Facets Developer

Programmers.io; United States; Remote; USD 96,000 - 179,000; Full time

Job summary

Programmers.io is seeking an experienced Facets/Java Developer to support Medicaid regulatory changes across Facets and related healthcare applications. The role involves translating Medicaid requirements into system configurations, integrations, and data-processing solutions while collaborating with regulatory, business, architecture, and QA teams.

The ideal candidate combines hands-on Facets claims and membership knowledge with Java engineering, DataStage/Talend experience, and a strong

Qualifications

• Hands-on experience with TriZetto Facets.
• Strong Java/J2EE engineering and programming skills.
• Experience with IBM DataStage and Talend/TalendWorks or similar ETL tools.
• Solid understanding of Medicaid managed-care operations and state regulatory requirements.
• Experience implementing regulatory or business-rule changes in healthcare payer platforms.
• Experience with membership, claims, and claims adjudication processes.
• Knowledge of Medicaid and Medicare health-plan processes.

Responsibilities

• Analyze Medicaid regulatory requirements and translate to technical changes across Facets and surrounding applications.
• Design, configure, and maintain solutions for enrollment, eligibility, membership, benefits.
• Develop Java-based applications, APIs, interfaces, batch programs, and integration components for Facets.
• Build and maintain ETL/data integration 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.

Skills

TriZetto Facets

Java/J2EE

IBM DataStage

Talend/TalendWorks

Medicaid knowledge

Regulatory changes

Membership processes

Claims processing

Medicaid/Medicare domain

Job description

Programmers.io is currently looking for a "Facets Developer"

Remote Role

.

Contract Role open for C2C OR W2

Role Summary

An experienced Facets / 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.