Business / Regulatory Analyst

Artifintech; Raleigh (NC); On-site; USD 90,000 - 130,000; Full time

Job summary

Artifintech is seeking an experienced Business/Regulatory Analyst with healthcare payer domain knowledge to interpret state regulatory mandates and translate them into clear, actionable business and system requirements. The role ensures end-to-end traceability from regulatory intent through solution design, implementation, testing, and validation.

Responsibilities include analyzing mandates, translating requirements, performing impact analysis across Facets, Claims, Eligibility, Enrollment, and

Qualifications

• Experience as a Business Analyst or Regulatory Analyst in the healthcare payer domain is required.
• Proficient with TriZetto Facets and related healthcare payer systems.
• Strong ability to translate regulatory requirements into actionable business and system requirements.

Responsibilities

• Analyze state mandates and regulatory requirements for healthcare payers.
• Translate regulatory requirements into business, functional, and system requirements.
• Perform impact analysis across Facets, Claims, Eligibility, Enrollment, applications, data and integrations.
• Partner with stakeholders including Solution Architects, Engineers, QA and compliance teams.
• Develop user stories, business rules, acceptance criteria, process flows, and documentation.
• Maintain traceability from regulatory intent through design, development, testing and validation.
• Identify gaps, risks, and affected business processes or systems.
• Support walkthroughs and clarifications throughout the development lifecycle.
• Collaborate with QA to ensure test scenarios cover regulatory requirements.
• Support readiness and validation of regulatory changes.

Skills

Regulatory analyst domain knowledge

TriZetto Facets

Healthcare payer functions

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.