Business Regulatory Analyst
Sarvan ChaudharyUnited StatesSENIORPosted 6d ago
MedicaidMedicareCMS regulatory complianceClaimsEligibilityEnrollmentProvider managementEDI transactionsFRDsUser StoriesRTMsAgileSAFeJiraAzure DevOpsSQLRegulatory testingTraceabilityAudit readinessFacetsQNXTMMIS
About the Role
We are looking for experienced Business Regulatory Analysts to support Medicaid and healthcare regulatory compliance initiatives.
Key Responsibilities
• Support Medicaid and healthcare regulatory compliance initiatives
• Analyze and implement regulatory requirements
• Ensure compliance with CMS regulations
Requirements
• 12+ years of Business Analyst experience
• 10+ years in healthcare payer operations
• Knowledge of Medicaid, Medicare & CMS regulatory compliance
• Experience with claims, eligibility, enrollment & provider management
• Familiarity with EDI transactions, FRDs, User Stories, RTMs
• Experience with Agile/SAFe, Jira, Azure DevOps & SQL
• Understanding of regulatory testing, traceability & audit readiness
• Experience with Facets, QNXT, MMIS, and state-specific Medicaid programs is a plus.