Senior Facets Config Analyst – Pricing & Workflow

HCL Technologies Limited; Rhode Island; On-site; USD 90,000 - 130,000; Full time

Job summary

HCL Technologies Limited in the United States is seeking an experienced Facets Config Analyst to support configuring, maintaining, and optimizing benefit, pricing, and workflow components within the Facets core administration platform.

This role requires strong expertise in healthcare claims benefit setup, contract configuration, medical policies, workflow, and end-to-end claims testing to ensure compliant and efficient system operations across pricing environments.

Qualifications

• 5+ years of experience in Facets Benefit, Pricing or workflow.
• Strong expertise in pricing modules, medical policy, ITS, and workflow module.
• Solid understanding of US healthcare claims.

Responsibilities

• Configure, maintain, and support Facets Pricing components (Fee Schedules, Pricing Rules, Contracts, MPP, Modifiers, Global Periods, Carve-outs).
• Configure pricing logic for Professional, Facility, and Ancillary claims (DRG, APC, Per Diem, Case Rates, Fee-for-Service).
• Interpret and implement medical policies into Facets and configure edits.
• Configure and support ITS scenarios and ensure compliance with BlueCard guidelines.
• Configure override and pend in the workflow module in Facets.
• Analyze and troubleshoot configuration issues related to benefit and pricing; perform Unit, SIT and UAT testing; validate outcomes against contracts, benefits, and policies.

Skills

Analytical thinking

Attention to detail

Strong communication

Stakeholder management

Pricing configuration

Tools

Facets

Job description

HCL Technologies Limited in the United States is seeking an experienced Facets Config Analyst to support configuring, maintaining, and optimizing benefit, pricing, and workflow components within the Facets core administration platform.

This role requires strong expertise in healthcare claims benefit setup, contract configuration, medical policies, workflow, and end-to-end claims testing to ensure compliant and efficient system operations across pricing environments.