Job Summary:
The Operations Application Developer II designs, codes, tests and analyzes software programs.
Essential Functions:
- Design, develop, and implement custom code and enhancements within the Facets core module
- Apply expertise in SQL scripting and Real-time development skills to analyze data and develop solutions
- Build and support claims integrations between Facets and external systems or data sources.
- Troubleshoot and resolve the providers load, claims processing and billing issues, performing root cause analysis, and applying technical fixes
- Interpret complex business rules and translate them into effective, scalable Facets development solutions.
- Participate in testing and validation of custom code to ensure accurate claims adjudication and output.
- Support production environments, provide post-deployment monitoring, and address any performance or functionality concerns
- Recommend, schedule, and perform software improvements and upgrades
- Consistently write, translate, and code software programs and applications according to specifications
- Perform technical code reviews of peers to ensure proper coding methodology is being adhered to
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s degree in computer science or software engineering or equivalent years of relevant work experience required
- Minimum of five (4) years of advanced OOP principles and design experience required
- Experience developing and designing n-tier applications with multi-tier architectures is preferred
- Facets Extension development or experience developing applications in the healthcare sector preferred
- UML Modeling experience is preferred
Competencies, Knowledge and Skills:
- Working technical knowledge of object-based programming languages, including C#, VB.NET, ASP.NET, or Python
- Expertise in SQL development using Stored Procedure and complex queries
- Knowledge of EDI 837, 835 and 834
- Strong hands-on development experience with Core TriZetto Facet Framework and with Facets Schema
- Proven expertise in Claims Adjudication and Processing
- Expert in TriZetto Facets core modules such as Enrollment, Provider, Utilization Management
- Good understanding of Workflow configuration, Benefit and Pricing configuration
- Strong knowledge of integrated development environments, including SVN, Microsoft Visual Studio, Team Foundation Server
- Knowledge of applicable data privacy practices and laws
- Strong understanding of software development life cycle, especially Agile, Test Driven Development, and Waterfall
- Familiarity with TDD and Iterative software development methodologies
- Flexible and adaptable in regard to learning and understanding new technologies
- Strong written and oral communication skills
- Strong interpersonal skills
- Highly self-motivated and directed
- Proven analytical and problem-solving abilities
- Ability to effectively prioritize and execute tasks in a high-pressure environment
- Ability to work both independently and in a team-oriented, collaborative environment
- Ability to work additional hours to meet project deadlines
Licensure and Certification:
- Certifications in technical tools and/or programming languages preferred (MCSD, Java, Onbase, Tibco, SAP, etc.)
- Certification in Trizetto Facets product preferred
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$70,800.00 - $113,200.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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