Operations Application Developer

Job Summary
The Operations Application Developer II is responsible for designing, coding, testing, and analyzing software programs, with a primary focus on Facets development and integrations. This role ensures the delivery of scalable, reliable, and effective software solutions while supporting claims processing, billing, and provider integrations.

Essential Functions

• Design, develop, and implement custom code and enhancements within the Facets core module.
• Apply expertise in SQL scripting and real-time development to analyze data and build solutions.
• Develop and support claims integrations between Facets and external systems.
• Troubleshoot provider load, claims processing, and billing issues with root cause analysis and technical fixes.
• Translate complex business rules into scalable Facets development solutions.
• Participate in testing and validation of custom code to ensure accurate claims adjudication.
• Support production environments with post-deployment monitoring and performance improvements.
• Recommend, schedule, and implement software improvements and upgrades.
• Perform peer code reviews to ensure best coding practices.
• Execute additional duties as assigned.

Education and Experience

• Bachelor’s degree in Computer Science, Software Engineering, or equivalent experience required.
• 4+ years of experience with advanced OOP principles and design.
• Preferred: n-tier application development, UML modeling, and healthcare sector experience.
• Facets Extension development highly desirable.

Competencies, Knowledge, and Skills

• Strong expertise in OOP languages: C#, VB.NET, ASP.NET, or Python.
• Advanced SQL development with stored procedures and complex queries.
• Knowledge of EDI 837, 835, 834 transactions.
• Hands-on experience with TriZetto Facets core modules: Enrollment, Provider, Utilization Management.
• Expertise in claims adjudication and processing.
• Familiarity with Workflow, Benefit, and Pricing configurations.
• Experience with development tools: SVN, Visual Studio, TFS.
• Knowledge of Agile, Waterfall, and TDD methodologies.
• Excellent problem-solving, communication, and collaboration skills.
• Ability to thrive in high-pressure environments and meet deadlines.

Licensure and Certification

• Preferred: Certifications in technical tools/programming (MCSD, Java, Onbase, Tibco, SAP, etc.).
• Preferred: Certification in TriZetto Facets product.

Working Conditions

• Office-based environment; may require extended periods of sitting or standing.

Compensation

• Salary range: $70,800 – $113,200, based on education, experience, and role scope.
• Potential bonus eligibility tied to company and individual performance.
• Comprehensive total rewards package supporting employee well-being.

Competencies

• Create an Inclusive Environment
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

Inclusion and Equal Opportunity
CareSource is proud to be an Equal Opportunity Employer. We are committed to fostering a diverse and inclusive workplace that welcomes individuals of all backgrounds.