Facets Developer

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Requirements:

• 8+ years of experience with Trizetto Facets and strong proficiency in SQL and .Net.
• 4+ years of experience with the Jiva and Cactus platforms.
• Hands-on experience in care management, utilization management, and provider management.
• Strong knowledge of healthcare claims processing and authorization workflows.
• Experience in system configuration and troubleshooting for Jiva.
• Deep understanding of healthcare industry standards, processes, and regulations.
• Experience with provider data management and credentialing.
• Familiarity with the Software Development Life Cycle (SDLC) and best practices.
• Hands-on experience with Safe Agile methodology.

Responsibilities:

• Develop and implement the authorization load from the Jiva platform to the Facets system.
• Analyze and resolve authorization issues reported by members or providers in Jiva and Facets.
• Develop processes to correct authorization data in Jiva and load the corrected data into Facets for claims processing.
• Lead and participate in projects to enhance and update the Jiva platform.
• Develop and maintain provider data solutions within the Cactus provider management application.
• Manage provider data and credentialing processes.
• Support incidents and enhancements related to Cactus feed into the Facets system.
• Provide ongoing support and troubleshooting for Jiva platform issues.
• Lead utilization management and claims processing activities within the Facets platform.