Apply📍 Philippines, India, Pakistan, Singapore
🔍 Healthcare
🏢 Company: CrewBloom
- 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.
- 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.
Software DevelopmentSQLAgile.NETCommunication SkillsCollaboration
Posted about 2 months ago
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