Pega Lead System Architect (Healthcare Contact Center)

Pega Lead System Architect (Healthcare Contact Center)
Alpharetta GA / Remote, USA
Duration: 10 Months

Must-Have Skills:

• Pega Certified Lead System Architect (CLSA) Mandatory
• Hands-on expertise in Pega Customer Service for Healthcare and Contact Center implementations
• Experience in Healthcare workflows (member services, claims, eligibility, prior authorization, appeals, provider interactions)

Good to Have:

• US Healthcare Payer/Provider domain knowledge (Medicare/Medicaid/Commercial)
• Cloud experience (AWS, Azure, or Google Cloud Platform)
• Knowledge of HIPAA compliance and PHI handling

Job Summary:

We are seeking an experienced Pega Lead System Architect (LSA) to lead the design and implementation of Pega-based solutions for our Healthcare Contact Center initiatives. This role will focus on building scalable, patient/member-centric solutions that enhance customer experience, improve agent efficiency, and streamline healthcare operations. The LSA will set architectural standards, enforce best practices, and ensure high-quality, maintainable delivery.

Key Responsibilities:

Lead the architecture, design, and implementation of Pega solutions tailored for Healthcare Contact Center platforms.

Define and enforce enterprise-level standards and best practices for Pega development.

Collaborate with business stakeholders, product owners, and technical teams to design solutions that support member services, claims, eligibility, and care management interactions.

Mentor and guide Pega developers; conduct code/design reviews and ensure adherence to best practices.

Analyze and resolve performance issues, ensuring scalability and high availability.

Stay updated with the latest Pega Customer Service for Healthcare framework and Contact Center capabilities.

Requirements:

Pega Certified Lead System Architect (CLSA) certification is mandatory.

8+ years of experience in Pega PRPC development, including at least 2+ years as a Pega LSA.

Strong expertise in Pega 8.x or later, with deep knowledge of Pega Customer Service for Healthcare.

Experience implementing Healthcare Contact Center workflows (member inquiries, benefits, prior authorization, claims, appeals, provider interactions, etc.).

Strong knowledge of Case Management, BPM, and Integration frameworks.

Hands-on integration experience with REST/SOAP services, EHR/EMR systems, CRM, CTI (telephony), and healthcare data sources.

Excellent communication, leadership, and stakeholder management skills.

Preferred Qualifications:

Experience with US Healthcare Payer/Provider domain (Medicare, Medicaid, Commercial plans).

Exposure to cloud platforms (AWS, Azure, Google Cloud Platform) and modern data/analytics integration in Contact Centers.

Knowledge of regulatory compliance (HIPAA, PHI handling).

Skill Matrix