Facets configuration Analyst

Job Description:

We are seeking an experienced Facets Configuration Pricing Analyst to join our healthcare team in a fully remote capacity. The ideal candidate will bring deep expertise in configuring the Facets Pricing module, with a focus on provider contracting, claims adjudication, and benefit plan setup. This role requires a strong understanding of healthcare payer systems and hands-on experience with pricing and network configuration within the Facets platform.

Key Responsibilities:

• Configure and maintain pricing structures within the Facets Pricing Module

• Set up and manage NetworX Pricer, Benefit Plans, and related configuration components

• Collaborate with Provider Contracting teams to translate business rules into system configuration

• Analyze and support Claims Adjudication processes related to pricing discrepancies or escalations

• Ensure compliance with Medicare, Medicaid, and commercial payer guidelines

• Participate in testing and validation of pricing setups to ensure accurate claim outcomes

• Document configuration changes and maintain audit-ready records

• Work with cross-functional teams including IT, business analysts, and QA to implement and troubleshoot system changes

Required Skills & Experience:

• 7+ years of hands-on experience with Facets Pricing Module Configuration

• Strong understanding of Provider Contracting and Claims Adjudication workflows

• Experience with NetworX Pricer and Benefit Plan Setup in Facets

• Healthcare payer background (Medicare/Medicaid experience is a strong plus)

• Ability to analyze pricing and adjudication results to identify issues and propose solutions

• Excellent communication and documentation skills

• Experience working in an Agile or collaborative project environment is preferred

Nice to Have:

• Knowledge of Facets Extensions or custom pricing logic

• Experience with integration testing and test data setup

• Familiarity with healthcare regulations and value-based payment models