- Design, develop, and support integrations involving the TriZetto Facets platform.
- Configure and develop Facets batch processes, workflows, and interfaces.
- Build and maintain inbound and outbound data integrations between Facets and enterprise applications.
- o Membership
- o Provider Management
- o Authorization/Referrals API & Middleware Development
- Develop REST and SOAP APIs for Facets-related integrations.
- Build middleware solutions using platforms such as:
- o MuleSoft
- o IBM ACE/IIB
- o Other ESB/API Management platforms
- Implement real-time and batch data exchange solutions. Data Integration & ETL
- Develop and maintain ETL processes supporting Facets data exchanges.
- Work with large-scale healthcare data files including:
- o EDI 834
- o EDI 835
- o EDI 837
- o EDI 270/271
- o EDI 276/277
- Create complex SQL queries, stored procedures, and performance tuning solutions. Healthcare Domain Support.
- Collaborate with business and operations teams to understand healthcare payer workflows.
- Support Medicaid, Medicare, Marketplace, and Commercial lines of business.
- Participate in production issue resolution and root cause analysis. Testing & Deployment.
- Support SIT, UAT, and production deployments.
- Develop unit test cases and integration test plans.
- Troubleshoot integration failures and coordinate defect resolution.
- Participate in release planning and deployment activities. Production Support.
- Monitor Facets interfaces and batch jobs.
- Investigate production issues and coordinate remediation efforts.
- Provide on-call support as needed.
- Identify process improvements and automation opportunities.
- Deliver projects within defined time and budget, and in line with high quality standards.
- Enable successful project delivery and customer satisfaction.
- Drive project and technology goals in compliance with organizational objectives.
Skills: -
5+ years of healthcare payer industry experience.
5+ years of hands-on experience working with the TriZetto Facets platform.
5+ years of experience developing Facets integrations and interfaces.
Experience supporting large-scale healthcare transformation and modernization initiatives.
Strong experience with:
SQL Server / Oracle Database
Stored Procedures
Complex SQL Query Development
REST APIs
SOAP Web Services
JSON / XML
ETL Development
Experience with one or more integration platforms:
Strong understanding of:
Claims Processing
Provider Management
Healthcare Benefits
Healthcare Payer Operations
Experience with HIPAA-compliant healthcare transactions.
Must have skills: -
- SQL Development
- APIs (REST/SOA)
- EDI Transactions (834, 835, 837)
- Production Support Experience
- Strong analytical and troubleshooting skills.
- Excellent communication and stakeholder management abilities.
- Ability to work directly with business users and healthcare operations teams.
- Strong documentation and knowledge transfer skills
- Ability to work independently and within cross-functional teams
- Experience in Google Cloud Platform (GCP) using Spanner/BigQuery
Good to have skills: -
- Experience with Medicaid Managed Care Organizations.
- Experience with:
- o Jiva
- o GuidingCare
- o Evolent
- o Salesforce Healthcare Cloud
- o Mulesoft
- Knowledge of FHIR and HL7 integrations.
- Experience working in Agile/Scrum environments.