Technical Architect

HCL Technologies Limited; San Antonio (TX); Presencial; USD 94.000 - 139.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Dental insurance

Vision insurance

Pharmacy coverage

Life insurance

Disability insurance

401(k) retirement plan

PTO 10 days

10 holidays per year

Descripción de la vacante

HCLTech in Texas seeks a seasoned Technical Architect with strong TriZetto Facets experience to lead healthcare payer solutions. You will design and implement Facets modules for claims processing, benefits configuration, and member/provider management, including ACA and Medicare programs, while coordinating with business and technical teams.

Role requires collaboration with PBM vendors, integration work, data analysis (SQL), and API integrations to support regulatory changes and transformation

Formación

• Experience with TriZetto Facets and healthcare claims processing.
• Strong knowledge of benefits configuration and member/provider management.
• Experience with ACA, Medicare programs and regulatory changes.
• Experience integrating with PBM vendors and healthcare data systems.
• Proficiency in SQL, data analysis, and API integrations within healthcare payers.

Responsabilidades

• Gather and analyze business requirements from healthcare stakeholders.
• Work extensively with TriZetto Facets modules.
• Support Claims Adjudication and Payment processing.
• Configure and validate Benefits, Accumulators, and Provider contracts.
• Analyze Member enrollment and eligibility processes.
• Collaborate with PBM vendors for Pharmacy benefit integrations.
• Support ACA Marketplace and Medicare business processes.
• Perform impact analysis for system enhancements and regulatory changes.
• Create BRDs, FRDs, User Stories, Process Flows, and Test Cases.
• Coordinate UAT and production implementation activities.
• Work closely with development, QA, and operations teams.

Conocimientos

Data Analysis

SQL

MS Excel

Agile / Scrum

API Integrations

Herramientas

Jira

Confluence

HP ALM / Quality Center

Descripción del empleo

HCLTech is looking for a highly talented and self- motivated Technical Architect with Facets experience implementing Facets. Technical Architect with extensive knowledge on Facets & Testing. Technical Architect with Healthcare Claims, Payment Process, Claims Processing, Processing Health Plans, Healthcare Data Warehouse experience. Technical Architect to join HCL Tech in advancing the technological world through innovation and creativity.

Must Have Experience:

• Experience with Facets
• Experience with Health Claims
• Experience with Payment Processes
• Experience with Processing Health Plans
• Experience with Design within Facets
• Experience with Development within Facets
• Experience with Integrating with systems within Health Policy
• Experience with Administrative & Claims processing
• Experience how payments are done
• Experience how Facets Integrates

Preferred Skills:

• Healthcare Data Warehouse
• Encounter Processing
• Value-Based Care
• Medicaid Knowledge
• FHIR & HL7
• Provider Contracting
• Claims Processing Lifecycle
• Benefits Administration
• Provider Management
• Payment & Reimbursement
• Coordination of Benefits (COB)
• ACA (Affordable Care Act)
• HIPAA Compliance

Job Summary

Seeking an experienced Healthcare Domain Analyst with strong expertise in TriZetto Facets, Claims Processing, Benefits Configuration, Member and Provider Management, Payment Adjudication, Accumulators, PBM integration, ACA, and Medicare programs. The candidate will collaborate with business stakeholders, operations teams, and technical teams to implement healthcare payer solutions and support business transformation initiatives.

Responsibilities

• Gather and analyze business requirements from healthcare stakeholders.
• Work extensively with TriZetto Facets modules.
• Support Claims Adjudication and Payment processing.
• Configure and validate Benefits, Accumulators, and Provider contracts.
• Analyze Member enrollment and eligibility processes.
• Collaborate with PBM vendors for Pharmacy benefit integrations.
• Support ACA Marketplace and Medicare business processes.
• Perform impact analysis for system enhancements and regulatory changes.
• Create BRDs, FRDs, User Stories, Process Flows, and Test Cases.
• Coordinate UAT and production implementation activities.
• Work closely with development, QA, and operations teams.

Technical Skills

• SQL
• Data Analysis
• MS Excel
• Jira
• Confluence
• HP ALM / Quality Center
• Agile / Scrum
• API Integrations
• EDI Transactions (834, 835, 837, 270/271)

Pay Range Minimum: 94,000k

Pay Range Maximum: 139,000k

HCLTech is an equal opportunity employer, committed to providing equal employment opportunities to all applicants and employees regardless of race, religion, sex, color, age, national origin, pregnancy, sexual orientation, physical disability or genetic information, military or veteran status, or any other protected classification, in accordance with federal, state, and/or local law. Should any applicant have concerns about discrimination in the hiring process, they should provide a detailed report of those concerns to [e-mail] for investigation.

Compensation and Benefits

A candidate's pay within the range will depend on their work location, skills, experience, education, and other factors permitted by law. This role may also be eligible for performance-based bonuses subject to company policies. In addition, this role is eligible for the following benefits subject to company policies: medical, dental, vision, pharmacy, life, accidental death & dismemberment, and disability insurance; employee assistance program; 401(k) retirement plan; 10 days of paid time off per year (some positions are eligible for need-based leave with no designated number of leave days per year); and 10 paid holidays per year.

How You'll Grow

At HCLTech, we offer continuous opportunities for you to find your spark and grow with us. We want you to be happy and satisfied with your role and to really learn what type of work sparks your brilliance the best. Throughout your time with us, we offer transparent communication with senior-level employees, learning and career development programs at every level, and opportunities to experiment in different roles or even pivot industries. We believe that you should be in control of your career with unlimited opportunities to find the role that fits you best.