This is a remote position.

Key Responsibilities:

• 
  Lead the design and configuration of the Facets platform to support CMS programs, including Medicare Advantage (MA) and Medicaid
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  Architect and maintain system rules, benefit structures, and workflows to ensure accurate claims adjudication and operational efficiency
• 
  Translate complex business and regulatory requirements into scalable system solutions
• 
  Provide technical leadership and guidance across Facets modules and system architecture
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  Oversee and support integrations between Facets and third-party systems and technologies
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  Analyze system performance, troubleshoot complex issues, and implement long-term solutions
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  Collaborate with cross-functional teams including operations, compliance, IT, and external vendors
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  Ensure system configurations meet compliance standards and evolving regulatory requirements
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  Maintain documentation for system architecture, configurations, and integrations

Requirements

Required Qualifications:

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  Minimum of 10 years of hands-on experience with the Facets platform
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  At least 3 years of experience working with CMS work products, including Medicare Advantage (MA) or Medicaid
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  Proficiency in at least six Facets modules, including:
  • 
    Medical Plan
  • 
    Member
  • 
    Practitioner
• 
  Experience working with Facets version 25.1 or newer
• 
  In-depth knowledge of Facets data architecture and underlying infrastructure
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  Proven experience integrating Facets with third-party technologies and systems
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  Strong understanding of healthcare payer operations and claims adjudication processes
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  Excellent communication skills, with the ability to interface with both technical and non-technical stakeholders