Facets Configuration SME​/DOFR - Division of Financial Responsibility

Overview

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 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 (Benefits available if needed)

C2C not available

• 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.

• 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.