Senior Product Specialist, Provider & Claims

What you'll do

• Design, configure, and optimize Facets Provider and Core Facets modules for healthcare operational workflows.
• Translate provider and claims requirements into scalable Facets configurations and product enhancements.
• Analyze existing Facets implementations to improve data accuracy and system performance.
• Lead testing activities for Facets enhancements to ensure successful deployments with minimal disruption.
• Provide advanced production support and perform root cause analysis to improve system stability.
• Align system configurations with business rules, benefit structures, and adjudication requirements.
• Support data integrations to ensure consistent provider information flow across healthcare applications.
• Develop documentation, operational procedures, and knowledge-sharing resources for product management.

What we're looking for

• 6+ years of hands-on experience configuring, supporting, and optimizing Facets Core solutions within healthcare payer environments.
• Extensive experience with Facets Provider modules, including provider maintenance, contract configuration, network management, and reimbursement structures.
• Strong knowledge of healthcare claims processing, benefits administration, and adjudication workflows.
• Proven ability to gather requirements, analyze complex business needs, and translate them into effective Facets configurations and enhancements.
• Experience supporting production environments, troubleshooting issues, conducting root cause analysis, and driving resolution efforts.
• Strong communication and stakeholder management skills with the ability to collaborate across business and technical teams.
• Experience coordinating testing activities, validating business outcomes, and ensuring high-quality system releases.
• Bachelor’s degree or equivalent work experience in Information Technology, Healthcare Administration, Business, or a related field.