Healthcare Payer Regulatory Analyst | Facets Expert

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

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