Facets Product and Benefits Consultant (Remote - US)

About The Role

As a Facets Product and Benefits Consultant, you will make an impact by designing, configuring, and implementing healthcare products and benefit plans within the Facets platform. You will be a valued member of the healthcare payer team, collaborating with business stakeholders, operations, claims, product, network, quality assurance, and technology teams to deliver scalable, compliant, and accurate benefit solutions that support effective claims adjudication and member experiences.

Responsibilities

• Analyze business, operational, and regulatory requirements and translate them into effective Facets Product and Benefits configurations.
• Design healthcare products, benefit structures, accumulators, cost-sharing models, coverage tiers, and network-based benefit rules.
• Configure, validate, and maintain Facets Product and Benefits components while ensuring solution quality, scalability, and alignment with business requirements.
• Partner with cross-functional teams to assess impacts across claims, pricing, provider networks, eligibility, and downstream systems.
• Develop test scenarios and validate claims outcomes for deductibles, copays, coinsurance, out-of-pocket maximums, accumulators, and network variations.
• Troubleshoot configuration issues, perform root cause analysis, and implement sustainable resolutions.
• Support production implementations, product launches, benefit updates, releases, and post-production stabilization activities.

Requirements

• Bachelor's degree in Information Technology, Business, Healthcare Administration, or a related field, or equivalent professional experience.
• 6+ years of healthcare payer experience, including at least 4 years of hands-on Facets Product and Benefits configuration experience.
• Strong expertise in healthcare benefit design, including copays, coinsurance, deductibles, out-of-pocket maximums, accumulators, limits, exclusions, and network variations.
• Deep understanding of how product and benefit configuration impacts claims adjudication, pricing, provider networks, eligibility, and membership processing.
• Experience documenting requirements, developing solution designs, performing configuration analysis, and supporting end-to-end testing activities.
• Strong analytical, problem-solving, communication, and stakeholder management skills.
• Experience supporting Commercial, Medicare, Medicaid, or other healthcare payer lines of business.

Qualifications

• Experience supporting Facets implementations, benefit renewals, platform modernization initiatives, or large-scale configuration remediation projects.
• Knowledge of Commercial, Medicare Advantage, Medicaid, Exchange, and ASO healthcare products.
• Experience with SQL, data analysis, configuration comparison tools, or Facets interface and batch processing.
• Familiarity with healthcare regulatory requirements, compliance standards, and audit controls.
• Experience working within Agile delivery environments and cross-functional implementation teams.

Skills

• Strong analytical and problem-solving skills.
• Effective communication and stakeholder management abilities.
• Ability to work independently and collaboratively.
• Proficiency in healthcare benefit design and configuration.

Benefits

• Medical/Dental/Vision/Life Insurance
• Paid holidays plus Paid Time Off
• 401(k) plan and contributions
• Long-term/Short-term Disability
• Paid Parental Leave
• Employee Stock Purchase Plan