Facets Developer (Remote)

We are seeking a skilled Facets Developer with extensive experience in healthcare systems, specifically the Trizetto Facets platform. The ideal candidate will have a deep understanding of healthcare processes such as care management, utilization management, and provider management. Expertise in Jiva and Cactus platforms, SQL, .Net, and the ability to lead and support platform enhancements are essential. This role involves developing, analyzing, and troubleshooting complex data processes across multiple healthcare platforms.

Job Responsibilities

Facets & Jiva Integration:

• Develop and implement the authorization load from the Jiva platform to the Facets system.
• Analyze and resolve authorization issues reported by members or providers in Jiva and Facets.
• Develop processes to correct authorization data in Jiva and load the corrected data into Facets for claims processing.
• Lead and participate in projects to enhance and update the Jiva platform.

Cactus Platform & Provider Management:

• Develop and maintain provider data solutions within the Cactus provider management application.
• Manage provider data and credentialing processes.
• Support incidents and enhancements related to Cactus feed into the Facets system.
• Analyze and gather business requirements for Cactus-related changes.

Healthcare Data & Process Management:

• Provide ongoing support and troubleshooting for Jiva platform issues.
• Configure the Jiva system to meet business requirements.
• Lead utilization management and claims processing activities within the Facets platform.
• Work on business process improvements to enhance the efficiency of the Jiva platform.

Collaboration & Communication:

• Actively participate in team meetings and discussions to share insights and drive solution delivery.
• Collaborate with onshore and offshore teams to ensure seamless execution of projects and ongoing system support.

Requirements

Technical Expertise:

• 8+ years of experience with Trizetto Facets and strong proficiency in SQL and .Net.
• 4+ years of experience with the Jiva and Cactus platforms.
• Hands-on experience in care management, utilization management, and provider management.
• Strong knowledge of healthcare claims processing and authorization workflows.
• Experience in system configuration and troubleshooting for Jiva.

Healthcare Domain Knowledge:

• Deep understanding of healthcare industry standards, processes, and regulations.
• Experience with provider data management and credentialing.

Development & Methodology:

• Familiarity with the Software Development Life Cycle (SDLC) and best practices.
• Hands-on experience with Safe Agile methodology.

Preferred Qualifications:

• Experience working in an onshore-offshore model or willingness to work in such a setting.
• Strong communication skills with the ability to collaborate effectively across teams.
• Healthcare experience is required.

System Requirements

• At least 15mbps for the main internet and at least 10mbps for backup
• A desktop or laptop that has an i5 processor with at least 8 GB RAM and an i3 processor for backup
• Note: Back-ups should still be able to function when there is a power interruption
• A webcam
• Noise-canceling USB Headset
• Quiet, Dedicated Home Office
• Smartphone

Benefits

• Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth.
• Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field.
• Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward.
• Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards.
• Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment.
• Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.