Job Title: Healthcare Systems Analyst (Facets + Payer)
Location: Woodlands, CA - Onsite
Duration: Long Term Contract
Must Have
• Deep expertise in healthcare payer processes: Enrollment, Eligibility, Benefits, Claims Adjudication, Billing, Provider Management
Strong SQL proficiency:
o Complex queries, joins, stored procedures
o Ability to analyze data across multiple systems/sources
• Solid understanding of database design, schemas, and data relationships
• Proven ability to analyze, reconcile, and troubleshoot payer data (claims, membership, benefits)
Functional understanding of Facets platform:
o Architecture, modules, and capabilities
o How Facets supports core payer workflows
• Working knowledge of AI/ML concepts and how they apply to healthcare data (e.g., predictive analytics, automation, insights)
• Ability to translate business requirements into functional designs and data mappings
• Experience across Commercial, Medicare, and/or Medicaid lines of business
• Strong collaboration skills across business, data, and engineering teams
Nice to Have
• Experience with Facets configuration or development
• Background in Java (Spring Boot / microservices)
• Familiarity with React UI applications and front-end workflows
• Understanding of API-based integrations and data flow between systems
• Hands-on experience in AI/ML projects (e.g., claims analytics, fraud detection, member insights, automation use cases)
• Exposure to Azure and AWS cloud platforms
• Knowledge of healthcare EDI transactions (834, 835, 837)
• Experience in data warehousing / data lake environments
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