Facets with Pre-Auth
Facets with Pre-Auth Introduction: This position involves working remotely and requires a minimum of 13 years of overall experience, with 7-10 years specifically in FACETS UM/Pre-Auth configuration. The ideal candidate will have expertise in TriZetto FACETS, UM/Utilization Management, Pre-Auth/Prior Authorization, US Healthcare Payer experience, UM workflows & clinical guidelines, state mandates, and strong documentation & communication skills. Responsibilities: Configure FACETS UM/Pre-Auth processes Implement and maintain UM workflows and clinical guidelines Ensure compliance with state mandates and regulations Collaborate with stakeholders to optimize utilization management processes Provide training and support to team members on FACETS Pre-Auth Document all configuration changes and updates Requirements: Required Skills: TriZetto FACETS expertise UM/Utilization Management experience Pre-Auth/Prior Authorization knowledge US Healthcare Payer experience Understanding of UM workflows and clinical guidelines Familiarity with state mandates and regulations Strong documentation and communication skills Preferred Skills: Experience with other healthcare management systems Certifications in utilization management or healthcare administration Experience with telemedicine or virtual care platforms Looking for strong consultants with hands-on FACETS Pre-Auth experience.