Facets Configuration Analyst

This is a fully remote position, open to applicants in Oregon.

📋 Description

• Design, configure, test, implement, and sustain the Facets core claims processing system.

• Set up and maintain various Facets modules, encompassing benefits, providers, products, contracts, pricing, claims, and eligibility.

• Assess business needs and convert them into comprehensive configuration specifications.

• Collaborate with business analysts, project managers, developers, operational teams, business stakeholders, and IT partners.

• Conduct impact assessments for changes in configuration and system enhancements.

• Create and execute test plans, scenarios, and validation activities.

• Address configuration issues and engage in root cause analysis for production incidents.

• Assist with system upgrades, implementations, conversions, and integration initiatives.

• Record configuration designs, business rules, workflows, and technical procedures.

• Ensure adherence to regulatory standards and healthcare industry guidelines.

• Take part in user acceptance testing and assist end users during implementation processes.

• Monitor system performance and suggest process enhancements.

• Provide continuous production support and maintenance for Facets applications.

⛳️ Requirements

• Bachelor's degree in Information Technology, Healthcare Administration, Business, or a related field; relevant experience may be considered.

• Over 3 years of experience with the TriZetto Facets platform.

• Proficient in configuring one or more Facets modules, which include Benefits, Claims, Provider, Products, Eligibility, and Pricing.

• Familiarity with healthcare payer operations and claims processing.

• Experience in gathering and analyzing business requirements.

• Strong analytical, problem-solving, and troubleshooting abilities.

• Knowledge of testing methodologies and defect management.

• Exceptional written and verbal communication skills.

• Capability to handle multiple priorities in a dynamic environment.

• Preferred: 5+ years of experience in Facets configuration.

• Preferred: Background in Medicare, Medicaid, Commercial, or Exchange products.

• Preferred: Understanding of EDI transactions including 834, 835, 837, and 278.

• Preferred: Experience with SQL for data analysis and validation purposes.

• Preferred: Awareness of healthcare regulations, including HIPAA.

• Preferred: Experience in Agile or Scrum environments.

🏝️ Benefits

• Multiple health and dental plans featuring nationally recognized networks.

• Vision benefits.

• Comprehensive wellness program.

• Employee assistance program available for you and your family.

• Competitive compensation.

• Retirement savings options.

• Company-sponsored disability and life insurance.

• Pre-tax savings opportunities (HSA and/or FSA).

• Professional development programs.

• Opportunities for remote work.

• Generous paid time off policy.

• Flexible scheduling to accommodate vacations, illness, life events, and unexpected situations.