BSA - Claims

BSA – ClaimsThe RoleUST is searching for 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.What You’ll Do· Serve as the primary Business Systems Analyst and SME for FACETS Membership, Enrollment, and Billing initiatives· Gather, analyze, document, and validate complex business and system requirements· 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 issuesThis position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.What You Need· 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· Skills· SME-level expertise in:· FACETS Membership· Enrollment & Eligibility· Billing & Premium Management· FACETS Front-End Functionality· FACETS Batch Processing· 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)· 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 Subject Matter Expertise· Complex SQL & Data Analysis· Requirements Elicitation & Documentation· Business Process Modeling· Solution Design & Validation· Stakeholder Management· Root Cause Analysis· Agile & Waterfall DeliveryLocation & CompensationCompensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.Role Location: Seattle, WashingtonCompensation Range: $88,000-$132,000Who We AreSince 1999, UST has worked side by side with the world’s best companies to make a powerful impact through transformation. Headquartered in the United States, UST is powered by technology, driven by AI, inspired by people, and led by our purpose, we partner with our clients from design to operation. Our AI-driven digital solutions, proprietary platforms, engineering, R&D, products, and innovation ecosystem turn core challenges into impactful, disruptive business outcomes. With deep industry knowledge and a future-ready mindset, we infuse expertise, innovation, and agility into our clients’ organizations—delivering measurable value and positive lasting change for them, their customers, and communities around the world. Together, with 30,000+ employees in 30+ countries, we build for boundless impact—touching billions of lives in the process. Visit us at .BenefitsFull-time, regular employees accrue a minimum of 10 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave and jury duty. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid Employee Only benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses as allowable under IRS guidelines. Benefits offerings vary in Puerto Rico.Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.Equal Employment Opportunity StatementUST is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.UST reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.#UST#CB#LI-FW UST Global