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AI Summary
osition Summary
The Facets Configuration Analyst is responsible for the design, configuration, testing, implementation, and maintenance of the Facets core claims processing system. This role collaborates with business stakeholders, operations teams, and IT partners to translate business requirements into system configurations that support health plan administration, claims processing, provider management, and benefit administration functions.
The ideal candidate possesses strong healthcare payer experience, deep knowledge of the Facets platform, and the ability to analyze complex business processes and implement effective system solutions.
Key Responsibilities
- Configure and maintain Facets modules including benefits, providers, products, contracts, pricing, claims, and eligibility.
- Analyze business requirements and translate them into detailed configuration specifications.
- Collaborate with business analysts, project managers, developers, and operational teams to ensure accurate system implementations.
- Perform impact assessments for requested configuration changes and system enhancements.
- Develop and execute test plans, test scenarios, and validation activities to ensure system accuracy and compliance.
- Troubleshoot configuration issues and participate in root cause analysis for production incidents.
- Support system upgrades, implementations, conversions, and integration projects.
- Document configuration designs, business rules, workflows, and technical procedures.
- Ensure compliance with regulatory requirements and healthcare industry standards.
- Participate in user acceptance testing (UAT) and support end users during implementation activities.
- Monitor system performance and recommend process improvements to optimize efficiency and accuracy.
- Provide ongoing production support and maintenance for Facets applications.
Required Qualifications
- Bachelor's degree in Information Technology, Healthcare Administration, Business, or related field; equivalent experience may be considered.
- 3+ years of experience working with the TriZetto Facets platform.
- Experience configuring one or more Facets modules including:
- Benefits
- Claims
- Provider
- Products
- Eligibility
- Pricing
- Knowledge of healthcare payer operations and claims processing.
- Experience gathering and analyzing business requirements.
- Strong analytical, problem-solving, and troubleshooting skills.
- Experience with testing methodologies and defect management.
- Excellent written and verbal communication skills.
- Ability to manage multiple priorities in a fast-paced environment.
Preferred Qualifications
- 5+ years of Facets configuration experience.
- Experience with Medicare, Medicaid, Commercial, or Exchange products.
- Knowledge of EDI transactions including 834, 835, 837, and 278.
- Experience with SQL for data analysis and validation.
- Familiarity with healthcare regulations, including HIPAA.
- Experience working in Agile or Scrum environments.
Salary Range
Now, a little about us …
At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first—both patients and those who dedicate their lives to delivering care.
And at the very core of this vital work is our incredibly talented people.
People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare.
Perks and benefits
Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career.
Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family.
Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more.
And everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way.
Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All qualified candidates are encouraged to apply.
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