Required Skills:
1. PEGA PRPC
2. Informatica
3. Healthcare EDI transactions
Job Description:
• Design and develop healthcare applications using Pega Infinity/PRPC.
• Configure and develop Case Types, Flows, Flow Actions, Data Pages, Data Transforms, Activities, Decision Rules, and SLAs.
• Develop and support Informatica PowerCenter/IICS mappings, workflows, and ETL processes.
• Integrate Pega applications with healthcare systems using REST/SOAP APIs, MQ, and Informatica services.
• Work with healthcare claims data including Member, Provider, Benefits, Enrollment, Authorization, and Claims.
• Analyze and implement business requirements related to Claims Processing, Prior Authorization, Appeals & Grievances, and Care Management.
• Support healthcare EDI transactions including HIPAA X12 837, 835, 270/271, 276/277.
• Develop data validation, exception handling, reconciliation, and audit frameworks.
• Participate in Agile ceremonies, sprint planning, estimation, and code reviews.
• Provide production support, troubleshooting, performance tuning, and defect resolution.
Years of Experience: 8+ Years of Experience
