Location: Seattle, Washington (On-site — No remote)
Experience Level: 10+ Years
Open Positions: 1
< dir="ltr">About the Role
Seeking an experienced Business Systems Analyst (BSA) – Provider with deep expertise in the TriZetto FACETS Provider platform, including Provider Configuration, Network Management, and Pricing. This role serves as a Subject Matter Expert (SME) supporting strategic Healthcare Payer initiatives, FACETS implementations, regulatory mandates, system enhancements, and upgrade programs.
The ideal candidate has strong knowledge of FACETS Provider modules, provider network management, reimbursement and pricing methodologies, batch processes, backend data models, and advanced SQL analysis, and will partner with business stakeholders, provider operations teams, architects, developers, and testing teams to deliver high-quality solutions across the provider domain.
< dir="ltr">What You'll Do
- Serve as the primary BSA and SME for FACETS Provider, Network, and Pricing initiatives
- Gather, analyze, document, and validate business and system requirements related to provider operations and reimbursement processes
- Collaborate with business and technical stakeholders to translate provider network and pricing requirements into scalable system solutions
- Perform impact analysis for regulatory mandates, enhancements, system upgrades, and modernization initiatives
- Analyze end-to-end provider lifecycle processes, including provider setup, credentialing integrations, contracting, network participation, and reimbursement methodologies
- Support FACETS implementation, migration, upgrade, and transformation programs
- Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documentation
- Conduct root cause analysis and recommend solutions for complex provider and pricing-related issues
- Partner with development, QA, architecture, and support teams throughout the SDLC
- Support UAT, defect triage, deployment validation, and post-production support activities
- Facilitate stakeholder meetings, solution workshops, and business process discussions
- Provide production support expertise for provider configuration, network management, and pricing-related issues
< dir="ltr">Required Qualifications
Experience
- 10+ years as a Business Systems Analyst or Business Analyst
- 5+ years hands-on experience with the TriZetto FACETS platform
- Extensive Healthcare Payer domain experience
- Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade initiatives
Skills
- SME-level expertise in:
- FACETS Provider Module
- Provider Configuration & Maintenance
- Provider Network Management
- Contracting & Reimbursement Models
- Pricing Configuration
- FACETS Front-End Functionality
- FACETS Batch Processing
- FACETS Backend Data Models
- Strong understanding of Healthcare Payer provider operations and network management processes
- Advanced SQL skills for complex queries, data validation, troubleshooting, and solution design
- Experience analyzing provider network, contracting, fee schedule, pricing, and reimbursement business processes
- Strong requirements gathering, business process analysis, and solutioning capabilities
- Experience creating functional specifications, business rules, gap analysis, and system documentation
- Excellent communication, stakeholder management, and facilitation skills
- Ability to collaborate effectively across business, operational, and technical teams
< dir="ltr">Preferred Qualifications
- Business Analysis certifications: CBAP, CCBA, or PMI-PBA
- Experience supporting healthcare regulatory and compliance initiatives
- Familiarity with Agile methodologies and tools (JIRA, Azure DevOps, ServiceNow)
- Exposure to Claims, Membership, Billing, and Core FACETS Administration functions
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