Healthcare Payer Regulatory & Business Analyst

Quantum Technologies. LLC; Raleigh (NC); On-site; USD 70,000 - 100,000; Full time

Job summary

Quantum Technologies. LLC is seeking an experienced Business / Regulatory Analyst to interpret state mandates and translate them into actionable business and system requirements.

The role covers end-to-end traceability from regulatory intent to solution design, testing, and validation. You will analyze regulatory mandates affecting healthcare payer operations, translate them into clear requirements, and collaborate with architects, engineers, QA teams, and regulatory colleagues to ensure

Qualifications

• Experience as a Business Analyst or Regulatory Analyst within the healthcare payer domain.
• Strong working knowledge of TriZetto Facets.
• Solid understanding of healthcare payer functions and regulatory processes.

Responsibilities

• Analyze and interpret state mandates, regulatory requirements, and 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 stakeholders, Solution Architects, Engineers, QA, and regulatory teams.
• Develop user stories, business rules, acceptance criteria, and process flows.

Skills

Healthcare payer domain

TriZetto Facets

Regulatory/Business analysis

Job description

Quantum Technologies. LLC is seeking an experienced Business / Regulatory Analyst to interpret state mandates and translate them into actionable business and system requirements.

The role covers end-to-end traceability from regulatory intent to solution design, testing, and validation. You will analyze regulatory mandates affecting healthcare payer operations, translate them into clear requirements, and collaborate with architects, engineers, QA teams, and regulatory colleagues to ensure