BSA – Provider

UST is seeking an experienced Business Systems Analyst (BSA) - Provider with deep expertise in the Tri Zetto FACETS Provider platform, including Provider Configuration, Network Management, and Pricing.

UST is seeking an experienced Business Systems Analyst (BSA) - Provider with deep expertise in the Tri Zetto FACETS Provider platform, including Provider Configuration, Network Management, and Pricing.

This role will serve as a Subject Matter Expert (SME) supporting strategic Healthcare Payer initiatives, FACETS implementations, regulatory mandates, system enhancements, and upgrade programs.

• Serve as the primary Business Systems Analyst and SME for FACETS Provider, Network, and Pricing initiatives
• Gather, analyze, document, and validate business and system requirements related to provider operations and reimbursement processes
• Collaborate with business and technical stakeholders to translate provider network and pricing requirements into scalable system solutions
• Perform impact analysis for regulatory mandates, enhancements, system upgrades, and modernization initiatives
• Analyze end-to-end provider lifecycle processes, including provider setup, credentialing integrations, contracting, network participation, and reimbursement methodologies
• Support FACETS implementation, migration, upgrade, and transformation programs
• Develop business requirements documents, functional specifications, process flows, use cases, and data mapping documentation
• Conduct root cause analysis and recommend solutions for complex provider and pricing-related issues
• Partner with development, QA, architecture, and support teams throughout the SDLC lifecycle

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

• 10+ years of experience as a Business Systems Analyst or Business Analyst
• Minimum 5+ years of hands‑on experience with the Tri Zetto FACETS platform
• Extensive Healthcare Payer domain experience
• Proven experience supporting complex FACETS implementations, regulatory mandates, and upgrade initiatives
• Skills
• SME-level expertise in:
• FACETS Provider Module
• Provider Configuration & Maintenance
• Provider Network Management
• Contracting & Reimbursement Models
• Pricing Configuration
• FACETS Front-End Functionality
• FACETS Batch Processing
• FACETS Backend Data Models
• Strong understanding of Healthcare Payer provider operations and network management processes
• Advanced SQL skills with the ability to write complex queries for analysis, data validation, troubleshooting, and solution design
• Experience analyzing provider network, contracting, fee schedule, pricing, and reimbursement business processes
• Strong requirements gathering, business process analysis, and solutioning capabilities
• Experience creating functional specifications, business rules, gap analysis, and system documentation
• Excellent communication, stakeholder management, and facilitation skills
• Ability to effectively collaborate with business, operational, and technical teams
• Preferred Qualifications
• Business Analysis certifications such as:
• CBAP (Certified Business Analysis Professional)
• CCBA (Certification of Capability in Business Analysis)
• PMI-PBA (Professional in Business Analysis)
• Experience supporting healthcare regulatory and compliance initiatives
• Familiarity with Agile delivery methodologies and tools such as JIRA, Azure Dev Ops, and Service Now
• Exposure to Claims, Membership, Billing, and Core FACETS Administration functions
• Key Competencies
• Provider Network Management Expertise
• Pricing & Reimbursement Knowledge
• FACETS Subject Matter Expertise
• Complex SQL & Data Analysis
• Requirements Elicitation &…