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.
