Facets Configuration Analyst (Remote - Canada)

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants anywhere in Canada . Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs. The working arrangements for this role are accurate as of the date of posting and may change based on business or client requirements.

5+ years of hands-on experience configuring the TriZetto Facets platform in a healthcare payer environment.

Strong experience configuring Group, Class, Plan, Product, Benefits, Provider Contracts, Pricing, Service Groups, Fee Tables, Workflow, CMU, and related Facets modules.

Proven experience interpreting provider reimbursement contracts and translating business requirements into Facets configuration solutions.

Strong knowledge of Facets backend functionality, including SQL query development, configuration validation, and claims processing analysis.

Experience troubleshooting claim adjudication, claim pend, and configuration-related issues.

Demonstrated experience supporting Medicare and Medicaid lines of business.

Ability to collaborate effectively with business users, operations teams, and clients to deliver scalable healthcare payer solutions.

Strong analytical, problem-solving, and communication skills.

Experience with Facets NetworX configuration and provider pricing setups.

Knowledge of healthcare claims payment methodologies and reimbursement models.

Experience supporting large-scale Facets implementations or migration initiatives.

Understanding of healthcare payer operations, benefits administration, and claims lifecycle processes.

Familiarity with healthcare regulatory requirements impacting Medicare and Medicaid programs.