Senior Business Analyst – Healthcare Payer / Facets / Regulatory

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
• Eligibility
• Enrollment / Membership
• Benefits
• 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.