Business Systems Analyst (FACETS Membership) Healthcare Payer & BPM

    Highlights

    The ideal candidate will possess strong functional and technical knowledge of FACETS Membership processes, backend data models, batch operations, advanced SQL analysis, and healthcare BPM workflows while partnering with business stakeholders, technology teams, operational leaders, and BPM teams to deliver high-impact solutions. UST is seeking an experienced Business Systems Analyst (BSA) - Membership with deep expertise in the TriZetto FACETS Membership platform, including Enrollment and Billing operations within a Healthcare Payer and BPM (Business Process Management) environment.

    Numbers & Facts

    LocationSeattle, WA

    Description

    Role: Business Systems Analyst (FACETS Membership) Healthcare Payer & BPM(23799-1)
    Location: Seattle, WA(No Remote)
    Duration: 6-12+ Months contract

    Must Have Skills

    Skill 1 Yrs of Exp FACETS
    Skill 2 Yrs of Exp SQL
    Skill 3 Yrs of Exp Jira
    Skill 4 Yrs of Exp - Agile

    Experience
    10+ Years


    About the Role

    UST is seeking an experienced Business Systems Analyst (BSA) - Membership with deep expertise in the TriZetto FACETS Membership platform, including Enrollment and Billing operations within a Healthcare Payer and BPM (Business Process Management) environment.

    This role will serve as a Subject Matter Expert (SME) responsible for driving business analysis, solution design, system enhancements, regulatory mandates, FACETS modernization initiatives, and business process optimization programs.

    The ideal candidate will possess strong functional and technical knowledge of FACETS Membership processes, backend data models, batch operations, advanced SQL analysis, and healthcare BPM workflows while partnering with business stakeholders, technology teams, operational leaders, and BPM teams to deliver high-impact solutions.

    What You'll Do
    Serve as the primary Business Systems Analyst and SME for FACETS Membership, Enrollment, and Billing initiatives.
    Gather, analyze, document, and validate complex business and system requirements.
    Collaborate with business stakeholders to understand membership, enrollment, billing, and operational process needs and translate them into functional and technical requirements.
    Perform impact assessments for regulatory mandates, enhancement requests, system upgrades, modernization programs, and BPM transformation initiatives.
    Analyze end-to-end Membership and Billing workflows to identify process improvements, operational efficiencies, and optimization opportunities.
    Support FACETS implementation, migration, upgrade, transformation, and process improvement initiatives.
    Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documents.
    Conduct root cause analysis and solution assessments for complex business and system issues.
    Work closely with development, QA, architecture, operations, and BPM delivery teams during design, testing, deployment, and support phases.
    Support User Acceptance Testing (UAT), defect triage, production validation, and post-implementation activities.
    Facilitate requirements workshops, stakeholder discussions, and solution review sessions.
    Provide production support expertise for membership, enrollment, billing, and operational workflow-related issues.
    Partner with business and BPM stakeholders to drive continuous improvement, operational excellence, and process standardization initiatives.

    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 and Healthcare BPM/BPO domain experience.
    Proven experience supporting complex FACETS implementations, regulatory mandates, upgrade projects, process transformation initiatives, and modernization programs.

    Required Skills
    SME-Level Expertise In
    FACETS Membership
    Enrollment & Eligibility
    Billing & Premium Management
    FACETS Front-End Functionality
    FACETS Batch Processing
    FACETS Backend Data Models

    Functional Skills
    Strong understanding of Healthcare Payer membership lifecycle processes and BPM operational workflows.
    Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design.
    Experience analyzing membership, enrollment, billing, eligibility, premium-related business processes, and operational workflows.
    Strong requirements gathering, business process analysis, process optimization, and solutioning skills.
    Experience creating functional specifications, business rules, process documentation, and system documentation.
    Strong communication and stakeholder management capabilities.
    Ability to bridge business, technical, and BPM operations teams to deliver scalable solutions.
    Experience supporting operational excellence, workflow optimization, SLA adherence, and process governance initiatives.

    Preferred Qualifications
    Business Analysis Certifications
    CBAP (Certified Business Analysis Professional)
    CCBA (Certification of Capability in Business Analysis)
    PMI-PBA (Professional in Business Analysis)
    Additional Preferred Experience
    Experience supporting Healthcare regulatory and compliance initiatives.
    Familiarity with Agile delivery methodologies and tools such as JIRA, Azure DevOps, and ServiceNow.
    Exposure to Claims, Provider, and Core FACETS Administration functions.
    Experience working in Healthcare BPM/BPO environments.
    Experience supporting business process transformation, automation, and continuous improvement programs.

    Key Competencies
    Membership & Enrollment Domain Expertise
    Billing & Premium Management Knowledge
    FACETS Subject Matter Expertise
    Complex SQL & Data Analysis
    Requirements Elicitation & Documentation
    Business Process Modeling
    BPM Process Analysis & Optimization
    Solution Design & Validation
    Stakeholder Management
    Root Cause Analysis
    Operational Excellence & Continuous Improvement
    Agile & Waterfall Delivery
    Healthcare Payer & BPM Domain Expertise

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