Healthcare Facets Analyst - Regulatory & Payer Expert

TechClub Inc; Minnetonka (MN); On-site; USD 90,000 - 120,000; Full time

Job summary

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

Qualifications

• 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.

Responsibilities

• 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.

Skills

Payer domain knowledge

Regulatory analysis

Requirements gathering

Stakeholder communication

Traceability management

Tools

TriZetto Facets

Job description

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