SUMMARY:

• Experienced Facets Team Lead/Trainer/Tester/Analyst/Consultant including benefits configuration, plan/product build, validating, auditing, testing, and data analysis
• Knowledge of several lines of business including HMO, PPO, EPO, Medicaid and Medicare
• Ability to analyze data and understand relationships
• Proven ability to improve processes
• Proven ability to learn new applications across diverse organizational structure
• Effective communication skills (written, verbal and listening)

CONSULTANT SKILLS:

• Facets
• Diamond
• Amisys
• Benefits Configuration
• Plan/Product Build
• Create Components
• Attach Components
• Membership & Billing
• Group Enrollment
• Subscriber Enrollment
• Client Interface Experience
• Requirements Documentation
• Implementation and Consulting
• Data Structure
• Data Types
• Data Models
• SQL Queries
• Problem - Solving
• UAT Testing
• Auditing
• Troubleshooting
• Claims Adjudication
• Pricing
• Contact Analysis
• EPO
• HMO
• PPO
• Medicaid
• Medicare
• SharePoint

EXPERIENCE:

Confidential

Facets Configuration Analyst

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Determine and document product build requirements
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• QC Product Design and Build
• Test Configuration
• Query Creation for Access Database

Confidential

Facets Configuration Analyst

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Determine and document product build requirements
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• Product Build Audits

Confidential

UAT Tester

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Determine and document product build requirements
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• UAT Testing
• Reimbursement Testing
• Create Test Plans
• Create Test Shells

Confidential

Facets Configuration Consultant / UAT Tester

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Determine and document product build requirements
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets

Confidential

Facets Configuration Consultant

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Determine and document product build requirements
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• UAT Testing
• Reimbursement Testing
• Create Test Plans
• Create Test Shells

Confidential

Facets Configuration Team Lead/Trainer/Consultant

Responsibilities:

• Lead and directly train a team of client resources, in particular as it relates to the delivery of project-based activities that Client is dependent on, in order to deliver the software product.
• Demonstrate excellence and significant experience in the project team.
• Play a key role in the client relationship management continuum and handle a wide range of communication and escalations that demand a high degree of diplomacy, discretion, insight, and judgment.
• Participate and contribute thought leadership to help drive professional services strategies.
• Acts as a liaison between internal organizations for project based continuity.
• Benefit configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• Analyze configurations across commercial and government lines of business

Facets Configuration Consultant

Confidential

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Membership configuration set-up and maintenance
• New group setup and maintenance
• Enroll new contract subscribers and members
• Auditing

Facets Configuration Consultant /Business Analyst

Confidential

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• Analyze configurations across commercial and government lines of business

Confidential

Facets Configuration Consultant

Responsibilities:

• Benefit package configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Benefits Auditing
• New Group Loads

Facets Configuration Consultant /Business Analyst

Confidential

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• Analyze configurations across commercial and government lines of business

Facets Configuration Consultant /Business Analyst

Confidential

Responsibilities:

• Benefit configuration setup and maintenance
• Plan/Product Build
• Create and Attach Product Components
• Benefits Auditing
• Validate current benefit configuration
• Review provider contracts and validate benefits
• Complete analysis of Facets for benefits and medical definitions
• Document benefits and medical definitions in Facets
• Analyze configurations across commercial and government lines of business