Facets Functional Lead

Candidate must have :

• Solid hands-on experience in Facets Testing
• Exposure to the US Healthcare domain (Payer/Provider)
• Good to have EDI experience
• Minimum 8 years of testing experience
• Strong experience in Facets Testing particularly in areas like Claims Membership and provider Module
• Strong team leading experience from onsite including onsite/offshore coordation
• Good stakeholder management skills including reporting skills

• Lead end-to-end Facets implementation and enhancement projects across Enrolment Billing Claims Provider or Configuration modules.

• Work with business stakeholders to analyse requirements design functional solutions and translate them into technical specs.

• Manage system configuration benefit setup product design plan builds membership/claims workflows provider contract setup and claims adjudication logic.

• Perform impact analysis gap analysis solution mapping and integration planning for Facets components.

• Coordinate with development QA ETL Data and Integration teams for feature rollout and defect resolution.

• Oversee UAT planning test case review scenario coverage and ensure timely defect resolution.

• Act as SME for Facets system functionality and mentor junior analysts/consultants.

• Drive production issue triaging RCA and long-term solution remediation.

• Prepare process documentation functional specs configuration guides and architecture process flows.

• Manage client expectations provide status reports and ensure delivery timelines and SLA compliance.

Required Skills & Experience

• Strong functional knowledge of TriZetto Facets application (core modules & subsystems).

• Experience with Facets Enrolment Billing Claims Provider Products & Benefits QNXT migration concepts or Integration.

• Hands-on experience in requirements gathering BRD/FRD writing solution design UAT and production support.

• Familiarity with SQL ETL flows batch jobs extensions EDI transactions (834/837/835/820) preferred.

• Understanding of US healthcare payer processes - Eligibility Claims Benefits Authorizations Coordination of Benefits Capitation Pricing & Utilization Management.

• Excellent communication presentation and client-facing skills.

• Ability to lead offshore/onshore functional teams and manage delivery.

Nice-to-Have Skills

• Experience in Facets upgrades (versions migrations)

• Exposure to Cloud-based Facets environments

• Knowledge of Facets Extensions HIPAA regulations Medicare/Medicaid

• Safe/Agile Project experience

• Certification in Healthcare Domain (AHIP CPC etc)

Educational Qualifications

• Bachelors degree in computer science IT Healthcare or related field.

• Masters degree preferred but not mandatory.

Candidate must have :

• Solid hands-on experience in Facets Testing
• Exposure to the US Healthcare domain (Payer/Provider)
• Good to have EDI experience
• Minimum 8 years of testing experience
• Strong experience in Facets Testing particularly in areas like Claims Membership and provider Module
• Strong team leading experience from onsite including onsite/offshore coordation
• Good stakeholder management skills including reporting skills