Job Summary

Serve as a lead product consultant for healthcare payer and claims solutions guiding end to end product strategy and technical design for complex Facets based platforms using Net technologies and SQL. Collaborate closely with business and technology stakeholders in a hybrid work model to deliver scalable compliant and high quality healthcare products that improve member and provider experiences.

Responsibilities

Drive end to end product consulting for healthcare payer solutions by translating complex business needs in claims processing into clear product capabilities and implementation roadmaps that maximize value for clients and members.
Guide design of Facets based healthcare products by aligning benefit configuration claims adjudication rules and integration patterns with payer operational goals and regulatory expectations.
Coordinate with cross functional teams in business engineering testing and operations to define detailed functional specifications and technical user stories for claims and payer products.
Shape data design decisions for MSQL and ANSI SQL environments by defining schemas queries and performance expectations that support high volume claims processing and analytics.
Oversee solution approaches using Net and Net Core by validating architecture integration methods and component responsibilities for secure and scalable healthcare applications.
Review and refine Facets technical configurations by assessing impacts on claims workflows accumulators provider contracts and member benefits to ensure accurate and timely adjudication.
Analyze production incidents and complex defects in claims and payer modules by tracing issues across Net services Facets configurations and SQL data to drive root cause resolution.
Document product features data flows and configuration standards in clear artifacts that enable consistent delivery easier onboarding and long term maintainability of healthcare platforms.
Partner with business stakeholders and subject matter experts to validate that product enhancements in claims and payer areas meet compliance quality and experience expectations.
Evaluate technical debt and process gaps across healthcare product components by recommending prioritized improvements that enhance reliability and productivity.
Advise testing teams on test data strategies claims scenarios and validation criteria necessary to confirm end to end behavior of payer products across Facets and surrounding systems.
Support release planning and deployment readiness activities by validating cutover steps configuration migrations and post deployment checks for changes across claims capabilities.
Communicate complex product and technical considerations to diverse audiences in concise terms that support sound decision making and shared understanding.

Qualifications

Apply extensive experience in healthcare products and claims operations to interpret payer requirements and convert them into practical product designs and configuration strategies.
Use strong Facets and Facets technical expertise to define table usage configuration constructs and extension approaches that achieve business outcomes while preserving platform integrity.
Leverage proficiency in MSQL and ANSI SQL to design efficient queries optimize stored procedures and support reporting that provides actionable insights into claims and payer performance.
Employ advanced skills in Net and Net Core to collaborate effectively with engineering teams on service designs integration interfaces and reusable components that support product evolution.
Demonstrate deep domain knowledge in payer and claims processes such as eligibility benefits authorizations and payments to validate solution accuracy and completeness.
Utilize experience in hybrid work environments to coordinate work planning collaboration and communication across onsite and remote team members for day shift operations.
Draw on more than ten years of relevant experience to independently manage complex healthcare product initiatives from discovery through implementation and stabilization.

Lead Product Consultant