Healthcare Facets BA (Claims/Membership)

Location: United States - Seattle, Washington

Required Qualifications: Experience 10+ years of experience as a Business Systems Analyst or Business Analyst. Minimum 5+ years of hands-on experience with the TriZetto FACETS platform. Extensive Healthcare Payer domain experience. Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade projects.

Required Skills: SME-level expertise in: FACETS Claims/Membership Enrollment & Eligibility Billing & Premium Management FACETS Front-End Functionality FACETS Batch Processing FACETS Backend Data Models Strong understanding of Healthcare Payer membership lifecycle processes. Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design. Experience analyzing membership, enrollment, billing, eligibility, and premium-related business processes. Strong requirements gathering, business process analysis, and solutioning skills. Experience creating functional specifications, business rules, and system documentation. Strong communication and stakeholder management capabilities. Ability to bridge business and technical teams to deliver scalable solutions.

Preferred Qualifications: Experience working with Blue Cross Blue Shield organizations. Business Analysis certifications such as: CBAP (Certified Business Analysis Professional) CCBA (Certification of Capability in Business Analysis) PMI-PBA (Professional in Business Analysis) Experience supporting Healthcare regulatory and compliance initiatives. Familiarity with Agile delivery methodologies and tools such as JIRA, Azure DevOps, and Service Now. Exposure to Claims, Provider, and Core FACETS Administration functions.

Key Competencies: Membership & Enrollment Domain Expertise Billing & Premium Management Knowledge FACETS Subject Matter Expertise Complex SQL & Data Analysis Requirements Elicitation & Documentation Business Process Modeling Solution Design & Validation Stakeholder Management Root Cause Analysis Agile & Waterfall Delivery