Business Systems Analyst (FACETS Membership)

Role : Business Systems Analyst (FACETS Membership)

Location: Washington onsite

The opportunity:

Serve as the primary Business Systems Analyst and SME for FACETS Membership, Enrollment, and Billing initiatives

• Gather, analyze, document, and validate complex business and system requirements
• Analyze end-to-end Membership and Billing workflows to identify process improvements and optimization opportunities
• Conduct root cause analysis and solution assessments for complex business and system issues
• Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documents
• Experience creating functional specifications, business rules, and system documentation
• Support FACETS implementation, migration, upgrade, and transformation initiatives
• Support User Acceptance Testing (UAT), defect triage, production validation, and post-implementation activities

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What you need:

• 10+ years of experience as a Business Systems Analyst or Business Analyst
• Minimum 5+ years of hands-on experience with the TriZetto FACETS platform
• Extensive Healthcare Payer domain experience
• Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade projects

• Required Skills:
• SME-level expertise in FACETS Membership, Enrollment & Eligibility, Billing & Premium Management, FACETS Front-End Functionality, FACETS Batch Processing, and FACETS Backend Data Models
• Strong understanding of Healthcare Payer membership lifecycle processes
• Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design
• Experience analyzing membership, enrollment, billing, eligibility, and premium-related business processes
• Strong requirements gathering, business process analysis, and solutioning skills
• Experience creating functional specifications, business rules, and system documentation
• Strong communication and stakeholder management capabilities
• Ability to bridge business and technical teams to deliver scalable solutions

• Key Competencies: Membership & Enrollment Domain Expertise, Billing & Premium Management Knowledge, FACETS Subject Matter Expertise, Complex SQL & Data Analysis, Requirements Elicitation & Documentation, Business Process Modeling, Solution Design & Validation, Stakeholder Management, Root Cause Analysis

• Preferred Qualifications:
• Experience working with Blue Cross Blue Shield organizations
• Business Analysis certifications such as CBAP (Certified Business Analysis Professional), CCBA (Certification of Capability in Business Analysis), or PMI-PBA (Professional in Business Analysis)
• Experience supporting Healthcare regulatory and compliance initiatives
• Familiarity with Agile delivery methodologies and tools such as JIRA, Azure DevOps, and ServiceNow
• Exposure to Claims, Provider, and Core FACETS Administration functions