Business Systems Analyst (FACETS Membership) – Healthcare Payer & BPM

Job Summary:

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 hands-on experience with FACETS front-end functionality, backend data models, batch processing, advanced SQL, and Healthcare BPM/BPO operations.

1. Key Responsibilities:
   Act as an SME for FACETS Membership, Enrollment, Eligibility, and Billing modules.
   Gather and document business requirements, functional specifications, process flows, and data mappings.
   Analyze FACETS backend data, batch processes, and healthcare payer operational workflows.
   Perform impact analysis for regulatory changes, system enhancements, upgrades, and modernization initiatives.
   Write complex SQL queries for data analysis, troubleshooting, and validation.
   Support FACETS implementations, migrations, UAT, defect resolution, and production activities.
   Collaborate with business, development, QA, and BPM teams to optimize workflows and improve operational efficiency.

Required Skills & Qualifications:

1. 10+ years of experience as a Business Analyst / Business Systems Analyst.
   5+ years of hands-on TriZetto FACETS experience (Mandatory).
   Strong expertise in FACETS Membership, Enrollment, Eligibility, Billing, and Premium Management.
   Hands-on knowledge of FACETS front-end, backend data models, and batch processing.
   Advanced SQL skills, including complex queries and data validation.
   Strong Healthcare Payer domain knowledge and Healthcare BPM/BPO experience.
   Experience with FACETS upgrades, regulatory mandates, system enhancements, and modernization projects.
   Excellent requirements gathering, stakeholder management, and business process improvement skills

1. Preferred Skills:
   CBAP, CCBA, or PMI-PBA certification.
   Agile/Scrum experience with JIRA or Azure DevOps.
   Exposure to FACETS Claims, Provider, and core administration.
   Healthcare process automation and operational transformation experience.