Healthcare Configuration Consultant / Analyst (Facets & SQL)

Healthcare Systems Configuration Analyst (FACETS, SQL)

Location: Mason, OH 45040 ( Hybrid – 3 days per week onsite - Mason, OH)

Duration: 6 Months with Possible extension

Work Hours: 8:00 AM – 5:00 PM (1-hour break)

Weekly Hours: 40 hours

Experience & Education

• Experience Required: 6+ years
• Education: Bachelor’s degree or equivalent work experience (flexible)

ROLE SUMMARY

• Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team , responsible for enabling member benefit configuration strategies by designing, implementing, and executing configuration solutions .
• This role is 60% hands-on configuration and 40% cross-functional collaboration , including leading meetings , capturing business requirements , testing execution , and troubleshooting Medicaid product implementations .
• The analyst will act as a Subject Matter Expert (SME) interfacing with cross-functional teams to deliver system and process solutions using FACETS and supporting automation tools.

Key Responsibilities

• Serve as a Subject Matter Expert representing the Configuration workstream for large Government Implementations ( Medicaid, Medicare, Med/Surgical ).
• Design, build, troubleshoot, and prototype Medicaid products using FACETS .
• Lead and represent cross-functional meetings to gather and document business requirements.
• Capture and document business requirements , process flows , and functional specifications .
• Execute testing , claims validation , and troubleshooting for configuration enhancements.
• Perform data analysis and validation by removing duplicates, errors, and outliers.
• Build SQL queries to extract backend data supporting configuration and testing needs.
• Conduct Fit/Gap Analysis for new client plans and provide configuration feedback.
• Collaborate with leadership on the Configuration roadmap and automation initiatives.
• Self-manage workload to meet SLAs and KPIs for project delivery.
• Maintain strong working relationships with stakeholders across all levels of leadership.

Mandatory Skills (Must Have)

• FACETS (Healthcare Claims & Benefit Configuration)
• Healthcare claims understanding / benefit configuration
• SQL / Database experience
• Medicaid product configuration experience
• Strong analytical and problem-solving skills
• Ability to lead and represent cross-functional meetings
• Business requirements gathering & documentation
• Testing execution & claims validation

Tools & Technologies

• FACETS (Claims testing & configuration)
• Oracle SQL (Data extraction & validation)
• Automation tools (Informatica-based, homegrown)
• Windows OS

Desired / Preferred Qualifications

• 4+ years of FACETS platform experience
• Experience with Medical Plan Benefit Configuration
• Provider Network & Agreement Configuration
• Strong understanding of Medicare / Medicaid
• Excellent communication and stakeholder management skills
• Ability to learn quickly and operate independently in complex environments