Cynet Systems
Job Location : all cities,AK, USA
Posted on : 2024-10-16T06:29:40Z
Job Description :
Job Description:
- Minimum 8 years of experience in Healthcare and Trizetto Facets.
- Minimum 4 years of experience in Jiva Platform and Cactus.
- Experience in Care Management, Utilization Management, and Provider Management.
- nalyze business processes, implementing solutions to enhance the efficiency and effectiveness of the Jiva platform.
- Develop and implement the authorization load from the Jiva platform to the Facets system.
- nalyze the authorization issues reported by members or providers in both Jiva and Facets.
- Develop processes to correct the authorization data in Jiva and load the corrected data into Facets for claims processing.
- Experience in utilization management and claims processing in Facets.
- Lead and participate in projects related to Jiva platform enhancements and updates.
- Provide ongoing support and troubleshooting assistance to Jiva issues.
- Perform system configuration required in Jiva.
- Experience in Cactus provider management application.
- Experience in provider data management and credentialing processes.
- Develop solutions to load and maintain provider data in Cactus.
- Support incidents and enhancements related to Cactus feed to Facets system.
- nalyze and gather business requirements and changes related to Cactus.
- Thorough knowledge of SDLC and best practices.
- Excellent communication skills and participates actively in team meetings and discussions.
Required Qualifications:
- Skill set: Facets, Jiva, Cactus, Case Management, Utilization Management, Provider Management, SQL, .Net.
- Hands-on experience with Safe agile methodology.
- Good communication skills.
- Healthcare experience is required.
- dded advantage if the candidate has onshore-offshore model experience / must have the interest to work in onshore-offshore model.