Business Systems Analyst

Sumeru Solutions; Washington (District of Columbia); On-site; USD 120,000 - 150,000; Full time

Job summary

Sumeru Solutions in Washington, DC area is seeking a Business Systems Analyst with deep FACETS Membership expertise. The role leads enrollment and billing initiatives, analyzes complex requirements, and partners with technology and operations teams to deliver scalable solutions.

You will drive regulatory compliance, modernization efforts, and data-driven improvements. The ideal candidate brings 10+ years as a BSA/BA, 5+ years on FACETS, and strong SQL, with stakeholder management and strong

Qualifications

• 10+ years as a Business Systems Analyst/Business Analyst.
• 5+ years with the TriZetto FACETS platform.
• Extensive Healthcare Payer domain experience.
• Experience supporting FACETS implementations, regulatory mandates, and upgrades.

Responsibilities

• Serve as the primary BSA and SME for FACETS Membership, Enrollment, and Billing initiatives.
• Gather, analyze, document, and validate complex requirements.
• Collaborate with stakeholders to translate needs into functional/technical requirements.
• Perform impact assessments for regulatory mandates and modernization programs.
• Develop BRDs, functional specs, data mapping docs, and use cases.
• Support FACETS implementation, migration, upgrades, and transformations.
• Conduct root-cause analysis and solution assessments.
• Lead design, testing, deployment, and post-implementation activities.

Skills

FACETS SME

SQL analysis

Healthcare payer domain

Requirements gathering

Stakeholder management

Bridge business-IT

Tools

JIRA

Azure DevOps

ServiceNow

Job description

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. The ideal candidate will possess strong functional and technical knowledge of FACETS Membership processes, backend data models, batch operations, and advanced SQL analysis while partnering with business stakeholders, technology teams, and operational leaders to deliver high-impact solutions.

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 issues.

Required Qualifications

• 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.

Required Skills

• SME-level expertise in: FACETS MembershipEnrollment & EligibilityBilling & Premium ManagementFACETS Front-End FunctionalityFACETS Batch ProcessingFACETS 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 ExpertiseBilling & Premium Management KnowledgeFACETS SME Expertise