Role description

Job Title

Product Configuration QA Analyst – Healthcare Payer (TriZetto Facets)

Location - Chennai/ Bangalore

Experience - 3 to 6 Years

Job Summary

We are seeking an experienced Product Configuration QA Analyst with strong expertise in Healthcare Payer Operations and TriZetto Facets. The ideal candidate will be responsible for validating and auditing product, benefit, and group configurations to ensure accuracy, compliance, and alignment with approved business requirements. This role requires strong analytical, testing, auditing, and defect management skills with a focus on quality improvement and defect prevention.

Key Responsibilities

Configuration Quality Validation

- Review and validate product, group, account, and benefit configurations against source documentation.
- Audit eligibility rules, benefit structures, accumulators, provider networks, and plan attributes.
- Ensure configurations comply with contractual requirements and approved business rules.
- Perform quality reviews and sign-off activities before production deployment.

Testing & Validation

- Execute configuration validation and functional testing within TriZetto Facets.
- Perform end-to-end testing of product and group configurations.
- Validate downstream impacts on enrollment, claims processing, and member servicing functions.
- Support User Acceptance Testing (UAT) and post-production verification activities.

Defect Management & Root Cause Analysis

- Identify configuration defects and quality issues.
- Analyze defect trends and recurring quality gaps.
- Conduct root cause analysis (RCA) across people, process, and technology areas.
- Recommend corrective and preventive actions to improve quality outcomes.

Reporting & Quality Governance

- Participate in calibration and quality review sessions.
- Maintain audit scorecards, quality metrics, and reporting dashboards.
- Track audit accuracy, defect leakage, and first-pass quality metrics.
- Present findings and improvement recommendations to leadership teams.

Compliance & Documentation

- Ensure adherence to configuration standards, policies, and procedures.
- Support audit readiness and documentation requirements.
- Validate compliance with regulatory, contractual, and organizational standards.

Required Skills & Competencies

- Robust experience in TriZetto Facets Product, Benefit, and Group Configuration.
- Healthcare payer domain expertise.
- Configuration Quality Assurance (QA) and audit experience.
- Functional Testing and End-to-End Testing.
- Defect Management and Root Cause Analysis.
- Claims Management knowledge.
- Strong analytical and problem-solving abilities.




- Excellent documentation and reporting skills.
- Ability to work independently and manage multiple priorities.

Required Experience

- 5+ years of Healthcare Payer Configuration experience.
- 2+ years of Configuration QA, Validation, or Audit experience.
- Hands-on experience reviewing and validating benefit plans and group setup documentation.
- Experience testing and validating product, benefit, and group configurations in TriZetto Facets.

Education

- Bachelor's Degree or equivalent relevant experience.

Preferred Qualifications

- Experience supporting healthcare enrollment and claims processes.
- Exposure to quality metrics, audit frameworks, and continuous improvement initiatives.
- Knowledge of healthcare regulations and compliance requirements.

Key Skills

- TriZetto Facets
- Product Configuration
- Group Configuration
- Benefit Configuration
- Healthcare Payer
- Functional Testing
- End-to-End Testing
- Claims Management
- UAT
- Root Cause Analysis (RCA)
- Defect Management
- Quality Assurance
- Audit & Compliance
- Provider Networks
- Eligibility Rules
- Accumulators

Key Performance Indicators (KPIs)

- Audit Accuracy Rate
- Defect Identification Rate
- Defect Leakage Rate
- First-Pass Quality
- Audit Completion Turnaround Time
- Calibration Consistency Score
- RCA Effectiveness

Skills

Functional Testing, End-to-End Testing, Claims Management, Healthcare Plan Configuration

Product Configuration QA Analyst BPM Role Summary The Product Configuration QA Analyst is responsible for independently validating product and group configurations in TriZetto Facets to ensure accuracy, completeness, and compliance with approved business requirements. The role performs quality audits, configuration testing, defect analysis, and root cause investigations while supporting defect prevention and continuous quality improvement. Key Responsibilities Quality Validation • Review configured products, groups, accounts, and benefit plans against source documentation. • Validate configuration accuracy across benefit structures, eligibility rules, accumulators, provider networks, and plan attributes. • Ensure TriZetto Facets configurations align with contract requirements and approved business rules. • Conduct comprehensive quality reviews before production deployment.



Testing Activities • Execute configuration validation testing in TriZetto Facets. • Perform end-to-end testing of benefit and group configurations. • Validate downstream impacts on enrollment, claims, and member servicing processes. • Support User Acceptance Testing (UAT) and production verification activities. Defect Analysis & Root Cause Analysis • Identify configuration defects and quality gaps. • Classify and trend configuration errors. • Conduct root cause analysis across people, process, and system dimensions. • Recommend corrective and preventive actions. Calibration & Reporting • Participate in quality calibration sessions. • Maintain audit scorecards and quality reporting metrics. • Analyze defect trends and quality performance indicators. • Provide actionable recommendations to configuration leadership. Compliance & Governance • Ensure adherence to configuration standards and procedures. • Support audit readiness and documentation requirements. • Validate compliance with regulatory and contractual obligations. Mandatory Skills & Competencies • Strong knowledge of healthcare payer product and group configuration in TriZetto Facets. • Experience reviewing benefit plans and group setup documents. • Strong analytical, testing, and auditing skills. • Ability to identify defects and perform root cause analysis. • Excellent documentation and reporting capabilities. Qualifications Education • Bachelor's degree or equivalent relevant experience. Experience • 5+ years of healthcare payer configuration experience. • Minimum 2+ years performing configuration QA or audit functions. • Experience validating benefit and group configurations. Required Platform • Hands-on experience testing and validating product, benefit, and group configuration in TriZetto Facets. Key Performance Indicators (KPIs) • Audit accuracy rate • Defect identification rate • Defect leakage rate • First-pass quality • Audit completion turnaround time • Calibration consistency score • RCA completion effectiveness

About UST
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.

📌 Associate III - BPM (Kerala)
🏢 UST
📍 Kerala