Urgent Hiring -- Pega Lead System Architect (LSA) – Healthcare Claims Domain -- Remote -- Long term !!
Kelly.d
Hi,
This is Kelly. I represent the Recruitment services within https://lillitechnology.com Lilli Technology is a global technology and business services consulting firm specializing in Business and IT Consulting & Staffing Services to commercial and government customers
Pega LSA
Remote
Rate : 70
Pega Lead System Architect (LSA) – Healthcare Claims Domain
Role Overview:
As a Pega LSA, you will lead the architecture, design, and implementation of Pega-based solutions tailored for healthcare claims processing. You will work closely with stakeholders to deliver scalable, compliant, and efficient systems that support claims adjudication, member services, and provider interactions.
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.
- Technical Skills:
- Pega PRPC 8.x or higher.
- Case Management, BPM, Decisioning, Declarative Rules.
- Integration: REST/SOAP, MQ, SQL, File listeners.
- RPA/RDA design and troubleshooting.
- SMA, DB Tracer, Clipboard, SLA setup.
- Soft Skills: Strong communication, leadership, and stakeholder management.
Preferred Qualifications:
- Experience with Pega Customer Service for Healthcare.
- Exposure to Pega COE and reusable component design.
- Familiarity with circumstancing, rule specialization, and rule versioning.