Lead Facets Product Consultant

Lead Facets Product Consultant

Location: USA -
Remote

Employment Type:
Full-Time

Job :

About the role

As a Facets Product Consultant / Facets Design Specialist, you will make an impact by providing deep Facets platform expertise, leading solution design initiatives, and helping healthcare clients optimize their Facets configuration architecture to improve claims processing efficiency, increase auto-adjudication rates, and support new lines of business.

You will be a valued member of the healthcare consulting team, collaborating with business stakeholders, technical teams, architects, and client leadership to deliver innovative Facets solutions that drive operational excellence and measurable business outcomes.

In this role, you will:

• Serve as the Facets Subject Matter Expert (SME) and trusted advisor for core Facets applications and sub-modules, providing strategic guidance on configuration design and optimization.
• Lead requirements discovery workshops and design sessions to translate business needs into scalable Facets solutions and configuration strategies.
• Evaluate current Facets environments and develop roadmaps to an optimized future-state architecture, including recommendations for best practices, underutilized functionality, and measurable performance improvements.
• Provide advanced analysis, troubleshooting, root cause identification, and solution recommendations for complex claims processing and configuration challenges.
• Partner with business and technical teams to implement solutions across Benefits, Provider, Enrollment, Claims, and ITS functions while facilitating knowledge transfer to client staff.
• Support Facets ITS initiatives, mandates, and application enhancements across enterprise healthcare environments.
• Collaborate effectively within onshore and offshore delivery models to ensure successful project execution and client satisfaction.

Work model

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants throughout the United States.

Regardless of your working arrangement, we are committed to supporting a healthy work-life balance through our wellbeing programs and flexible work environment.

What you need to have to be considered

• 8+ years of experience working with Tri Zetto Facets in healthcare payer environments.
• Proven experience serving as a Facets SME, Product Consultant, Functional Lead, or Design Specialist.
• Strong expertise across Benefits, Provider, Enrollment, Claims, and ITS functionality.
• Deep understanding of Facets configuration architecture, claims adjudication processing, and Facets data structures.
• Experience leading requirements gathering, solution design workshops, and configuration strategy discussions with business stakeholders.
• Strong experience performing claims root cause analysis and resolving complex configuration and processing issues.
• Demonstrated ability to analyze business requirements and translate them into effective Facets configuration solutions.
• Exceptional verbal and written communication skills with the ability to present recommendations and influence stakeholders at multiple levels.
• Experience working successfully within onshore and offshore delivery models.

These will help you stand out

• Experience optimizing Facets environments to improve auto-adjudication rates and operational efficiency.
• Expertise with benefits cost share configuration, PCA, and claims processing optimization.
• Experience leveraging Workflow to address Utilization Management (UM), Coordination of Benefits (COB), Provider, and Member Match scenarios.
• Healthcare consulting experience supporting large-scale payer transformation programs.
• Experience developing implementation of roadmaps, configuration…