Lead Facets System Engineer (Remote)

CareFirst•Reston, VA

10h•Remote

About The Position

This role defines, designs, and develops system requirements, performing trade-off analysis of performance, life-cycle cost, risk, producibility, and other system or program requirements. The engineer will assess architecture and current hardware limitations, define and design system specifications, and evaluate input/output processes and working parameters for hardware/software compatibility. This position coordinates the design of subsystems and the integration of the total system, defines system support requirements (monitoring, capacity, staffing, patching/updating), and analyzes and resolves program support deficiencies. The engineer will also conduct independent technical investigations in systems design.

Requirements

Bachelor's Degree in Information Technology or Computer Science OR an additional 4 years of relevant work experience in lieu of a Bachelor's degree.
8 years proven success overseeing the design, development, and implementation of software systems and applications.
8+ years of experience supporting, administering, engineering, or implementing the Facets platform in a healthcare payer environment.
8+ years of experience with health insurance claims processing, including claims lifecycle, adjudication, benefits configuration, provider servicing, membership, and production support.
Experience troubleshooting and resolving complex claims processing issues, system integrations, and production incidents impacting claims operations.
Experience leading large-scale system implementations, upgrades, integrations, or transformation initiatives supporting healthcare claims platforms.
Experience collaborating with business operations teams including Claims, Enrollment, Provider Services, Customer Service, and Configuration teams.
Knowledge of programming languages and web based technologies.
Proficient in Microsoft Office applications.
Ability to collaborate to solve technical problems across teams.
Excellent communication skills both written and verbal.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Must be eligible to work in the U.S. without Sponsorship.

Nice To Haves

ITIL Foundations v3 within 180 Days
Experience with healthcare EDI transactions, claims workflows, and related integrations is preferred.
Experience with Blue Cross Blue Shield Inter-Plan Processing (IPP) is preferred.

Responsibilities

Installs, tunes, upgrades, troubleshoots, and maintains all computer systems relevant to the supported applications, including operating system administration, user account management, disaster recovery strategy, and networking configuration.
Develops and implements techniques to prevent system problems, troubleshoots incidents to recover services, and supports root cause analysis.
Evaluates new systems by performing in-depth tests, including end-user reviews.
Researches software and related products to support recommendations and purchasing.
Determines systems integration issues by evaluating components, developing and completing performance tests, analyzing test data, studying project requirements, analyzing user and potential user input, and evaluating similar and related products and systems.
Develops system automation and system integration of business processes.
Improves engineering job knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, benchmarking state-of-the-art practices, and participating in professional societies.
Acts as a mentor for junior and senior team members.