Facets Configuration for Hyderabad with Top Leading US Healthcare

Roles & Responsibilities:

Understanding the Business requirements and Change Requirements.
Configuring/ Building the product based on the customer needs and requirements Quality check of the products configured by other team members

Creating and executing test cases for different modules in Facets

Tracking and Reporting the Defects

Attending the daily scrum calls

Involve in defect calls & status meetings

Updating the daily status to project manager

Attending weekly Onshore/offshore conference calls

Total Exp:7+yrs


Required Qualifications:

At least 7 years of experience in Healthcare IT in Payer domain.

2 to 5 years of experience with Facets on the following modules Claims, Benefit Plans / Product, Membership, Provider, Billing, Capitation, Commissions, Utilization Management (UM), Enrollment, Network Management, Profile Pricing, Customer Service, Letters

2 to 5 of experience on configuration and testing on the above mentioned modules

2+ Years of general consulting experience.

Experience in end-to-end Facets implementations

Interpret and configure & test the provider contracts and pricing methodologies

Experience in converting the client requirement into user stories and business requirement

Hands on experience on Facets configuration and testing of the facets claims system, must have an in-depth understanding of the claims adjudication process.

Proven ability to support complex system configuration changes and new configuration requirements, including configuration analysis, and product design, build and test.

Experience working with EDI systems and good knowledge of the HIPAA 5010 transactions.

Experience in client facing consulting experience and leading multiple Facets engagement are added advantage

Good knowledge of Facets claim system data structure schema preferred

Ability to work with Facets using SQL & Experience in running complex SQL queries and data integration is a plus

Experience with commercial, group/individual, Medicare, Medicaid plans are plus

Enrollment experience, Claims test pro experience, Knowledge of the networX pricing tool is an added advantage

AHM-250 or PAHM certification from the Professional Academy for Healthcare Management is a plus.

Strong written and verbal communication and presentation skills, organizational and comprehension capabilities for communication on project status and issues interface with Client and internal stakeholders.