Role description
BSA - Membership
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.
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 This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
What You Need
* 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 * 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 * ... For full info follow application link.UST Global celebrates diversity and inclusion. We are an Equal Employment Opportunity employer. We welcome candidates to apply for employment from diverse backgrounds and believe your unique perspective adds to the richness of our company culture. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.