Business / Regulatory Analyst

Machine Learning Technologies, LLC; Raleigh (NC); On-site; USD 90,000 - 120,000; Full time

Job summary

Machine Learning Technologies, LLC seeks an experienced Business/Regulatory Analyst with strong healthcare payer domain knowledge to interpret state mandates and translate them into actionable business and system requirements. The role maintains end-to-end traceability from regulatory intent through solution design, implementation, testing, and validation.

You will analyze mandates, develop user stories and acceptance criteria, and collaborate with architects, engineers, QA, and compliance teams

Qualifications

• Experience as a Business Analyst or Regulatory Analyst in the healthcare payer domain.
• Strong working knowledge of TriZetto Facets and related payer systems.
• Ability to translate regulatory mandates into clear business and system requirements.
• Maintain end-to-end traceability from regulation to solution validation.

Responsibilities

• Analyze and interpret state mandates and regulatory requirements for healthcare payers.
• 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

Regulatory analysis

Business analysis

Healthcare payer domain

Tools

TriZetto Facets

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.