Business Analyst L3

Wipro • Minneapolis, MN

3d

About The Position

The role is described as performing initial business analysis and creating basic process documents in line with defined guidelines to help team members understand client requirements and support early-stage analysis and documentation activities.

The posting also includes a detailed description for a Senior Facets / Java Developer – Medicaid Regulatory Solutions role. That role supports implementation of state-specific Medicaid regulatory changes across Facets and surrounding healthcare applications, working with regulatory, business, architecture, and QA teams to translate requirements into system configuration, application changes, integrations, and data-processing solutions. The described work combines Facets claims and membership knowledge with Java engineering, ETL, Mainframe, and Medicaid managed-care expertise.

Requirements

• Strong hands-on experience with TriZetto Facets.
• Strong Java/J2EE engineering and programming skills.
• Experience with IBM DataStage and Talend/TalendWorks or comparable enterprise ETL technologies.
• Strong understanding of Medicaid managed-care operations and state-specific regulatory requirements.
• Experience implementing regulatory or business-rule changes within healthcare payer platforms.
• Strong Facets experience in membership, eligibility, benefits, claims, claims adjudication, and pricing/payment processing.
• Good understanding of Medicaid and Medicare health-plan processes.
• Experience with SQL, databases, batch processing, APIs/interfaces, and data integration.
• Strong debugging, production support, and root-cause-analysis skills.
• Ability to interpret business and regulatory requirements and convert them into detailed technical solutions.
• Mandatory skill: HC - Payor.
• 3–5 years of experience.

Nice To Haves

• Medicare-Medicaid or dual-eligible experience.
• Experience working with multiple state Medicaid programs.
• Experience supporting large health plans or Medicaid MCO environments.
• Healthcare EDI/X12 knowledge.
• Knowledge of automated CI/CD, code quality, and test automation practices.

Responsibilities

• Perform initial business analysis and create basic process documents in accordance with defined guidelines.
• Analyze regional and state Medicaid regulatory requirements and translate them into technical changes across Facets and surrounding applications.
• Design, develop, configure, and maintain solutions for enrollment, eligibility, membership, benefits, claims, pricing, payment, provider-related processing, Medicaid business rules, and applicable Medicare/Medicaid coordination.
• Develop and enhance Java-based applications, APIs, interfaces, batch programs, and integration components supporting Facets.
• Develop or modify Mainframe programs and batch-processing components supporting Medicaid processes.
• Perform Facets configuration and development for regulatory and business-rule changes.
• Build and maintain ETL and data integration solutions using IBM DataStage and Talend/TalendWorks.
• Analyze upstream and downstream impacts of regulatory changes across Facets, data platforms, interfaces, and surrounding applications.
• Conduct code reviews, unit testing, defect resolution, root-cause analysis, and technical quality assessments.
• Support system integration testing, regression testing, and production implementation.
• Troubleshoot complex claims, membership, eligibility, and regulatory-processing issues.
• Develop reusable engineering approaches for common regulatory requirements while accommodating state-specific variations.
• Maintain technical specifications, mappings, configuration documentation, traceability, and implementation artifacts.

Benefits

• Medical and dental benefits options.
• Disability insurance.
• Paid time off, inclusive of sick leave.
• Other paid and unpaid leave options.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed