Job Description

* The Facets Specialist will conduct requirements discovery sessions and lead design sessions with the objective of determining how best to design and configureclaims applications within Facets to meet the defined requirements.
* The role requires excellent general consulting and Facets application skills.
* Experience should include a strong understanding of core functionality * The Facets Specialist will conduct requirements discovery sessions and lead design sessions with the objective of determining how best to design and configureclaims applications within Facets to meet the defined requirements.
* The role requires excellent general consulting and Facets application skills.
* Experience should include a strong understanding of core functionality with an emphasis in benefit designs and Claims operations.Experience with claims root cause analysis, benefits cost shares, PCA anduse of Workflow to solve for UM, COB, Provider and member match issues is preferred.
* Serve as a Subject Matter Expert in the FACETS workflow applications and sub-modules.The SME shall provide the client with detailed assessment of existing required workflow claims routing rules and queues structure configuration, and offer recommendations in how to optimize them in order to increase auto-adjudication rate and eliminate bottlenecks within the claims pend processes.The SME resource should also be able to provide concrete project plans to bring the current FACETS Workflow configuration architecture to an optimize future state including: best practice workflow configuration, assessment of workflow sub-modules not currently leveraged, provide measurable metrics of claims performance in workflow queues, and targeted testing of workflow routing routines
* Ability to provide advance analysis, problem solving, and interpret application configuration.
* Good knowledge of Facets data structures.
* Must be able to liaison effectively with business and technical groups and transfer Facets application knowledge to customer's staff.
* Clearly articulate(both verbal and written)issues and provide alternative solutions.