Serve as a Technical Functional Analyst bridging business and technology for Medicaid/Healthcare eligibility and enrollment. Provide hands-on Pega case management, workflows, integrations, production support, UAT/SIT, defect triage, root cause analysis, and stakeholder coordination. Support large-scale systems and work with architects, developers, integrators, and state agencies. SQL and Power BI skills and Pega certifications preferred.
Role: Business Analyst
Location – Atlanta, GA- Onsite
Note: Client is looking for minimum of 15 years of experience with Healthcare background with Pega skills.
Job Description:
We are now looking for a Technical Functional Analyst (TFAL) with strong expertise in both Pega and Medicaid/Healthcare. This role requires a candidate who can effectively bridge the gap between business and technology teams, with hands-on experience in eligibility and enrollment processes, as well as a strong understanding of Pega case management, workflows, integrations, and production support.
Key Requirements:
- 15+ years of Technical Functional Analyst or Business Systems Analyst experience.
- Mandatory Healthcare OR Eligibility & Enrollment domain expertise, including:
- Eligibility Determination
- Enrollment Lifecycle Management
- Renewals and Redeterminations
- Case Management
- Notices and Correspondence
- Stacking and Benefit Determination
- Mandatory Pega expertise, including:
- Pega Case Management
- Workflows and Business Processes
- Decision Rules
- Routing and Assignments
- Integrations and Interfaces
- Production Support and Troubleshooting
- Experience supporting large-scale systems.
- Strong experience working with Pega Architects, Developers, System Integrators, and State Agency stakeholders.
- Experience with UAT, SIT, defect triage, root cause analysis, and production stabilization.
- Strong SQL and Power BI skills are preferred.
- Pega certifications (PBA/CSA) are highly preferred.
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