Business / Regulatory Analyst

Quantum Technologies. LLC; Raleigh (NC); On-site; USD 70,000 - 100,000; Full time

Job summary

Quantum Technologies. LLC is seeking an experienced Business / Regulatory Analyst to interpret state mandates and translate them into actionable business and system requirements.

The role covers end-to-end traceability from regulatory intent to solution design, testing, and validation. You will analyze regulatory mandates affecting healthcare payer operations, translate them into clear requirements, and collaborate with architects, engineers, QA teams, and regulatory colleagues to ensure

Qualifications

• Experience as a Business Analyst or Regulatory Analyst within the healthcare payer domain.
• Strong working knowledge of TriZetto Facets.
• Solid understanding of healthcare payer functions and regulatory processes.

Responsibilities

• Analyze and interpret state mandates, regulatory requirements, and payer business needs.
• Translate regulatory requirements into clear business, functional, and system requirements.
• Perform impact analysis across Facets, Claims, Eligibility, Enrollment, applications, data, and integrations.
• Partner with stakeholders, Solution Architects, Engineers, QA, and regulatory teams.
• Develop user stories, business rules, acceptance criteria, and process flows.

Skills

Healthcare payer domain

TriZetto Facets

Regulatory/Business analysis

Job description

US Citizen, Green Card, H-1B, OPT-EAD, CPT, Other

Role Summary: We are looking for an experienced Business / Regulatory Analyst with strong Facets and healthcare payer domain knowledge to interpret state and regulatory mandates and translate them into clear, actionable business and system requirements. The role will maintain end-to-end traceability from regulatory intent through solution design, implementation, testing, and validation.

Key Responsibilities

• Analyze and interpret state mandates, regulatory requirements, and healthcare payer business needs.
• Translate regulatory requirements into clear business, functional, and system requirements.
• Perform impact analysis across Facets, Claims, Eligibility, Enrollment, applications, data, and integrations.
• Partner with business stakeholders, Solution Architects, Engineers, QA teams, and compliance/regulatory teams.
• Develop user stories, business rules, acceptance criteria, process flows, and requirement documentation.
• Maintain requirements traceability from the original regulatory mandate through design, development, testing, and final validation.
• Identify gaps, dependencies, risks, and impacted business processes or systems.
• Support requirement walkthroughs and clarify requirements throughout the development lifecycle.
• Work with QA teams to ensure test scenarios and acceptance criteria adequately cover regulatory requirements.
• Support implementation readiness and validation of regulatory changes.

Required Skills

• Strong experience as a Business Analyst or Regulatory Analyst within the healthcare payer domain.
• Good working knowledge of TriZetto Facets.
• Strong understanding of healthcare payer functions, particularly:

We are an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, national origin, citizenship/ immigration status, veteran status, or any other status protected under federal, state, or local law.