Facets Design Specialist (Remote - USA)

As a Facets Design Specialist, you will make an impact by serving as a trusted advisor, solution architect, and subject matter expert for Facets core applications and configuration. You will help healthcare payer clients optimize Facets functionality, improve claims auto-adjudication performance, support new business implementations, and drive strategic configuration transformation initiatives.

You will be a valued member of the Healthcare Consulting team, collaborating closely with client business leaders, technical teams, architects, product specialists, and offshore delivery teams to deliver scalable, high-quality Facets solutions.

In this role, you will:

Serve as the lead Facets Subject Matter Expert (SME), providing guidance on application design, configuration strategy, and optimization opportunities.

Lead requirements discovery, solution design, and configuration workshops to translate business needs into effective Facets solutions.

Assess current-state Facets environments and develop future-state configuration roadmaps that improve efficiency, scalability, and claims auto-adjudication rates.

Provide architecture recommendations, gap analyses, implementation strategies, and integration approaches to support business and technology objectives.

Lead proofs of concept, solution demonstrations, and design discussions while ensuring alignment with client requirements and industry best practices.

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants anywhere in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

10+ years of experience working with TriZetto Facets implementation, configuration, optimization, or consulting engagements.

Deep expertise in Facets core modules, including Benefits, Providers, Enrollment, and Claims.

Experience leading requirements gathering, solution design, configuration strategy, and application architecture discussions.

Strong understanding of healthcare payer operations, business processes, and Facets configuration best practices.

Experience conducting configuration assessments and developing actionable roadmaps for modernization and optimization initiatives.

Proven ability to analyze business and technical requirements and translate them into scalable solution architectures.

Experience supporting product upgrades, application maintenance, enhancement initiatives, and large-scale implementation projects.

Strong knowledge of Facets data models and application architecture.

Experience presenting recommendations and solutions to executive stakeholders, business leaders, and technical teams.

Excellent written and verbal communication skills with the ability to explain complex concepts to both technical and non-technical audiences.

Experience working successfully within onshore/offshore delivery models.

Experience improving claims auto-adjudication performance through configuration optimization.

Strong background in claims root cause analysis and issue resolution.

Experience with Benefits Cost Share configuration, PCA, Workflow, and troubleshooting UM, COB, Provider, and Member Match issues.

Experience identifying and implementing underutilized Facets modules and functionality.

Consulting experience supporting healthcare payer digital transformation or modernization initiatives.

Experience leading cross-functional teams and mentoring junior consultants or product specialists.