, and drive consistent execution.

Qualifications

Key Responsibilities

• Design and document comprehensive health plan operations desk level procedures for a health plan.

• Translate business processes and system functionality into clearly defined, step-by-step operational procedures for end users.

• Develop DLPs that outline:

• Standard workflows

• Exception handling processes

• Step-by-step issue resolution procedures

• Ensure documentation is accurate, complete, and aligned with current Facets system behavior and business rules.

• Partner with operations teams align DLPs with Facets system set up across membership, billing, claims, benefits, provider, and pricing modules.

• Translate operations logic into operational procedures for claims processing, adjustments, and issue resolution.

• Support troubleshooting of claims and benefit-related issues tied to configuration gaps or system logic.

• Validate that operational processes reflect accurate claims, adjudication workflows and system dependencies.

• Provide deep subject matter expertise in:

• Membership including premium billing

• Claims adjudication workflows

• Benefits configuration and plan design

• Provider payment and reimbursement processes

• Develop procedures that help teams:

• Investigate errors

• Identify configuration issues

• Execute corrections and reprocessing steps

• Ensure procedures support consistent, complaint claims and benefits operations

• Create DLPs that clearly outline:

• How to identify root causes of claims or configuration issues

• Step-by-step actions to resolve issues within Facets or downstream systems

• Escalation paths and cross-team dependencies

• Partner with operational and IT teams to analyze recurring issues and improve existing procedures.

• Drive consistency in how teams diagnose and resolve claims, configuration, and workflow issues.

• Collaborate with Claims, Enrollment, Provider Configuration, IT, and Operations teams to define and validate processes.

• Translate complex technical and system concepts into clear, business-friendly documentation.

• Support training initiatives by providing DLP documentation and operational guidance for end users

• Continuously evaluate and enhance DLPs to improve:

• Operational efficiency

• Accuracy and consistency

• Issue resolution timelines

• Standardized procedures across clients and environments to ensure repeatable, scalable delivery models.

• Support system implementations, conversions, and operational transformations with DLP development.

Required Qualifications

• 5+ years of experience working within Healthcare Payer operations.

• 5+ years of healthcare payer experience (Medicare and Medicaid).

• 5+ years of hands-on experience with claims systems (Facets, QNXT, HealthRules), particularly in:

• Premium billing

• Claims processing

• Benefits/Provider configuration

• Operational workflows

• Strong experience developing:

• Desk Level Procedures (DLPs)

• SOPs, workflows, or operational documentation

• Deep understanding of:

• Eligibility and premium billing

• Claims adjudication processes

• Benefits configuration and plan structures

• Proven ability to:

• Translate complex processes into clear, step-by-step instructions

• Troubleshoot and resolve system/process-related issues

• Experience working in a consulting or client-facing environment.

• Experience building training materials or user guides.

• AI Tools experience with Copilot, ChatGPT, Claude

The estimated base salary for this job is $105,000 - $135,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes, and required travel. This job is also eligible to participate in Huron's annual incentive compensation program, which reflects Huron's pay for performance philosophy. The job is also eligible to participate in Huron's benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

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Posting Category

Healthcare-Payer

Opportunity Type

Regular

Country

United States of America