100% Remote Facets Configuration Subject Matter Expert (SME)
Hybrid • Posted 5 hours ago • Updated 33 minutes ago

DMS Vision Inc.
Dice Job Match Score™
📊 Calculating match score...
Job Details
Skills
- Facets
- Architecture
- architect
- SME
Summary
Hi,
Hope you are doing well,
Please find the job description given below and let me know your interest.
Position: 100% Remote Facets Configuration Subject Matter Expert (SME)
Location: Remote
Duration: 12+month project
Quick Interview
Job Description
The Facets Configuration SME is responsible for designing, configuring and maintaining core Facets benefit, product and pricing configurations to support Commercial, Medicare and Medicaid lines of business. This role partners closely with business, clinical and IT teams to translate operational and
regulatory requirements into accurate, scalable Facets configurations while ensuring compliance, performance and downstream system integrity.
This role is hands-on, detail-oriented and critical to successful implementations, migrations and ongoing operations.
Key Responsibilities Facets Configuration and Design
- Configure Facets products, benefits, plans, riders, accumulators, co-pays, coinsurance, deductibles and limits
- Build and maintain benefit matrices, contract structures and product hierarchies
- Configure provider contracts, reimbursement logic, fee schedules and pricing rules
- Support configuration for Commercial, Medicare Advantage, Medicaid and Marketplace products
- Translate business, regulatory and operational requirements into Facets configuration specifications
- Partner with business analysts, clinical teams and operations to validate benefit intent and edge cases
- Identify configuration gaps, limitations or risks early and recommend solutions
- Support unit testing, integration testing and UAT for configured components
- Analyze claims outcomes to validate benefit and pricing accuracy
- Troubleshoot configuration-related claim, eligibility and enrollment issues
- Support Facets implementations, upgrades, migrations and product launches
- Assist with legacy system migrations and crosswalks into Facets
- Provide go-live and post-go-live stabilization support
- Create and maintain configuration documentation and design artifacts
- Support change management, versioning and configuration governance processes
- Ensure compliance with CMS, state Medicaid and commercial regulatory requirements
Required Skills and Experience Core Skills
- Deep hands-on experience configuring TriZetto Facets
- Strong understanding of healthcare benefits, claims adjudication and pricing logic
- Experience configuring accumulators, benefit tiers and complex cost-share structures
- Ability to analyze claims results and trace configuration impacts
- Experience supporting one or more of:
- Commercial
- Medicare Advantage
- Medicaid
- Marketplace / ACA
- Understanding of CMS and state Medicaid regulations as they relate to configuration
- Strong analytical and problem-solving skills
- Ability to read and interpret Facets tables, configuration screens and output
- Experience working with downstream systems (EDW, reporting, care management, finance)
Preferred Qualifications
- Facets implementation or upgrade project experience
- Experience working in a consulting or managed services environment
- Familiarity with related TriZetto modules (NetworX, TMS, Encounter Management)
- Experience supporting benefit changes during annual product or rate cycles
Soft Skills
- Strong communication skills with both technical and non-technical stakeholders
- Comfortable working in fast-paced, ambiguous environments
- Detail-oriented with a strong sense of ownership and accountability
- Able to independently drive work while collaborating across teams
Thanks & Regards,
Gaurav Gaur
Email: | Phone :
LinkedIn:
DMS Vision ,INC
4645 Avon Lane, Suite 210
Frisco, TX 75033
- Dice Id: 91133942
- Position Id: 2026-2032
- Posted 5 hours ago
Company Info
About DMS Vision Inc.
At DMS Vision, our main goal is to be an integral part of our customer’s success. With ambition to be a Global Premier Provider of innovative, value-based technology solutions, our team has the drive and determination to do whatever it takes to meet the needs of our clients. Through our services, we strive to save our client’s money, time and hassle in every way possible.
At DMS Vision, we provide IT Staffing, Software Development, Cybersecurity and IoT Development and Services.
Whenever we take on a new project, we take extensive measures to learn all that we can take care about our client’s business. This allows us to better understand their goals and become familiar with the company’s philosophy.
We combine the insights obtained from this unique perspective with our professional strategic processes to develop a detailed plan for achieving the client’s ultimate vision of accomplishment. Our collaborative approach to problem solving and our technological expertise enables us to tackle even the most complex of our customer’s problems.
Similar Jobs
It looks like there aren't any Similar Jobs for this job yet.
Search all similar jobs