Pega Lead System Architect - Healthcare Claims Domain

  • Posted 4 hours ago | Updated 4 hours ago

Overview

Remote
Depends on Experience
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 6 Month(s)
No Travel Required

Skills

Pega PRPC
Smart Claims Engine
EHR/EMR
CRM
CTI
HIPAA
REST
SOAP

Job Details

Key Responsibilities:

Architect and design Pega applications focused on healthcare claims workflows (e.g., intake, validation, adjudication, appeals).

Lead development using Pega PRPC and Smart Claims Engine (SCE).

Integrate Pega with healthcare systems (EHR/EMR, CRM, CTI) and external services (REST/SOAP).

Ensure compliance with healthcare regulations (e.g., HIPAA).

Mentor developers and enforce Pega guardrails and best practices.

Optimize performance and scalability of claims processing solutions.

Collaborate with business analysts and product owners to translate requirements into technical designs.

Required Skills & Experience:

Certification: Pega Certified Lead System Architect (CLSA).

Experience: 8 10+ years in Pega development, with 2+ years as LSA.

Healthcare Domain Expertise: Deep understanding of payer/provider workflows, Medicare/Medicaid, and commercial plans.

Claims Processing: Hands-on experience with Smart Claims Engine (SCE) and X12 standards

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