Job Description
Responsible for the elicitation, prioritization, and conversion of business/functional requirements to system requirements, as well as provision of analysis for applications in production (large and/or more complex initiatives). Responsible for the development of functional designs for new, customized, or enhanced systems. The ultimate outcome of this role is the production of clear, timely, precise and accurate technical designs that are traceable to documented business/functional requirements and guide the successful design, development and deployment of IT Solutions.
What You’ll Do
Partner with business stakeholders and technical teams to gather, analyze, prioritize, and document business and functional requirements.
Translate business needs into functional system designs and technical requirements for new, enhanced, or customized solutions.
Analyze end-to-end business processes, system workflows, and technical dependencies to identify impacts, risks, and opportunities for improvement.
Conduct gap analyses and provide recommendations for system enhancements, process improvements, and solution strategies.
Ensure traceability between business requirements, functional designs, development efforts, and delivered solutions.
Leverage SQL, Facets data structures, and analytical tools to support functional analysis, testing, troubleshooting, and production support activities.
Collaborate with developers, architects, analysts, and business teams to evaluate solution alternatives and balance business needs, usability, performance, and technical constraints.
Provide subject matter expertise for system functionality, business processes, and application design.
Support implementation, testing, and production readiness activities for system enhancements and releases.
Mentor junior analysts and provide guidance on analysis, documentation, and solution design best practices.
What You Bring
Bachelor's degree or advanced degree (where required)
Strong understanding of healthcare claims processing and healthcare payer operations.
Strong understanding in Facets Claims process, IPP(BlueCard) and FEP is preferred
5+ years of experience in systems analysis, business analysis, Facets, Blue Card (IPP) or a related field
In lieu of degree, 7+ years of related experience
Bonus Points
Experience gathering requirements, developing functional designs, and supporting technology implementations
Strong analytical, problem-solving, and communication skills
Experience using SQL for data analysis and system investigation
5+ years of hands-on experience with TriZetto Facets, Blue Card(IPP) and FEP is preferred
Experience with Facets Claims modules and IPP Claims process
Experience configuring, customizing, integrating, and supporting Facets applications
Experience in .NET programming and the ability to analyze the code.
Knowledge of healthcare payer operations and related business processes
Experience evaluating upstream and downstream system impacts in complex enterprise environments
What You’ll Get
The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
Work-life balance, flexibility, and the autonomy to do great work
Medical, dental, and vision coverage along with numerous health and wellness programs
Parental leave and support plus adoption and surrogacy assistance
Career development programs and tuition reimbursement for continued education
401k match including an annual company contribution
Learn more
Where You’ll Work
Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.
In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.
Whether your role is…