Job Description
As a Facets UM/Pre-Auth Configuration Specialist, you will be part of an Agile team responsible for supporting healthcare applications, configuring utilization management workflows, and implementing new features while following industry-standard development and configuration practices.
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Key Responsibilities
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- 7–10 years of hands-on experience in UM/Pre-Auth configuration within FACETS.
- Strong understanding of UM workflows, clinical guidelines, and state mandates.
- Collaborate with clinical and utilization management stakeholders.
- Demonstrate a deep understanding of US Healthcare payer operations.
- Analyze and implement complex business rules and FACETS configurations.
- Maintain strong technical documentation and communication.
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Required Skills
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- FACETS
- Utilization Management (UM)
- Pre-Authorization / Pre-Auth
- Healthcare Payer Operations
- UM Workflows & Clinical Guidelines
- FACETS Configuration
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Preferred
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- Technical certifications across relevant technologies are desirable.
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