FACETS Consultant (with Pre-Auth/UM configuration)

Position: FACETS Consultant (with Pre-Auth/UM configuration)
Location: Remote
Employment: Contract


Job Description:
We are looking for a FACETS UM Consultant with strong experience in Utilization Management (UM) and Pre-Authorization (Prior Authorization) configuration within the FACETS platform.
 

Key Responsibilities:

• Analyze and review existing FACETS Pre-Auth/UM rules (core & custom)
• Evaluate rule logic for authorization routing, benefit limits, and medical necessity
• Identify gaps in intake, determination, and UM workflows
• Conduct requirement discovery sessions with clients
• Ensure compliance with state mandates and regulatory requirements
• Collaborate with UM operations, clinical teams, and configuration teams

Required Skills:

• 8 years of experience in FACETS UM / Pre-Auth configuration
• Strong understanding of US Healthcare payer operations
• Experience with UM workflows and clinical guidelines
• Ability to analyze complex rule configurations and processes
• Strong stakeholder communication and collaboration skills