FACETS Consultant (Pre-Auth/UM) || 100% Remote
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Position: FACETS Consultant (with Pre-Auth/UM configuration)Location: RemoteEmployment: ContractJob Description:We are looking for a FACETS UM Consultant with strong experience in Utilization Management (UM) and Pre-Authorization (Pre-Auth) configuration within the FACETS platform.Key Responsibilities:Analyze and review existing FACETS Pre-Auth/UM rules (core & custom)Evaluate rule logic for authorization routing, benefit limits, and medical necessityIdentify gaps in intake, determination, and UM workflowsConduct requirement discovery sessions with clientsEnsure compliance with state mandates and regulatory requirementsCollaborate with UM operations, clinical teams, and configuration teams Required Skills:8 years of experience in FACETS UM / Pre-Auth configurationStrong understanding of US Healthcare payer operationsExperience with UM workflows and clinical guidelinesAbility to analyze complex rule configurations and processesStrong stakeholder communication and collaboration skills