A new Job, ID: 236069 <http://ejobsville.com/display-job/236069> was added at eJobsVille.com - For the Best Tech Jobs in Town <http://ejobsville.com/>
Title: Facets Config and Auto-Adjudication Specialist posted on 2014-09-02 20:33:49 Job Description:*Position : Facets Config and Auto-Adjudication Specialist * Contract : 7 Month Contract-to-hire Location : Eden Prairie, MN **Must pass a drug test and background check once offered the position** Mid-level position working with a team of healthcare professionals responsible for the creation and evaluation of requirements, solution creation, selection, and architectural consulting based on established standards and existing architecture. Drive and oversee the development of Solutions from inception to deployment and ensure they do not deviate from the original design. Contribute to project estimation and scheduling by offering high-level solutions based on brief overviews of client needs. Utilize detailed knowledge of the Trizetto Facets application in the design and build of plan/products/benefits. Ability to leveraging existing configuration components. Be involved in the review and testing of configurations. Utilize knowledge of both the front end and back end components of Facets in order to query configurations and other data and determine approaches required to design and build configurations. *Qualifications: * - Must have a working knowledge of business processes and IT platforms in the following areas, and be an expert in the first two: - Benefit, Pricing and Claim Platform Configuration (expert) - Auto-Adjudication (expert) - Provider pick and Member pick processes and techniques - Claim pend logic, Claim payment logic - Contracts and pricing - Integrating with pricing and clinical editing engines - UM – Authorization matching - COB and TPL processing - Billing and Payments (Capitation, Claims, Commissions) - Expert in Facets Application Architecture and Configurable components - Understands benefit needs, interprets in Facets way and perform benefit configuration, group structure configuration, etc - Working knowledge of multiple claims processing platforms - Strong understanding of customer and market dynamics and requirements - Ability to recognize revenue generating opportunities. - Ability to develop and deliver presentations to ‘C’ level executives Job Requirements: *Job Requirements:* - Bachelor’s Degree in Computer Science, Information Systems or other related field, or equivalent work experience. Master’s degree preferred. - 5+ years working in healthcare - 3+ years platform configuration experience in Facets including NetworkX (Configuration Architect, Designer, Implementor) - 1+ years experience functioning in a virtual environment - 1+ years working in a matrix organization - Ability to travel 75% - 100% is required *Click here to view full job description and apply <http://ejobsville.com/display-job/236069> (Registration not mandatory to apply for this job)* ------------------------------ Best regards, eJobsVille.com - For The Best Tech Jobs In Town -- You received this message because you are subscribed to the Google Groups "Oracle-Projects" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. To post to this group, send email to [email protected]. Visit this group at http://groups.google.com/group/oracle-projects. For more options, visit https://groups.google.com/d/optout.
