What are the responsibilities and job description for the Senior Pega Developer (CSSA 8.x Certified) Healthcare Domain***TX/CT position at SmartIMS Inc.?
Job Details
Job Title: Senior Pega Developer (CSSA 8.x Certified) Healthcare Domain
Location. Austin/Dallas/Bloomfield.
Duration: Long Term
Job Summary:
We are seeking a highly skilled Senior Pega Developer (CSSA 8.x Certified) with strong experience in designing and implementing BPM solutions in the Healthcare domain. The candidate will be responsible for end-to-end development of Pega applications, integrating business processes, and driving digital transformation initiatives in compliance with healthcare industry standards.
Key Responsibilities:
- Design, develop, and implement Pega PRPC 8.x applications tailored to healthcare workflows and compliance needs (HIPAA, CMS, etc.).
- Collaborate with business and technical teams to analyze requirements and translate them into scalable Pega solutions.
- Develop healthcare-related business rules, case types, workflows, and decision logic.
- Integrate Pega applications with external healthcare systems (e.g., EDI, Facets, or other payer/provider systems) using REST, SOAP, or JMS.
- Optimize system performance, implement security best practices, and ensure adherence to Pega guardrails.
- Support and troubleshoot production issues, ensuring application reliability and compliance with healthcare regulations.
- Participate in sprint planning, design reviews, and peer code reviews.
- Mentor and guide junior developers in best practices and Pega design patterns.
- Contribute to solution architecture discussions and assist with Pega platform upgrades and enhancements.
Required Skills & Qualifications:
- Bachelor s/Master s Degree in Computer Science, Information Technology, or related field.
- 10 years of total IT experience with at least 6 years of hands-on experience in Pega PRPC.
- Pega Certified Senior System Architect (CSSA 8.x) certification mandatory.
- Proven experience working on Pega projects in the Healthcare domain (payer or provider).
- Strong understanding of healthcare processes claims, member enrollment, provider management, utilization management, etc.
- Expertise in case management, decisioning, integration services, and UI development within Pega.
- Proficiency in Pega tools such as Agents, Activities, Data Pages, Flow Rules, and Declarative Rules.
- Experience in Agile/Scrum methodology and familiarity with JIRA/Confluence.
- Excellent analytical, debugging, and communication skills.
Preferred Skills:
- Experience with Pega Customer Service for Healthcare (CSHC) or Pega Smart Claims Engine.
- Familiarity with Facets, EHR/EMR systems, or HIPAA EDI transactions (837, 835, 270/271).
- Exposure to Pega Cloud, DevOps (Jenkins, Git, CI/CD), and AWS/Azure environments.
- Prior experience in upgrading/migrating Pega versions (7.x to 8.x).
- Ability to lead small technical teams and coordinate across business and IT stakeholders.
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