Healthcare System Analyst – Payer Systems ) in Mason, Ohio

Healthcare System Analyst – Payer Systems (Facets, Java & React Platforms) in Mason, Ohio – Onsite

Duration: Contract

Must Have:

• Deep expertise in healthcare payer processes: Enrollment, Eligibility, Benefits, Claims Adjudication, Billing, Provider Management

• Strong SQL proficiency:

o Complex queries, joins, stored procedures

o Ability to analyze data across multiple systems/sources

• Solid understanding of database design, schemas, and data relationships

• Proven ability to analyze, reconcile, and troubleshoot payer data (claims, membership, benefits)

• Functional understanding of Facets platform:

o Architecture, modules, and capabilities

o How Facets supports core payer workflows

• Working knowledge of AI/ML concepts and how they apply to healthcare data (e.g., predictive analytics, automation, insights)

• Ability to translate business requirements into functional designs and data mappings

• Experience across Commercial, Medicare, and/or Medicaid lines of business

• Strong collaboration skills across business, data, and engineering teams

Nice to Have:

• Experience with Facets configuration or development

• Background in Java (Spring Boot / microservices)

• Familiarity with React UI applications and front-end workflows

• Understanding of API-based integrations and data flow between systems

• Hands-on experience in AI/ML projects (e.g., claims analytics, fraud detection, member insights, automation use cases)

• Exposure to Azure and AWS cloud platforms

• Knowledge of healthcare EDI transactions (834, 835, 837)

• Experience in data warehousing / data lake environments