Healthcare IS · 13 hours ago
Facets Benefit Configuration
United States
Contract
Remote
Mid Level
3+ years expHealthcare IS is seeking a detail-oriented and experienced Facets Benefit Configuration Specialist. This role involves configuring, testing, and maintaining benefits within the TriZetto Facets system to support accurate claims processing and ensure compliance with business requirements and regulatory standards.
ConsultingData IntegrationElectronic Health Record (EHR)Health CarePharmaceutical
Responsibilities
Configure and maintain benefit plans, products, and provider contracts within the Facets system
Translate business requirements into system configurations that ensure accurate benefit administration and claims adjudication
Perform end-to-end testing, including unit, integration, and user acceptance testing, to validate benefit configuration
Collaborate with business analysts, developers, QA teams, and end users to gather requirements and resolve issues
Troubleshoot benefit-related configuration issues and provide timely resolutions
Support implementation of new benefit designs, products, and regulatory changes
Document configuration processes, test results, and system updates for audit and reference purposes
Provide subject matter expertise on Facets benefits to internal teams and stakeholders
Qualification
Required
Bachelor's degree in Information Systems, Business, Healthcare Administration, or related field (or equivalent work experience)
3+ years of experience working with Facets benefit configuration in a healthcare payer or managed care environment
Strong understanding of healthcare benefits, claims processing, and regulatory requirements (Medicare, Medicaid, Commercial)
Proficiency in Facets modules such as Benefits, Provider, Membership, and Pricing
Strong analytical, problem-solving, and communication skills
Preferred
Experience with SQL or reporting tools is a plus
Company
Healthcare IS
Healthcare IS is a consulting firm that extends its services in the areas of pharmacy, revenue cycle management and data warehousing.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Catherine Dargin
CPOE Pharmacist Analyst
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