Senior Business Systems Analyst - FACETS Membership

Job Description

Job Description

Pay Range: $61.00hr - $66.00hr

Job Overview:

The organization is seeking an experienced Business Systems Analyst (BSA) - Membership with deep expertise in the TriZetto FACETS Membership platform, including Enrollment and Billing operations within a Healthcare Payer environment. This role will serve as a Subject Matter Expert (SME) responsible for driving business analysis, solution design, system enhancements, regulatory mandates, and FACETS modernization initiatives. The ideal candidate will possess strong functional and technical knowledge of FACETS Membership processes, backend data models, batch operations, and advanced SQL analysis while partnering with business stakeholders, technology teams, and operational leaders to deliver high-impact solutions.

Responsibilities:

The candidate will serve as the primary Business Systems Analyst and Subject Matter Expert (SME) for FACETS Membership, Enrollment, and Billing initiatives. The candidate's responsibilities include gathering, analyzing, documenting, and validating complex business and system requirements. The successful candidate will collaborate with business stakeholders to understand membership, enrollment, and billing needs and translate them into functional and technical requirements.

• Perform impact assessments for regulatory mandates, enhancement requests, system upgrades, and modernization programs.
• Analyze end-to-end Membership and Billing workflows to identify process improvements and optimization opportunities.
• Support FACETS implementation, migration, upgrade, and transformation initiatives.
• Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documents.
• Conduct root cause analysis and solution assessments for complex business and system issues.
• Work closely with development, QA, architecture, and operations teams during design, testing, deployment, and support phases.
• Support User Acceptance Testing (UAT), defect triage, production validation, and post-implementation activities.
• Facilitate requirements workshops, stakeholder discussions, and solution review sessions.
• Provide production support expertise for membership, enrollment, and billing-related issues.

Required Qualifications:

• 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:

The candidate should possess 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.

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.

Key Competencies:

• Membership & Enrollment Domain Expertise.
• Billing & Premium Management Knowledge.
• FACETS System Knowledge.

Benefits:

Our Benefits Include:

• Medical, Dental, and Vision Insurance
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities

Disclaimer : Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Systems Inc. reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

About Cynet Systems

Founded in 2010 and headquartered in the Washington, DC metro area, Cynet Systems Inc. is a leading technology staffing and workforce solutions company serving Fortune 500 companies, government agencies, and enterprise organizations across the United States and Canada. We deliver agile, scalable talent solutions across IT, engineering, life sciences, clinical, and professional staffing, powered by a high-performing recruitment engine operating across North America and Asia.

As a nationally and locally certified Minority Business Enterprise (MBE), Cynet Systems is committed to helping organizations build high-performing teams while empowering professionals to grow rewarding careers. Our organization is certified to ISO 9001, ISO 14001, ISO 27001, and SOC 2 Type II standards, reflecting our commitment to quality, security, operational excellence, and customer success.