Facets Analyst

TechClub Inc; Minnetonka (MN); Presencial; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

TechClub Inc. is seeking 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. You will analyze mandates and regulatory requirements, translate them into functional specifications, and collaborate

Formación

• Experience as a Business Analyst or Regulatory Analyst in healthcare payer domain.
• Ability to translate regulatory mandates into clear business and system requirements.
• Experience maintaining end-to-end traceability from regulatory intent through design, testing and validation.

Responsabilidades

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

Conocimientos

Payer domain knowledge

Regulatory analysis

Requirements gathering

Stakeholder communication

Traceability management

Herramientas

TriZetto Facets

Descripción del empleo

Role: Business / Regulatory Analyst – Facets

(100% onsite Role)

Job Description:

Role: Business / Regulatory Analyst – Facets Domain: Healthcare / Payer Primary Skills: Facets, Claims, Eligibility, Regulatory Analysis, Requirements Management

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:
• Claims
• Provider-related processes
• Experience interpreting and translating regulatory or state-specific mandates into technology requirements.
• Experience with requirements gathering, impact analysis, user stories, acceptance criteria, and traceability.
• Ability to work across business, application, data, and integration teams.
• Strong analytical, documentation, and stakeholder communication skills.

Skills: Healthcare Regulatory~Healthcare Principles and Functions~Healthcare Domain~Modern Functional Quality Engineering