Sr Facets Business Systems Analyst

Mindlance is recruiting for a confidential client seeking a Senior Facets Business Systems Analyst. The role leads complex Facets configuration and maintenance, translates business requirements into system designs, and supports testing, technical issue resolution, and cross-functional projects.

Responsibilities:

• Document detailed Facets product configuration requirements (BCRs), including benefit codes, exceptions, provider tiering, and benefit administration rules
• Develop detailed configuration design documents that translate business requirements into Facets system setup specifications
• Create and maintain requirements-to-test traceability to ensure all requirements are fully validated through testing
• Partner with Claims, UM, Care Management, and Service teams to gather detailed requirements for claims routing, exception handling, and manual review processes
• Develop detailed Facets workflow design documents, build configurations, and support claims and service testing activities
• Lead the Facets configuration and maintenance of most complex and highly critical system tables and data elements across multiple system environments
• Lead the analysis, development and implementation of configuration changes to improve system performance and user efficiency
• Coordinate and monitor configuration for accuracy and compliance to change control processes
• Own the end to end delivery of projects assigned to - this involves requirement documentation, design completion, Facets build delivery and test support
• Provide significant business acumen (breadth and depth) and global technical expertise in critical systems/applications to support proactive Facets configuration solutioning for highly complex and varied business issues, while considering broader impacts of technical decisions to the current and future state business environment
• Act as domain SME for IT projects to help map their data needs to Facets configuration applications
• Act as configuration SME to triage any Facets integration solutions developed by IT partners
• Lead the review, analysis and development of solutions for highly critical business systems, which may have impacts across multiple business areas or systems/applications
• Review the test scenarios, give feedback to testers; review claims test results; sometimes perform shadow testing to ensure complex configuration solution is working as we expect
• Leads work groups in assessment of business issues and facilitates the resolution of most complex or broad system/application problems by:
• Coordinating initial triage for severity and business impact of system/application failures
• Leading the troubleshooting and analysis necessary to determine root cause of issues
• Coordinating the development of applicable business processes and solutions, to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met
• End to end issue resolution support, like claims remediation support, impact analysis, process updates etc

Requirements:

• Facets tool Knowledge with deep understanding of Medical Product config, Group/member enrollment, provider network config and claims
• Good understanding of Facets data Model
• Microsoft SQL
• MS Excel