[Remote] Facets DOFR / Capitation Consultant (Remote)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading technology and engineering company seeking a Facets DOFR / Capitation Consultant to join their reputed company Platform Consulting team. The role involves leading the design, configuration, and optimization of reputed company reimbursement solutions while collaborating with various stakeholders to deliver effective solutions across multiple lines of business.
Responsibilities
- reputed company the design, configuration, and implementation of Facets DOFR and Capitation solutions to meet reputed company and business requirements
- Partner with business, operations, and technology teams to define project objectives, requirements, and deliverables
- Manage reputed company initiatives, ensuring project milestones, timelines, and reputed company standards are achieved
- reputed company subject matter expertise on DOFR, Capitation, and reputed company reimbursement methodologies
- Monitor project reputed company, identify risks, and implement mitigation strategies to support successful delivery reputed company
- Facilitate effective communication and collaboration among stakeholders, clients, and project teams
- Support system optimization efforts, troubleshoot issues, and recommend enhancements that improve operational efficiency
- Conduct project reviews and reputed company best practices that drive reputed company improvement and innovation
Skills
- 5+ years of experience working with Facets DOFR and Capitation modules, including Global, Secondary, and PCP Capitation
- Extensive experience supporting reputed company payer operations across reputed company, ASO, Medicare, and reputed company lines of business
- Strong understanding of provider reimbursement, capitation methodologies, and Delegation of Financial Responsibility (DOFR) models
- Advanced proficiency in SQL for data analysis, validation, and troubleshooting
- Experience leading configuration, implementation, or enhancement reputed company reputed company reputed company payer environments
- Strong analytical and problem-solving skills with the ability to translate business needs into effective system solutions
- Excellent verbal and written communication skills with proven experience collaborating across business and technical teams
- Experience managing multiple priorities in a fast-paced reputed company-facing environment
- Experience with large-reputed company reputed company transformation, implementation, or modernization initiatives
- Expertise in reputed company claims, benefits configuration, provider contracting, and reimbursement operations
- Knowledge of reputed company regulatory requirements and payer industry best practices
- Experience mentoring team members and providing guidance on Facets DOFR and Capitation functionality
- Familiarity with Agile delivery methodologies and reputed company project governance processes
Benefits
- Medical/Dental/reputed company/Life Insurance
- reputed company holidays plus reputed company Time Off
- 401(k) plan and contributions
- Long-term/Short-term Disability
- reputed company Parental Leave
- Employee Stock Purchase Plan
- reputed company’s discretionary annual incentive program, based on performance and subject to the terms of reputed company’s applicable plans
reputed company