Role description
BSA - Provider
The Role
UST is seeking an experienced Business Systems Analyst (BSA) - Provider with deep expertise in the TriZetto FACETS Provider platform, including Provider Configuration, Network Management, and Pricing.
This role will serve as a Subject Matter Expert (SME) supporting strategic Healthcare Payer initiatives, FACETS implementations, regulatory mandates, system enhancements, and upgrade programs.
What You'll Do
• Serve as the primary Business Systems Analyst and SME for FACETS Provider, Network, and Pricing initiatives
• Gather, analyze, document, and validate business and system requirements related to provider operations and reimbursement processes
• Collaborate with business and technical stakeholders to translate provider network and pricing requirements into scalable system solutions
• Perform impact analysis for regulatory mandates, enhancements, system upgrades, and modernization initiatives
• Analyze end-to-end provider lifecycle processes, including provider setup, credentialing integrations, contracting, network participation, and reimbursement methodologies
• Support FACETS implementation, migration, upgrade, and transformation programs
• Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documentation
• Conduct root cause analysis and recommend solutions for complex provider and pricing-related issues
• Partner with development, QA, architecture, and support teams throughout the SDLC lifecycle
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
What You Need
• 10+ years of experience as a Business Systems Analyst or Business Analyst
• Minimum 5+ years of hands-on experience with the TriZetto FACETS platform
• Extensive Healthcare Payer domain experience
• Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade initiatives
• Skills
• SME-level expertise in:
• FACETS Provider Module
• Provider Configuration & Maintenance
• Provider Network Management
• Contracting & Reimbursement Models
• Pricing Configuration
• FACETS Front-End Functionality
• FACETS Batch Processing
• FACETS Backend Data Models
• Strong understanding of Healthcare Payer provider operations and network management processes
• Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design
• Experience analyzing provider network, contracting, fee schedule, pricing, and reimbursement business processes
• Strong requirements gathering, business process analysis, and solutioning capabilities
• Experience creating functional specifications, business rules, gap analysis, and system documentation
• Excellent communication, stakeholder management, and facilitation skills
• Ability to effectively collaborate with business, operational, and technical teams
• Preferred Qualifications
• Business Analysis certifications such as:
• CBAP (Certified Business Analysis Professional)
• CCBA (Certification of Capability in Business Analysis)
• PMI-PBA (Professional in Business Analysis)
• Experience supporting healthcare regulatory and compliance initiatives
• Familiarity with Agile delivery methodologies and tools such as JIRA, Azure DevOps, and ServiceNow
• Exposure to Claims, Membership, Billing, and Core FACETS Administration functions
• Key Competencies
• Provider Network Management Expertise
• Pricing & Reimbursement Knowledge
• FACETS Subject Matter Expertise
• Complex SQL & Data Analysis
• Requirements Elicitation & Documentation
• Business Process Modeling
• Solution Design & Validation
• Stakeholder Management
• Root Cause Analysis
• Agile & Waterfall Delivery
Location & Compensation
Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.
Role Location: Seattle, Washington
Compensation Range: $88,000-$132,000
Benefits
Full-time, regular employees accrue a minimum of 10 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave and jury duty. They are eligible to participate in the Company's 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid Employee Only benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses as allowable under IRS guidelines. Benefits offerings vary in Puerto Rico.
Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) Retirement Plan with employer matching.
Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.
Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).
All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.
