BSA - Provider

Role description

BSA - Provider

The Role

UST is seeking an experienced Business Systems Analyst (BSA) - Provider with deep expertise in the TriZetto FACETS Provider platform, including Provider Configuration, Network Management, and Pricing. This role will serve as a Subject Matter Expert (SME) supporting strategic Healthcare Payer initiatives, FACETS implementations, regulatory mandates, system enhancements, and upgrade programs.

What You'll Do

* Serve as the primary Business Systems Analyst and SME for FACETS Provider, Network, and Pricing initiatives * Gather, analyze, document, and validate business and system requirements related to provider operations and reimbursement processes * Collaborate with business and technical stakeholders to translate provider network and pricing requirements into scalable system solutions * Perform impact analysis for regulatory mandates, enhancements, system upgrades, and modernization initiatives * Analyze end-to-end provider lifecycle processes, including provider setup, credentialing integrations, contracting, network participation, and reimbursement methodologies * Support FACETS implementation, migration, upgrade, and transformation programs * Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documentation * Conduct root cause analysis and recommend solutions for complex provider and pricing-related issues * Partner with development, QA, architecture, and support teams throughout the SDLC lifecycle

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 domain experience * Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade initiatives * Skills *

SME-level expertise in:

* FACETS Provider Module * Provider Configuration & Maintenance * Provider Network Management * Contracting & Reimbursement Models * Pricing Configuration * FACETS Front-End Functionality * FACETS Batch Processing * FACETS Backend Data Models * Strong understanding of Healthcare Payer provider operations and network management processes * Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design * Experience analyzing provider network, contracting, fee schedule, pricing, and reimbursement business processes * Strong requirements gathering, business process analysis, and solutioning capabilities * Experience creating functional specifications, business rules, gap analysis, and system documentation * Excellent communication, stakeholder management, and facilitation skills * Ability to effectively collaborate with business, operational, and technical teams * Preferred Qualifications *

Business Analysis certifications such as:

* CBAP (Certified Business Analysis Professional) * CCBA (Certification of Capability in Business Analysis) * PMI-PBA (Professional in Business Analysis) * Experience supporting healthcare regulatory and compliance initiatives * Familiarity with Agile delivery methodologies and tools such as JIRA, Azure DevOps, and ServiceNow * Exposure to Claims, Membership, Billing, and Core FACETS Administration functions * Key Competencies * Provider Network Management Expertise * Pricing & Reimbursement Knowledge * FACETS Subject Matter Expertise * Complex SQL & Data Analysis * Requirements Elicitation & Documentation * Business Process Modeling * Solution Design & Validation * Stakeholder Management * Root Cause Analysis * Agile & Waterfall Delivery

Location & Compensation

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Seattle, Washington

Compensation Range:

$88,000-$132,000

Who We Are

Since 1999, UST has worked side by side with the world's best companies to make a powerful impact ... 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.