Lead the end-to-end design, development, and deployment of Pega applications focused on Rx Prior Authorization workflows.
Collaborate with clinical, business, and IT stakeholders to gather and analyze requirements specific to drug coverage, formulary rules, and utilization management.
Architect scalable and compliant solutions using Pega PRPC, Pega Healthcare frameworks, and decisioning capabilities.
Integrate Pega with external systems such as pharmacy benefit managers (PBMs), claims adjudication systems, and electronic health records (EHRs).
Mentor junior developers and conduct code reviews to ensure quality and performance.
Drive automation of manual processes such as clinical review routing, real-time benefit checks, and appeals management.
