Business Analyst L3

Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients’ most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world.

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Role Purpose

The purpose of this role is to perform initial business analysis and create basic process documents in line with defined guidelines to assist team members in understanding client requirements and supporting early-stage analysis and documentation activities.

Role:
Senior Facets / Java Developer
- Medicaid Regulatory Solutions

Job Description.

An experienced Facets / Mainframe / Java Developer or Engineer to support implementation of state-specific Medicaid regulatory changes across Facets and surrounding healthcare applications. The engineer will work with regulatory, business, architecture, and QA teams to translate Medicaid requirements into system configuration, application changes, integrations, and data-processing solutions. The ideal candidate combines strong Facets claims and membership knowledge with hands-on Java engineering, Data Stage/Talend experience, Mainframe and Medicaid managed-care domain expertise.

• Analyze regional/state Medicaid regulatory requirements and translate them into technical changes across Facets and surrounding applications.
• Design, develop, configure, and maintain solutions supporting:
  • Member enrollment and eligibility
  • Membership maintenance
  • Benefits and plan configuration
  • Claims intake and adjudication
  • Claims pricing and payment
  • Provider-related claim processing
  • Medicaid-specific edits and business rules
  • Medicare/Medicaid coordination where applicable
• 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 associated with regulatory and business-rule changes.
• Build and maintain ETL/data integration solutions using IBM Data Stage and Talend/Talend Works.
• 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 where regulatory requirements are common while accommodating state-specific variations.
• Maintain technical specifications, mappings, configuration documentation, traceability and implementation artifacts.

• Strong hands-on experience with Tri Zetto Facets.
• Strong Java/J2EE engineering and programming skills.
• Experience with IBM Data Stage and Talend/Talend Works 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
  • Pricing/payment processing
• Good understanding of both 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/regulatory requirements and convert them into detailed technical solutions.

• Medicare-Medicaid / 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

Mandatory

Skills:

HC
- Payor.

Experience:

3-5 Years.

The expected compensation for this role ranges from $45,000 to $110,000 .Final compensation will depend on various factors, including your geographical location,…