Facets Process & Documentation Specialist

At Huron were redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our clients challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently passionately relentlessly do great worktogether.

Are you the kind of person who stands ready to jump in roll up your sleeves and transform ideas into action Then come discover Huron.

Whether you have years of experience or come right out of college we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning coaching diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients shareholders communities and colleagues.

Huron Consulting Group offers a competitive compensation and benefits package including medical dental and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching bank at work and on-site workshops as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.
Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment hiring employment compensation benefits promotions transfers training and all other terms and conditions of employment. Huron will not discriminate on the basis of age race color gender marital status sexual orientation gender identity pregnancy national origin religion veteran status physical or mental disability genetic information creed citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Key Responsibilities

• Design and document comprehensive health plan operations desk level procedures for a health plan.
• Translate business processes and system functionality into clearly defined step-by-step operational procedures for end users.
• Develop DLPs that outline:
  • Standard workflows
  • Exception handling processes
  • Step-by-step issue resolution procedures
• Ensure documentation is accurate complete and aligned with current Facets system behavior and business rules.
• Partner with operations teams align DLPs with Facets system set up across membership billing claims benefits provider and pricing modules.
• Translate operations logic into operational procedures for claims processing adjustments and issue resolution.
• Support troubleshooting of claims and benefit-related issues tied to configuration gaps or system logic.
• Validate that operational processes reflect accurate claims adjudication workflows and system dependencies.
• Provide deep subject matter expertise in:
  • Membership including premium billing
  • Claims adjudication workflows
  • Benefits configuration and plan design
  • Provider payment and reimbursement processes
• Develop procedures that help teams:
  • Investigate errors
  • Identify configuration issues
  • Execute corrections and reprocessing steps
• Ensure procedures support consistent complaint claims and benefits operations
• Create DLPs that clearly outline:
  • How to identify root causes of claims or configuration issues
  • Step-by-step actions to resolve issues within Facets or downstream systems
  • Escalation paths and cross-team dependencies
• Partner with operational and IT teams to analyze recurring issues and improve existing procedures.
• Drive consistency in how teams diagnose and resolve claims configuration and workflow issues.
• Collaborate with Claims Enrollment Provider Configuration IT and Operations teams to define and validate processes.
• Translate complex technical and system concepts into clear business-friendly documentation.
• Support training initiatives by providing DLP documentation and operational guidance for end users
• Continuously evaluate and enhance DLPs to improve:
  • Operational efficiency
  • Accuracy and consistency
  • Issue resolution timelines
• Standardized procedures across clients and environments to ensure repeatable scalable delivery models.
• Support system implementations conversions and operational transformations with DLP development.

Required Qualifications

• 5 years of experience working within Healthcare Payer operations.
• 5 years of healthcare payer experience (Medicare and Medicaid).
• 5 years of hands-on experience with claims systems (Facets QNXT HealthRules) particularly in:
  • Premium billing
  • Claims processing
  • Benefits/Provider configuration
  • Operational workflows
• Strong experience developing:
  • Desk Level Procedures (DLPs)
  • SOPs workflows or operational documentation
• Deep understanding of:
  • Eligibility and premium billing
  • Claims adjudication processes
  • Benefits configuration and plan structures
• Proven ability to:
  • Translate complex processes into clear step-by-step instructions
  • Troubleshoot and resolve system/process-related issues
• Experience working in a consulting or client-facing environment.
• Experience building training materials or user guides.
• AI Tools experience with Copilot ChatGPT Claude

The estimated base salary for this job is $105000 - $135000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors including but not limited to specific skills or certifications years of experience market changes and required travel. This job is also eligible to participate in Hurons annual incentive compensation program which reflects Hurons pay for performance philosophy. The job is also eligible to participate in Hurons benefit plans which include medical dental and vision coverage and other wellness programs. The salary range provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

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