Resp & Qualifications
PURPOSE:
Play a vital role in ensuring successful delivery of technology solutions that support Facets modernization efforts. Possess expert-level knowledge of Facets platform, play a critical role in leading the delivery of complex Facets platform upgrades and supporting cross-cutting corporate initiatives relative to Facets platform and its capabilities. Stay up-to-date with the latest technologies and best practices related to Facets development. Experience in Facets batch jobs using HBA architecture. Good Experience in Claims Adjudication& Processing. Bridge the gap between business needs and technical execution, ensuring cross-functional alignment and measurable outcomes.
ESSENTIAL FUNCTIONS:
- Drive and influence the Facets application roadmap in close collaboration with enterprise architects, product owners, and business stakeholders, ensuring alignment with evolving business goals and regulatory demands, Design, develop, and maintain custom interfaces, extensions, and REST APIs for the Facets platform. Lead and mentor a team of developers, providing guidance and support. Delegate tasks to engineering/technical staff. Ensure code quality and adherence to best practices.
- Ensures that all upgrades, enhancements, and integrations with Facets are forward-compatible, scalable, and contribute to long-term architectural goals. Performs software analysis, including requirements and uses case development and design. Implements and documents source code to design specifications. Performs software testing including developing and running automated unit tests, drafting, and executing structured automated test cases. Compile, assess, and report data results from software testing and analysis.
- Develops software solutions for enterprise environments and other technologies. Analyzes and implements functional and non-functional (e.g. performance, availability) requirements and designs, implements, and tests software. Performs operations & maintenance (O&M) of existing systems. Identifies areas for improvement and streamlining. Demonstrated experience with front-end and back-end programing and integration frameworks and tools. Assist in the estimation of development of application features
- Provides direct technical support for high level, high visibility and critical trouble calls for supported applications. Works with cross functional teams to develop highly reliable software that runs at scale. Provides recommendations to infuse new technology. Extend open-source libraries and systems as necessary to meet the needs of the team. Play a crucial role in product scoping and roadmap / architecture discussions. Continually evaluate emerging technologies to identify opportunities, trends, and best practices. Mentoring of junior software engineers
SUPERVISORY RESPONSIBILITY:
Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.
QUALIFICATIONS:
Education Level: Bachelor's Degree in Information Technology or Computer Science OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
Experience: 8 years proven success overseeing the design, development, and implementation of software systems and applications. Knowledge of Facets application (including upgrades, extensions, and configurations)
Preferred Qualifications:
- Expert-level knowledge of Facets platform, features and its capabilities.
- Strong analytical, diagnostic, and problem-solving abilities.
- Excellent communication and interpersonal skills.
- Experience in leading and mentoring teams.
- Experience in project management.
- 5 years experience with software development, software architecture/design, user requirements definition and software specification development.
- 3+ years of Systems Architecture experience.
Knowledge, Skills and Abilities (KSAs)
- Deep understanding of TriZetto Facets core modules - Enrollment, Billing, Claims, Provider, UM etc)
- Facets data model, configuration and system behavior
- Extension Frameworks - Facets Extension (Batch, Online, Workflow)
- Healthcare Payer Domain - Familiarity with CMS regulations, HIPAA, EDI (837, 834, 835), Claims adjudication, provider contracts, member eligibility
- Development tools and tech stack - C#, .NET Framework, SQL Server/T-SQL, Stored procedures, triggers, and database tuning
- Enterprise integration - APIs, Web Services (SOAP/REST), ETL tools and interface engines
- SDLC & DevOps - Agile/Scrum methodologies, CI/CD pipelines (Azure DevOps, Jenkins), Source Control (Git, TFS)
- Experience in project management.
- Excellent communication and interpersonal skills.
- Experience in leading and mentoring teams.
Salary Range: $96,552 - $191,763
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Department
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.
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