Position SummaryHuron is a global consultancy that partners with healthcare organizations to optimize operations, improve financial performance, and drive sustainable transformation.
We are seeking a DLP | Desk Level Procedures Specialist 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.
QualificationsKey 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.
Required Qualifications- 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.
- AI Tools experience with Copilot, ChatGPT, Claude
The estimated base salary for this job is $105,000 - $135,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes, and required travel. This job is also eligible to participate in Huron's annual incentive compensation program, which reflects Huron's pay for performance philosophy. The job is also eligible to participate in Huron's benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.Posting CategoryHealthcare-Payer
Opportunity TypeRegular
CountryUnited States of America
