Senior Facets Product Consultant / Facets Solution Manager

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.
• Years of Experience: 17.00 Years of Experience

Skills:

• Category Name Required Importance Experience
• Facets Facets - Billing Yes 1
• Facets Facets - Membership Yes 1

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities