What are the responsibilities and job description for the Pn Systems Engineer - INS (Remote) position at CareFirst BlueCross BlueShield?
Resp & Qualifications
PURPOSE:
Seeking an experienced Facets Architect to provide strategic technical expertise in designing and delivering scalable, secure, and high-performing solutions on the TriZetto Facets platform with a focus on robust integration across internal platforms and external partner systems. This role plays a pivotal role in driving architecture decisions, optimizing data solutions, claims processing, payment and other core payer functions through scalable and secure architecture on TriZetto Facets platform.
Essential Functions
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.
Licenses/Certifications Preferred
Strong SQL, Scripting, and automation experience. Deep understanding of healthcare payer systems, NetworX Pricer, custom extensions, EDI integration, claims, and membership workflows.
Familiar with HIPAA, PHI handling, and compliance practices. Experience of Agile/Scrum practices and tools like JIRA, Confluence.
Preferred Qualifications
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
Facets Competency Center
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
PURPOSE:
Seeking an experienced Facets Architect to provide strategic technical expertise in designing and delivering scalable, secure, and high-performing solutions on the TriZetto Facets platform with a focus on robust integration across internal platforms and external partner systems. This role plays a pivotal role in driving architecture decisions, optimizing data solutions, claims processing, payment and other core payer functions through scalable and secure architecture on TriZetto Facets platform.
Essential Functions
- Architecture, design, and governance of end-to-end solutions for the Core Systems, including claims adjudication, provider data, member enrollment, and payment systems. lead the design and implementation of integrations between Facets and internal systems (e.g., portals, core platforms, analytics tools) and external partners (e.g., clearinghouses, providers, regulatory bodies). Facets database architecture, including data modeling, schema design, indexing strategies, performance tuning, and optimization.
- Drive modernization efforts including cloud optimization, decoupling of monolithic systems, and replatforming of legacy components into microservices. Create and maintain architecture blueprints aligned to enterprise strategy, modernization goals, and compliance requirements. Ensure effective data flow across systems, focusing on interoperability, performance, and system reliability.
- Partner with business, architecture and technology teams to align solution designs with payer workflows and operational requirements
- Ensure effective data exchange, real-time and batch processing strategies, and high system availability. Provide guidance and governance of Facets extensions, customizations, configuration, and third-party integrations
- Support API strategy, DevOps adoption, and enablement of reusable integration components.
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.
Licenses/Certifications Preferred
- ITIL Foundations v3 within 180 Days
Strong SQL, Scripting, and automation experience. Deep understanding of healthcare payer systems, NetworX Pricer, custom extensions, EDI integration, claims, and membership workflows.
Familiar with HIPAA, PHI handling, and compliance practices. Experience of Agile/Scrum practices and tools like JIRA, Confluence.
Preferred Qualifications
- Experience with Infrastructure as Code. Exposure to microservices architecture and API security models.
- Familiarity with data lake/data mesh concepts and integration into enterprise analytics platforms.
- Working knowledge of CMS regulations, HIPAA, NCQA standards.
- 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.
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
Facets Competency Center
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
Salary : $146,000 - $260,975