Facets Claims Benefit Consultant

Top 3 Must-Haves Strong understanding of the Facets core application functionality, especially benefit structures and claims operations process flows. Expert knowledge in benefit-costs and type of service mapping, limits, and accumulators. Experience with claims root cause analysis, benefits cost shares, PCA, and Workflow to solve. Job Description A Facets Claims Benefit Consultant is responsible for providing customers with application domain expertise related to claims and benefits functionality within the Facets platform. The consultant will conduct requirements discovery sessions with clients to determine outcomes, KPIs, and operational practices for benefits and claims. The role requires excellent general consulting and Facets application skills and may require remote participation. Key Responsibilities Provide advanced analysis, problem-solving, and interpret application configuration. Emphasize benefit structures related to evidence of coverage, claims operations process flows, and best practices in end-to-end design on claims/benefits value chains. Apply expert knowledge in benefit-costs, type of service mapping, limits, and accumulators. Liaison effectively with business and technical groups, transferring Facets application knowledge to client staff. Clearly articulate (both verbal and written) issues and provide alternative solutions. Work effectively with onshore/offshore resource models. Preferred Experience Commercial large implementation experience with Facets. Multiple TriZetto implementation roles. Experience solving benefit cost share and type of service mapping. Strong knowledge of Facets benefit data structures. #J-18808-Ljbffr TechDigital Group