Healthcare Payer Regulatory Analyst (Facets)

Machine Learning Technologies, LLC; Raleigh (NC); Presencial; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

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

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

Regulatory analysis

Business analysis

Healthcare payer domain

Herramientas

TriZetto Facets

Descripción del empleo

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