Job Description
We are seeking a highly experienced Facets Technical SME for a long-term contract opportunity. This role is ideal for a senior-level professional who specializes in the backend operations of the TriZetto Facets platform, with strong capabilities in batch processing, data analysis, and interface management. The position does not involve front-end configuration but instead emphasizes deep system behavior and troubleshooting expertise.
You'll collaborate with various cross-functional teams (operations, configuration, and integration) to support system stability, data integrity, and compliance across multiple lines of business.
This is a remote opportunity, with a preference for candidates residing on the East Coast for alignment with working hours.
Key Responsibilities

Manage and troubleshoot eligibility, claims, financials, and enrollment processes within Facets.
Maintain in-depth knowledge of batch cycles, including daily, weekly, monthly, and EOM/EOY processes.
Investigate and resolve reprocessing issues, retroactivity impacts, and failed jobs.
Conduct advanced SQL-based data analysis to identify root causes and validate processing accuracy.
Support inbound and outbound interface transactions including 834, 837, provider, and encounter files.
Partner with integration teams to resolve mapping and data flow issues.
Lead support for production incidents, batch failures, and environment concerns.
Participate in Facets upgrades, patching, data conversions, and legacy system migrations.
Create and maintain technical documentation, including troubleshooting guides and workflows.

Required Skills

Advanced experience with Facets backend processing and architecture.
Proficiency in SQL with focus on healthcare claims, enrollment, and financial data analysis.
Expertise with EDI transactions (834, 837, etc.) and system integrations.
Strong background in healthcare domain, including Commercial, Medicaid, Medicare Advantage, or ACA.
Familiarity with CMS and Medicaid processing requirements.

Preferred Experience

Experience with Facets implementation, migration, or upgrades.
Knowledge of related TriZetto products (QNXT, TMS, NetworX).
Consulting or managed services background supporting large health plans.

Why Consider This Role?

Remote flexibility with preference for East Coast-based professionals.
Long-term contract stability (12+ months).
Opportunity to work on large-scale, multi-line-of-business healthcare systems.
Dynamic, fast-paced projects involving meaningful technical challenges.

Company Description

WellTech Partners is an equal opportunity employer.

WELLTECH PARTNERS

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