Facet Consultant

Yuvarnan C K

VBeyond Corporation · Technical Recruiter

Active within past month

Job description

Role : Facets with pre-Auth
Mode : Contract
Location : Remote

UM & Pre-Auth
• UM (Utilization Management): Managing and reviewing healthcare services to determine whether they are medically necessary.
• Pre-Authorization (Prior Authorization): Obtaining approval from the insurance company before certain treatments, procedures, or medications are provided.
2. Front-End and Back-End Tables
The client expects experience working with FACETS database tables and configuration screens:
• Front-end: FACETS application/configuration screens where rules are set up.
• Back-end: Dat
• abase tables where FACETS configuration and healthcare data are stored.
3. FACETS Configuration
The candidate should have hands-on experience configuring FACETS, such as:
• UM and Pre-Authorization rules
• Benefits and healthcare plans
• Authorization workflows
• Clinical rules and requirements

• Payer/business configuration

As a Facets with Pre-Auth, 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:
• 7 - 10 years in UM/Pre-Auth configuration within FACETS.
• Familiarity with UM workflows, clinical guidelines, and state mandates.
• Experience working with clinical/utilization management stakeholders.
• Deep understanding of US Healthcare payer operations.
• Ability to analyze complex rules and configurations.
• Strong documentation and communication skills

More information

Job skills

Utilization Management

Prior Authorization

Company overview

VBeyond Corporation

Staffing and Recruiting·201-1,000 employees

VBeyond is a Search and HR consulting firm- by the Professionals, for the Professionals and of the Professionals! VBeyond is engaged in pioneering offerings in the Human Capital and Professional Services space. VBeyond is headquartered in Hillsborough , NJ, USA, and through its network of offices globally, we cater to the Asia, Asia-Pacific, Europe and North America and Canada market. VBeyond is in the business of Executive Search, Digital Search, Permanent Hiring, Recruitment Process Outsourcing (RPO), Contract Staffing, Specialized Training & Development and Professional Services in multiple industries viz. Information Technology, IT Enabled Services, Banking & Financial Services, Engineering & Utilities, Manufacturing, Insurance, Retail & Consumer and Oil & Gas and Healthcare & Life Sciences with multiple functions viz. Digital, Analytics & E-Commerce, Information Technology, Sales & Marketing, Finance, Human Resource, Risk & Audit and Procurement & Supply Chain. Co-founded by seasoned industry practitioners, VBeyond goes beyond the routine to the talent it works with. VBeyond offers effective recruitment solutions to enterprises with an emphasis on quality, reliability and scalability. With a team comprising professionals and industry participants, we believe our ‘customer intimacy’ helps us to deliver differentiated and uniquely customized services, firmly believe in diversity & inclusion and our methodical approach to recruiting is a distinguished pioneer of the industry.