Facets Configuration /DoFR (Division of Financial Responsibility)

Remote Full-time
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. Join our team as the expert you are now and create your future. Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Huron is seeking an experienced Facets Configuration Subject Matter Expert (SME) with deep expertise across core Facets modules and specific hands-on experience with DOFR (Division of Financial Responsibility). This SME will support complex configuration initiatives across claims, provider/payment arrangements, benefit structures, and financial responsibility allocations. The role plays a critical part in ensuring accurate adjudication, operational efficiency, and compliance across payer, IPA, and delegated models. W2 Hourly (Not available to H1B/C2C) Key Responsibilities Lead end‑to‑end Facets configuration, including Benefits, Provider, Claims, Pricing, and Workflow components, ensuring accurate system behavior and alignment with business rules. Configure and maintain DOFR rules, financial accountability structures, and division-of-payment logic across delegated entities, IPAs, and health plans. Interpret and translate contract terms, plan documents, and organizational payment models into system‑ready configuration specifications. Collaborate closely with internal business teams—Claims, Finance, Provider Contracting, Delegation Oversight, Enrollment, and IT—to ensure configuration accuracy, alignment, and traceability. Perform configuration testing: UAT, regression, scenario‑based adjudication, DOFR payment validation, and impact analysis. Conduct root‑cause analysis for claims or financial discrepancies related to DOFR, provider pricing, or benefit interpretation. Support downstream and upstream integrations, including pricing engines, delegated entity data exchanges, and reporting datasets. Maintain configuration documentation, version control, job aids, and process playbooks in accordance with Huron standards. Serve as a senior advisor for internal and client teams, offering guidance on Facets best practices, configuration strategy, and optimization. Required Qualifications 10+ years of hands‑on Facets configuration experience across multiple subsystems (e.g., Benefits, Provider, Workflow, Claims). 2+ years of direct DOFR configuration experience, including familiarity with delegated risk models, provider payment allocations, and reconciliation workflows. Strong understanding of claims adjudication, benefit interpretation, reimbursement methodologies, and provider contract logic. Experience working in payer, IPA, MSO, or delegated-risk environments. Proficiency with SQL for troubleshooting, data validation, and configuration analysis. Demonstrated experience supporting system upgrades, release cycles, or new implementation initiatives. Strong analytical, problem‑solving, and documentation skills. Excellent communication skills, with the ability to collaborate across technical and nontechnical stakeholders. ations: #LI-DT1 #LI-Remote Position Level Senior Associate Country United States of America At Huron, we’re redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client’s challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work…together. Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron. Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues. Huron Consulting Group offers a competitive compensation and benefits package including 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; and paid parental leave and adoption assistance. Our 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. All benefits and programs are subject to applicable eligibility requirements. Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

Apply Now

Apply Now
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Remote Part Time Data Entry Clerk, Typing

Remote Full-time

Client Advisor with Athletic Background

Remote Full-time

**Experienced Virtual Customer Service Representative – Remote Opportunity with arenaflex**

Remote Full-time

[Work From Home] Customer Service Representative

Remote Full-time

Allstate Sales Agent

Remote Full-time

Part Time Work From Home Remote Data Entry - Teen Jobs

Remote Full-time

Experienced Customer Success Associate Internship - SkillBridge Program for Transitioning Military Personnel - Exceptional Customer Experience and Business Growth

Remote Full-time

Clinical Research Associate, Sponsor Dedicated, IVD

Remote Full-time

Amazon Delivery Driver

Remote Full-time

Senior Software Developer, Reliability

Remote Full-time
← Back to Home