100% Remote // Java Facets Developer (Eligibility, Medicaid, Claims)

Talent Groups; USA; Vor Ort; USD 83.000 - 152.000; Vollzeit

Zusammenfassung

Talent Groups in the United States seeks an experienced Java Facets Developer to support Medicaid/Medicare regulatory changes across Facets and related applications. The role blends mainframe and Java engineering, ETL (DataStage/Talend), and data integration to implement state-specific rules and ensure compliant processing of enrollment, eligibility, claims, and payments. The ideal candidate couples payer-domain knowledge with hands-on coding and testing.

Qualifikationen

• Strong hands-on experience with TriZetto Facets in a payer environment.
• Strong Java/J2EE engineering and programming skills.
• Experience with IBM DataStage and Talend/TalendWorks.
• Deep understanding of Medicaid managed-care operations and state-specific regulatory requirements.
• Experience implementing regulatory or business-rule changes within healthcare payer platforms.

Aufgaben

• Analyze regional Medicaid regulatory requirements and translate them into technical changes across Facets and related apps.
• Design, configure, and maintain solutions for enrollment, eligibility, membership, benefits, claims, and pricing.
• Develop Java-based applications, interfaces, and batch components for Facets.
• Modify Mainframe programs and batch processing for Medicaid processes.
• Build ETL/data integration workflows using DataStage and Talend.
• Perform testing, code reviews, and root-cause analysis for production issues.
• Support system integration testing and production deployments.
• Document specifications, mappings, and implementation artifacts.

Kenntnisse

TriZetto Facets

Java/J2EE

SQL & Databases

APIs & Interfaces

Data integration

Debugging & root-cause analysis

Batch processing

Mainframe knowledge

Tools

IBM DataStage

Talend/TalendWorks

Jobbeschreibung

Java Facets Developer (Eligibility, Medicaid, Claims)

Contract

Job Description:

An experienced Facets / Mainframe / Java Developer or Engineer to support implementation of state-specific Medicaid regulatory changes across Facets and surrounding healthcare applications.

The engineer will work with regulatory, business, architecture, and QA teams to translate Medicaid requirements into system configuration, application changes, integrations, and data-processing solutions. The ideal candidate combines strong Facets claims and membership knowledge with hands‑on Java engineering, DataStage/Talend experience, Mainframe and Medicaid managed‑care domain expertise.

Key Responsibilities

• Analyze regional/state Medicaid regulatory requirements and translate them into technical changes across Facets and surrounding applications.
• Design, develop, configure, and maintain solutions supporting:
  • Member enrollment and eligibility
  • Membership maintenance
  • Benefits and plan configuration
  • Claims intake and adjudication
  • Claims pricing and payment
  • Provider‑related claim processing
  • Medicaid‑specific edits and business rules
  • Medicare/Medicaid coordination where applicable
• Develop and enhance Java‑based applications, APIs, interfaces, batch programs, and integration components supporting Facets.
• Develop or modify Mainframe programs and batch‑processing components supporting Medicaid processes.
• Perform Facets configuration and development associated with regulatory and business‑rule changes.
• Build and maintain ETL/data integration solutions using IBM DataStage and Talend/TalendWorks.
• Analyze upstream and downstream impacts of regulatory changes across Facets, data platforms, interfaces, and surrounding applications.
• Conduct code reviews, unit testing, defect resolution, root‑cause analysis, and technical quality assessments.
• Support system integration testing, regression testing and production implementation.
• Troubleshoot complex claims, membership, eligibility, and regulatory processing issues.
• Develop reusable engineering approaches where regulatory requirements are common while accommodating state‑specific variations.
• Maintain technical specifications, mappings, configuration documentation, traceability and implementation artifacts.

Required Experience

• Strong hands‑on experience with TriZetto Facets.
• Strong Java/J2EE engineering and programming skills.
• Experience with IBM DataStage and Talend/TalendWorks or comparable enterprise ETL technologies.
• Strong understanding of Medicaid managed‑care operations and state‑specific regulatory requirements.
• Experience implementing regulatory or business‑rule changes within healthcare payer platforms.
• Membership
• Claims
• Claims adjudication
• Good understanding of both Medicaid and Medicare health‑plan processes.
• Experience with SQL, databases, batch processing, APIs/interfaces and data integration.
• Strong debugging, production support and root‑cause-analysis skills.
• Ability to interpret business/regulatory requirements and convert them into detailed technical solutions.

Preferred

• Experience working with multiple state Medicaid programs.
• Experience supporting large health plans or Medicaid MCO environments.
• Healthcare EDI/X12 knowledge.
• Knowledge of automated CI/CD, code quality and test automation practices.