Facets Process & Documentation Specialist

Huron Consulting Services • Chicago, IL

5d • Remote

About The Position

Huron is a global consultancy that partners with healthcare organizations to optimize operations, improve financial performance, and drive sustainable transformation. We are seeking a Facets Process & Documentation Specialist (DLP | Desk Level Procedures) with strong expertise in health plan operations, membership processing, claims processing system (i.e.: Facets). This role will focus on designing, documenting, and optimizing Desk Level Procedures (DLPs) that support critical payer workflows across membership, claims, benefits, and configuration processes. This individual will play a key role in translating complex system workflows and business processes into clear, actionable step-by-step procedures that enable operational teams to resolve issues, maintain compliance, and drive consistent execution.

Requirements

• 5+ years of experience working within Healthcare Payer operations.
• 5+ years of healthcare payer experience (Medicare and Medicaid).
• 5+ years of hands-on experience with claims systems (Facets, QNXT, HealthRules), particularly in: Premium billing, Claims processing, Benefits/Provider configuration, Operational workflows.
• Strong experience developing: Desk Level Procedures (DLPs), SOPs, workflows, or operational documentation.
• Deep understanding of: Eligibility and premium billing, Claims adjudication processes, Benefits configuration and plan structures.
• Proven ability to: Translate complex processes into clear, step-by-step instructions, Troubleshoot and resolve system/process-related issues.
• Experience working in a consulting or client-facing environment.
• Experience building training materials or user guides.

Nice To Haves

• AI Tools experience with Copilot, ChatGPT, Claude

Responsibilities

• Design and document comprehensive health plan operations desk level procedures for a health plan.
• Translate business processes and system functionality into clearly defined, step-by-step operational procedures for end users.
• Develop DLPs that outline: Standard workflows, Exception handling processes, Step-by-step issue resolution procedures.
• Ensure documentation is accurate, complete, and aligned with current Facets system behavior and business rules.
• Partner with operations teams align DLPs with Facets system set up across membership, billing, claims, benefits, provider, and pricing modules.
• Translate operations logic into operational procedures for claims processing, adjustments, and issue resolution.
• Support troubleshooting of claims and benefit-related issues tied to configuration gaps or system logic.
• Validate that operational processes reflect accurate claims, adjudication workflows and system dependencies.
• Provide deep subject matter expertise in: Membership including premium billing, Claims adjudication workflows, Benefits configuration and plan design, Provider payment and reimbursement processes.
• Develop procedures that help teams: Investigate errors, Identify configuration issues, Execute corrections and reprocessing steps.
• Ensure procedures support consistent, complaint claims and benefits operations.
• Create DLPs that clearly outline: How to identify root causes of claims or configuration issues, Step-by-step actions to resolve issues within Facets or downstream systems, Escalation paths and cross-team dependencies.
• Partner with operational and IT teams to analyze recurring issues and improve existing procedures.
• Drive consistency in how teams diagnose and resolve claims, configuration, and workflow issues.
• Collaborate with Claims, Enrollment, Provider Configuration, IT, and Operations teams to define and validate processes.
• Translate complex technical and system concepts into clear, business-friendly documentation.
• Support training initiatives by providing DLP documentation and operational guidance for end users.
• Continuously evaluate and enhance DLPs to improve: Operational efficiency, Accuracy and consistency, Issue resolution timelines.
• Standardized procedures across clients and environments to ensure repeatable, scalable delivery models.
• Support system implementations, conversions, and operational transformations with DLP development.

Benefits

• medical, dental, and vision coverage to employees and dependents
• a 401(k) plan with a generous employer match
• an employee stock purchase plan
• a generous Paid Time Off policy
• paid parental leave and adoption assistance
• Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed