Business Systems Analyst (FACETS Provider)

Business Systems Analyst (FACETS Provider)

Location: United States Seattle, Washington

Position : Long term contract

• 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 lifecycle. Support User Acceptance Testing (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.

Required Skills :

• Required Qualifications Experience 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 initiatives.

• 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 with the ability to write complex queries for analysis, 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 effectively collaborate with business, operational, and technical teams.

Preferred Qualifications Business Analysis certifications:

• CBAP (Certified Business Analysis Professional)
• CCBA (Certification of Capability in Business Analysis)
• 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, Membership, Billing, and Core FACETS Administration functions.