Facets Configuration Analyst

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🌲 Oregon – Remote

🌲 Oregon – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Tegria

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2020

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

Tegria is a global healthcare consulting and services company that partners with provider and payer organizations to advance care, improve performance, and tackle the biggest challenges in healthcare. They offer a range of services including patient access optimization, data analytics, cloud solutions, and revenue cycle transformation to create value and enhance healthcare delivery. Tegria focuses on streamlining operations, fostering innovation, and leveraging technology to maximize performance and improve patient experiences.

📋 Description

• Design, configure, test, implement, and maintain the Facets core claims processing system • 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, operational teams, business stakeholders, and IT partners • Perform impact assessments for configuration changes and system enhancements • Develop and execute test plans, test scenarios, and validation activities • 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 and support end users during implementation activities • Monitor system performance and recommend process improvements • Provide ongoing production support and maintenance for Facets applications

🎯 Requirements

• 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, and 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: 5+ years of Facets configuration experience • Preferred: Experience with Medicare, Medicaid, Commercial, or Exchange products • Preferred: Knowledge of EDI transactions including 834, 835, 837, and 278 • Preferred: Experience with SQL for data analysis and validation • Preferred: Familiarity with healthcare regulations, including HIPAA • Preferred: Experience working in Agile or Scrum environments

🏖️ Benefits

• Multiple health and dental plans with nationally recognized networks • Vision benefits • Total wellness program • Employee assistance program for you and your family • Competitive wages • Retirement savings plans • Company-paid disability and life insurance • Pre-tax savings opportunities (HSA and/or FSA) • Professional development offerings • Opportunities for remote work • Generous paid-time-off program • Flexible scheduling to accommodate vacations, illness, life events, and unexpected circumstances