Facets Developer
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Job Location:
Portland, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
4 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Title: Facets Developer
Location: - Remote
Experience: 8Years
What is in it for you
As an Facets with pre-Auth you will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards .
Responsibilities: -
- A Facets UM Consultant is responsible for providing customers with application domain expertise related to Utilization Management rules and processes within the Facets platform. The consultant will analyze and review the existing Pre-Auth/UM rules configuration (both core and custom defined) and conduct requirements discovery sessions with clients to finalize outcomes KPIs and operational practices for the modified UM rules in adherence to State mandates
- Review and analyze FACETS Pre-Auth/UM rules for state-specific customization.
- Evaluate rule logic for authorization routing benefit limits and medical necessity guidelines.
- Identify gaps affecting intake determination and UM workflows. Work closely with UM operations clinical teams and configuration groups.
- 5 - 8 years in UM/Pre-Auth configuration within FACETS.
- Familiarity with UM workflows clinical guidelines and state mandates.
- Experience working with clinical/utilization management stakeholders.
- Deep understanding of US Healthcare payer operations.
- Ability to analyze complex rules and configurations.
Educational Qualifications: -
- Engineering Degree BE/ME/BTech/MTech/BSc/MSc.
Technical certification in multiple technologies is desirable.
Skills: -
Mandatory skills
Pre- Auth Healthcare
