FICO Rules Engine Developer – Healthcare / Facets

Job Description:

We are looking for an experienced FICO Rules Engine Developer with strong hands-on experience in FICO BRMS / Blaze Advisor and TriZetto Facets healthcare platform.

Key Responsibilities:

• Design, develop, and maintain business rules using FICO BRMS / Blaze Advisor.

• Develop decision tables, decision trees, rule flows, and rule sets.

• Integrate FICO Rules Engine with TriZetto Facets.

• Support healthcare payer processes, including claims adjudication, member eligibility, benefits, provider management, and authorization.

• Troubleshoot rule execution and production issues.

• Work with SQL/PLSQL, REST/SOAP APIs, Java, XML, and JSON.

• Support rule testing, deployment, version management, and CI/CD.

Required Skills:

• Strong FICO BRMS / Blaze Advisor experience.

• Hands-on TriZetto Facets experience.

• US Healthcare Payer domain knowledge.

• Claims adjudication, eligibility, benefits, and provider management.

• SQL / PL-SQL and API integration experience.

• Knowledge of HIPAA, EDI transactions (837, 835, 834, 270/271).

• Git, Jenkins, and Agile methodology.

Preferred: Experience with Medicare, Medicaid, and Commercial health insurance programs.