Note: The job is a remote job and is open to candidates in USA. Vaiticka Solution is seeking a Facets Workflow Consultant who will analyze and optimize claims and benefits workflows within the Facets platform. The role involves reviewing existing workflow rules, identifying customizations, and supporting clients in improving their operations.

Responsibilities

• Review 4000+ Facets workflow rules and identify state‑specific and group‑specific customizations
• Map rule dependencies and evaluate downstream impact across claims, membership, billing, and provider modules
• Document differences between baseline and client‑specific configurations
• Work with business, configuration, and QA teams to validate rule behavior
• Recommend optimizations, including consolidation of redundant rules

Skills

• 5–8 years as a Business or System Analyst working with Facets
• Strong understanding of claims workflows, provider validation, and benefits administration
• Experience reviewing large rule/configuration repositories
• Solid knowledge of US healthcare payer operations
• Ability to interpret and analyze complex rules and configurations
• Strong documentation and communication skills
• Facets Workflow Rules Configuration
• SQL for rule impact analysis
• Facets Data Model & Operations
• Knowledge of state/regulatory variations
• Critical thinking & problem solving
• Leadership & collaboration
• Ability to manage large rule inventories

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