Utilization Management with Facets & Pre-Auth Exp.
As a Pre-Auth Consultant you will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards .
Mandatory skills
• FACETS UM/Pre-Auth Configuration • ITS/Authorization Routing Logic • SQL & Rule Traceability
Responsibilities: -
7 - 10 years in UM/Pre-Auth configuration within FACETS.
Familiarity with UM workflows, clinical guidelines, and state mandates.
Experience working with clinical/utilization management stakeholders
. • Deep understanding of US Healthcare payer operations.
Ability to analyze complex rules and configurations.
Strong documentation and communication skills.
Educational Qualifications: -
Engineering Degree - BE/ME/BTech/MTech/BSc/MSc.
Technical certification in multiple technologies is desirable.