Senior Facets Systems Analyst (Payer & Enrollment)

Blue Cross and Blue Shield of North Carolina; Louisiana (MO); Hybrid; USD 119,000 - 190,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and surrogacy support

Tuition reimbursement and career dev.

Job summary

Blue Cross NC is seeking an experienced business systems professional to drive end-to-end requirements elaboration and functional design for enterprise-wide healthcare solutions. You will translate business needs into technical specifications, aligning with regulatory and architecture standards.

You will lead cross-functional sessions, document design artifacts, and guide teams through complex data mapping, rule definition, and system impacts across portfolios while balancing ROI and timelines.

Qualifications

• Bachelor's degree or advanced degree (where required).
• 8+ years of experience in related field; in lieu of degree, 10+ years of experience.
• Trizetto Facets enrollment, billing and/or claims experience required.
• Strong knowledge with payer systems and enrollment functions, processing and automation.

Responsibilities

• Facilitate the design, construction, deployment, and maintenance of complex solutions through design documents, gap analysis, data mapping and risk assessment.
• Elaborate business requirements into functional designs aligned with enterprise architecture.
• Conduct systems analysis to validate designs and ensure end-to-end quality of product.
• Prioritize requirements through negotiation and release/phases.
• Create and document functional designs and ensure traceability across systems.
• Serve as expert advisor for systems analysis and process design services.

Skills

Payer systems knowledge

Education

Bachelor's degree or advanced degree (where required)

In lieu of degree, 10+ years of experience

Tools

Trizetto Facets

Job description

Blue Cross NC is seeking an experienced business systems professional to drive end-to-end requirements elaboration and functional design for enterprise-wide healthcare solutions. You will translate business needs into technical specifications, aligning with regulatory and architecture standards.

You will lead cross-functional sessions, document design artifacts, and guide teams through complex data mapping, rule definition, and system impacts across portfolios while balancing ROI and timelines.