Facets + Jiva Developer

TechDigital Group; Illinois; Hybrid; USD 80,000 - 110,000; Full time

Job summary

TechDigital Group is seeking a Healthcare IT professional with extensive experience in Facets, Jiva, and Cactus. Candidates should have a minimum of 8 years in healthcare environments, along with hands-on experience in managing utilization and provider processes.

The role includes analyzing business processes, developing solutions to enhance the Jiva platform and managing provider data. A track record in projects related to Jiva platform enhancements is essential.

Qualifications

• Minimum 8 years of experience in Healthcare and Trizetto Facets.
• Minimum 4 years of experience in Jiva Platform and Cactus.
• Strong communication skills and experience in case management.

Responsibilities

• Analyze business processes to enhance Jiva platform efficiency.
• Develop and implement authorization load from Jiva to Facets.
• Lead projects related to Jiva platform enhancements and updates.

Skills

Facets

Jiva

Cactus

SQL

DotNet

Case Management

Utilization Management

Provider Management

Safe Agile Methodology

Job description

Top Must Have's:

• Facets (8 yrs min) Jiva and Cactus - 4 yrs
• SQL, .Net - 8 yrs min

Responsibilities

• Minimum 8 years of experience in Healthcare and Trizetto Facets.
• Minimum 4 years of experience in Jiva Platform and Cactus.
• Experience in Care Management, Utilization Management and Provider Management.
• Analyze business processes, implementing solutions to enhance efficiency and effectiveness of Jiva platform.
• Develop and implement the authorization load from Jiva platform to Facets system.
• Analyze the authorization issues reported by member or provider in both Jiva and Facets.
• Develop processes to correct the authorization data in Jiva and load the corrected data into Facets for claims processing.
• Experience in utilization management and claims processing in Facets.
• Lead and participate in projects related to Jiva platform enhancements and updates.
• Provide ongoing support and troubleshooting assistance to Jiva issues.
• Perform system configuration required in Jiva.
• Experience in Cactus provider management application.
• Experience in provider data management and credentialing processes.
• Develop solutions to load and maintain provider data in Cactus.
• Support incidents and enhancements related to Cactus feed to Facets system.
• Analyze and gather business requirements and changes related to Cactus.
• Thorough knowledge of SDLC and best practices.
• Excellent communication skill and participates actively in team meetings discussions.

Required Qualifications

• Skill set: Facets, Jiva, Cactus, Case Management, Utilization Management, Provider Management, SQL, .Net.
• Hands on experience with Safe agile methodology.
• Good communication skills.
• Healthcare experience is required.
• Added advantage if the candidate has onshore – offshore model experience / must have interest to work in onshore offshore model.