Facets Configuration Analyst

Summary

Tegria is a healthcare technology company focused on improving care, technology, revenue, and operations for healthcare organizations. The Facets Configuration Analyst designs, configures, tests, implements, and maintains the Facets core claims processing system, translating business requirements into solutions for health plan administration, claims processing, provider management, and benefits administration. The role also supports system implementations, troubleshooting, compliance, testing, upgrades, and ongoing production operations.

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

Skills

• 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
• 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

Qualifications

Must Haves

• 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

Nice to Haves

• 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

Benefits

• A choice of multiple health and dental plans with nationally recognized networks
• Vision benefits
• A total wellness program
• An employee assistance program for you and your family
• Retirement savings plans
• Company-paid disability and life insurance
• Pre-tax savings opportunities (HSA and/or FSA)
• Professional development offerings
• Opportunities for remote work
• 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