Huron · 7 hours ago
Facets Configuration SME / DOFR - Division of Financial Responsibility
United States
Full-time
Remote
Senior Level, Lead/Staff
10+ years expHuron is a consulting firm that helps healthcare organizations enhance performance and drive growth. They are seeking a Facets Configuration Subject Matter Expert to support complex configuration initiatives across claims and financial responsibility allocations, ensuring operational efficiency and compliance.
ConsultingInformation TechnologyProfessional Services
Responsibilities
Lead end‑to‑end Facets configuration, including Benefits, Provider, Claims, Pricing, and Workflow components, ensuring accurate system behavior and alignment with business rules
Configure and maintain DOFR rules, financial accountability structures, and division-of-payment logic across delegated entities, IPAs, and health plans
Interpret and translate contract terms, plan documents, and organizational payment models into system‑ready configuration specifications
Collaborate closely with internal business teams—Claims, Finance, Provider Contracting, Delegation Oversight, Enrollment, and IT—to ensure configuration accuracy, alignment, and traceability
Perform configuration testing: UAT, regression, scenario‑based adjudication, DOFR payment validation, and impact analysis
Conduct root‑cause analysis for claims or financial discrepancies related to DOFR, provider pricing, or benefit interpretation
Support downstream and upstream integrations, including pricing engines, delegated entity data exchanges, and reporting datasets
Maintain configuration documentation, version control, job aids, and process playbooks in accordance with Huron standards
Serve as a senior advisor for internal and client teams, offering guidance on Facets best practices, configuration strategy, and optimization
Qualification
Required
10+ years of hands‑on Facets configuration experience across multiple subsystems (e.g., Benefits, Provider, Workflow, Claims)
2+ years of direct DOFR configuration experience, including familiarity with delegated risk models, provider payment allocations, and reconciliation workflows
Strong understanding of claims adjudication, benefit interpretation, reimbursement methodologies, and provider contract logic
Experience working in payer, IPA, MSO, or delegated-risk environments
Proficiency with SQL for troubleshooting, data validation, and configuration analysis
Demonstrated experience supporting system upgrades, release cycles, or new implementation initiatives
Strong analytical, problem‑solving, and documentation skills
Excellent communication skills, with the ability to collaborate across technical and nontechnical stakeholders
Benefits
Benefits available if needed
Company
Huron
Huron is a global professional services firm that collaborates with clients to put possible into practice by creating sound strategies, optimizing operations, accelerating digital transformation, and empowering businesses and their people to own their future.
5001-10000 employees
H1B Sponsorship
Huron has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (40)
2024 (42)
2023 (37)
2022 (31)
2021 (44)
2020 (32)
Funding
Current Stage
Public CompanyTotal Funding
unknown2004-10-13IPO
Leadership Team
C. Mark Hussey
President and CEO
J. Ronald Dail
EVP - Chief Operating Officer
Recent News
2025-11-21
MarketScreener
2025-11-05
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