Business Systems Analyst (FACETS Membership)

Job Description

We are seeking an experienced Business Systems Analyst (BSA) with strong expertise in TriZetto FACETS Membership, Enrollment, Eligibility, and Billing within the Healthcare Payer domain.

The ideal candidate will have 10+ years of Business Analysis experience, including at least 5+ years of hands-on FACETS experience, with strong knowledge of FACETS front-end functionality, backend data models, batch processing, and advanced SQL.

The candidate will act as a Subject Matter Expert (SME), supporting business requirements, system enhancements, regulatory initiatives, production issues, and FACETS modernization projects.
Required Qualifications

• 10+ years of experience as a Business Analyst or Business Systems Analyst.
• 5+ years of hands-on experience with TriZetto FACETS.
• Strong Healthcare Payer domain expertise.
• Extensive functional knowledge of:
• FACETS Membership
• Enrollment and Eligibility
• Billing and Premium Management
• FACETS Front-End Functionality
• FACETS Batch Processing
• FACETS Backend Data Models
• Advanced SQL skills, including complex queries, joins, data validation, and troubleshooting.
• Experience with FACETS implementation, upgrades, enhancements, and regulatory mandates.
• Strong experience in requirements gathering, business process analysis, functional documentation, and solution design.
• Excellent communication, analytical, and stakeholder management skills.

Preferred Qualifications

• Experience working with Blue Cross Blue Shield (BCBS) organizations.
• CBAP, CCBA, or PMI-PBA certification.
• Experience with healthcare regulatory and compliance initiatives.
• Knowledge of Agile methodologies and tools such as JIRA, Azure DevOps, and ServiceNow.
• Exposure to FACETS Claims, Provider, and Core Administration modules.