16 results (1 new)
Remote
•
Yesterday
Position: Facets NetworX Developer Location: Remote Job Description: Ability to create/ update NetworX Pricing data like Agreements, Rate Sheets, Rate Terms, Qualifier Groups, Fee Schedule, Networks, Provider Rows. Ability to read Provider Contracts/ Agreements & map to Rate Terms. Ability to Automate loading of NetworX Pricing data using C# API/ SQL Scripting. Regards Krishna eye
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Contract, Third Party
Depends on Experience
Remote
•
Today
Position: Facets NetworX Developer Location: Remote JD: Ability to create/ update NetworX Pricing data like Agreements, Rate Sheets, Rate Terms, Qualifier Groups, Fee Schedule, Networks, Provider Rows. Ability to read Provider Contracts/ Agreements & map to Rate Terms. Ability to Automate loading of NetworX Pricing data using C# API/ SQL Scripting. eye
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Third Party, Contract
Depends on Experience
Remote
•
3d ago
Senior Facets Configuration Analyst Location: Remote Duration: 12+ months Required skills: 3 years of residential requirements in the US; Strong knowledge of the Facets Data Model Expert hands on configuration experience in the following applications: o Facets System Administration o Security profiles o Workflow o NetworX o Product/Benefits 10+ years of Facets configuration experience Thorough understanding of set-up and functionality of the following processes: o Provider o Membership o Claims
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Full-time
Depends on Experience
Remote
•
9d ago
Job Description: Facets configuration analysts with experience in product build and NetworX configuration. Required skills: 3 years of residential requirements in the US; Strong knowledge of the Facets Data Model Hands-on configuration experience within the product Facets module within the last 2 years. 5+ years of Facets configuration experience At least 3 years of experience in Core Functionalities of FACETS which includes Membership, Provider Management, Claim Processing, Billing, Plan/Produ
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Contract
Depends on Experience
Remote
•
9d ago
Position: Facets System Analyst Location: Remote Duration: 12+ Months As a Facets System Analyst, you will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Responsibilities: - Supporting batch and AdHoc member mailings. Researching existing functionality if issues are identified or for impact of new business/project. Working with business partners to confirm/clarify requirements. Documenting details
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Contract
Depends on Experience
Remote
•
28d ago
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 ga
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Contract, Third Party
$55 - $57
Remote
•
6d ago
As an Facets Developeryou will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Mandatory skills Facets.SQL.Excellent communication (listening, written & verbal) and analytical skills.Healthcare Experience.Ability to successfully work on multiple efforts independently and simultaneously.Good to have skills: - JiraMicrosoft (Word, Excel, Teams, SharePoint, Outlook, OneNote, etc.) Intermediate.Facets I
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Third Party, Contract
Depends on Experience
Mountlake Terrace, Washington
•
3d ago
Job Title: Facets Developer NET Developer Job Description With SQL and Healthcare Experience .NET Developer with advanced proficiency in SQL and proven expertise in healthcare applications. Hands-on experience in Facets - Member, Claims, Providers, Accum and open access services (web / REST services APIs). Preferability to have experience to design, build, and deploy intelligent systems powered by Generative AI and Agentic AI frameworks. The successful candidate will be responsible for designin
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Contract
Depends on Experience
Remote
•
15d ago
Our Client, an IT Services and Consulting company, is looking for a Facets Performance Test Engineer to work remotely. Responsibilities: Analyze and design test scripts for performance testingParticipate in internal/customer review status meetings and coordinate with all project stakeholders to communicate testing progressConduct testing for in-scope requirements and functions according to approved test strategy and test planConduct defect triage meetings with development teams, business teams,
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Contract
58 - 60
Hybrid in Grand Rapids, Michigan
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30+d ago
Job Title: Business Systems Analyst 100% Hybrid: Onsite Cadence- Two days per week (Tuesday and second day TBD) Expenses allowed: TBD Equipment to be Provided Must Have Critical thinking skills Effective time management Expert Facets claims processing and configuration knowledge. Extensive medical coding and billing. Moderate clinical edit knowledge. Prior Optum CES or other clinical edit vendor knowledge. Problem solving skillsJob Summary: Under minimal supervision, formulates and defines syste
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Contract, Third Party
Depends on Experience
Hybrid in Grand Rapids, Michigan
•
30+d ago
Job Title: Business Systems Analyst 100% Hybrid: Onsite Cadence- Two days per week (Tuesday and second day TBD) Expenses allowed: TBD Equipment to be Provided Must Have Critical thinking skills Effective time management Expert Facets claims processing and configuration knowledge. Extensive medical coding and billing. Moderate clinical edit knowledge. Prior Optum CES or other clinical edit vendor knowledge. Problem solving skillsJob Summary: Under minimal supervision, formulates and defines syste
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Third Party, Contract
Depends on Experience
Remote
•
8d ago
Ability to create/ update NetworX Pricing data like Agreements, Rate Sheets, Rate Terms, Qualifier Groups, Fee Schedule, Networks, Provider Rows.Ability to read Provider Contracts/ Agreements & map to Rate Terms.Ability to Automate loading of NetworX Pricing data using C# API/ SQL Scripting.
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Third Party, Contract
50 - 55
Remote
•
Today
Benefits Configuration Analyst- Facets Role & Responsibilities: Design, analyze, and implement benefit coding change requests with a high level of precision, ensuring alignment with client specifications and regulatory requirements.Gather, interpret, and evaluate complex client requirements to assess the impact of benefit designs on claims processing; effectively communicate tailored benefit setup options to stakeholders and internal teams, thereby advising on optimal solutions.Manage non-standa
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Full-time
$55,000 - $65,000
Remote
•
13d ago
Must Have s: CWR must have worked in the US for the past 3 years Test Automation, Test Data Management, Cloud Migrations, Business Workflows Testing, Integrations/E2E testing * 4 6 years of automation and testing experience with 2 - 4+ years in healthcare payer system and 3 5+ years automating Facets applications. * Design, develop, and maintain automated test scripts using Selenium and WebDriver for Facets UI based business workflows. * Build and enhance robust test automation frameworks (data
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Contract, Third Party
Depends on Experience
Remote or Georgia
•
Today
Stellar Consulting Solutions is a boutique business & technology consulting company headquartered in Atlanta, GA. We deliver high quality, agile, and experienced workforce for niche technology projects of any scale. We help forward thinking clients to solve specific problems by understanding their needs and align talent that can move fluidly to match skill supply and demand on a real-time basis. Stellar Consulting has a unique combination of technical and digital skills to recruit, engage, and
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Contract, Third Party
$70
Remote
•
7d ago
Job Description:We are seeking an experienced Facets QA Analyst with strong expertise in Facets claims processing, SQL, and healthcare domain knowledge. The ideal candidate will be responsible for creating and executing test cases, validating claim outcomes, performing data analysis, and ensuring system functionality aligns with business requirements. Key Responsibilities:Define, create, and document test cases in Jira based on business and technical requirementsExecute manual and system test ca
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Contract
45 - 45
