Facets + Jiva Developer

TechDigital Group; Town of Texas (WI); Hybrid; USD 90,000 - 120,000; Full time

Job summary

TechDigital Group is seeking an experienced healthcare technology professional with a focus on Jiva and Cactus platforms. The ideal candidate will have a minimum of 8 years in healthcare, specifically with Facets and Jiva, and substantial experience in Utilization and Provider Management.

The role involves analyzing and enhancing business processes, leading projects, and providing support for the Jiva platform. Strong communication and hands-on experience with Safe agile methodology are essential. This position is located in the Town of Texas, Wisconsin.

Qualifications

• 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.
• Hands-on experience with Safe agile methodology.

Responsibilities

• Analyze business processes, implementing solutions to enhance efficiency of Jiva platform.
• Lead projects related to Jiva platform enhancements.
• Provide ongoing support and troubleshooting assistance to Jiva issues.
• Analyze and gather business requirements related to Cactus.
• Develop solutions to load and maintain provider data in Cactus.

Skills

Facets

Jiva

Cactus

SQL

.Net

Utilization Management

Provider Management

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.