Job Title: Facets + Jiva Developer

Duration:11/4/2024-12/31/2025

Location: Remote (support CST)

Years of Experience:10.00 Years of Experience

Top Must Have's:

Facets (8 yrs min) Jiva and Cactus - 4 yrs

SQL, .Net - 8 yrs min

Responsibilities

Minimum 8 years of experience in Healthcare and Trizetto Facets.

Minimum 4 years of experience in Jiva Platform and Cactus

Experience in Care Management, Utilization Management and Provider Management

Analyze business processes, implementing solutions to enhance efficiency and effectiveness of Jiva platform.

Develop and implement the authorization load from Jiva platform to Facets system

Analyze the authorization issues reported by member or provider in both Jiva and Facets

Develop processes to correct the authorization data in Jiva and load the corrected data into Facets for claims processing.

Experience in utilization management and claims processing in Facets.

Lead and participate in projects related to Jiva platform enhancements and updates.

Provide ongoing support and troubleshooting assistance to Jiva issues.

Perform system configuration required in Jiva.

Experience in Cactus provider management application.

Experience in provider data management and credentialing processes

Develop solutions to load and maintain provider data in Cactus

Support incidents and enhancements related to Cactus feed to Facets system

Analyze and gather business requirements and changes related to Cactus

Thorough knowledge of SDLC and best practices

Excellent communication skill and participates actively in team meetings discussions

Required Qualifications

Skill set: Facets, Jiva, Cactus, Case Management, Utilization Management, Provider Management, SQL, .Net

Hands on experience with Safe agile methodology

Good communication skills.

Healthcare experience is required

Added advantage if the candidate has onshore offshore model experience / must have interest to work in onshore offshore model