Business or System Analyst (Facets Workflow and claims)

Vaiticka Solution is looking for a Business or System Analyst specializing in Facets Workflow and claims. The role involves analyzing and optimizing claims and benefits workflows within the Facets platform, including reviewing workflow rules and supporting clients in improving operations.

Responsibilities:

• Review 4000+ Facets workflow rules and identify state‑specific and group‑specific customizations
• Map rule dependencies and evaluate downstream impact across claims, membership, billing, and provider modules
• Document differences between baseline and client‑specific configurations
• Work with business, configuration, and QA teams to validate rule behavior
• Recommend optimizations, including consolidation of redundant rules

Requirements:

• 5–8 years as a Business or System Analyst working with Facets
• Strong understanding of claims workflows, provider validation, and benefits administration
• Experience reviewing large rule/configuration repositories
• Solid knowledge of US healthcare payer operations
• Ability to interpret and analyze complex rules and configurations
• Strong documentation and communication skills
• Facets Workflow Rules Configuration
• SQL for rule impact analysis
• Facets Data Model & Operations
• Knowledge of state/regulatory variations
• Critical thinking & problem solving
• Leadership & collaboration
• Ability to manage large rule inventories