Pega Developer (Proactive)

Sr. Pega Developer
Remote

Purpose:

• Work with Product Teams to support new and on-going enhancements to the Clinical Operations Review Engine ("CORE") which is the prior authorization review application.
• The Clinical Review Product Teams are working towards the following objectives:
  • No Touch PA: Claim Integration, Workflow Automation, Criteria Auto-population.
  • Enable a process to automate the detailing and effectuation of Prior Authorizations:
• Define detailing rules, Integrate with RxCLAIM (Our legacy Claims Adjudication system, Integrate with RxRenu (Our RxCLAIM replacement) and a new PA data repository.
• Medical Drug Review readiness. This is largely TBD as the most recent request.
• Teams will define system needs and enhancements.
• Support migration of remaining Commercial Prior Authorization review clients from CoverMyMeds (vendor) to our internal CORE application
• Support continuing enhancements for Medicare Part D requirements on CORE application in preparation for 2024 migration from internal legacy application onto
• CORE application.

Position Overview:

• The Software Engineer Lead is responsible for designing, developing, testing, deploying and
• maintaining technology solutions.
• This role will work within a Product Team that is supported by an existing Lead Pega Engineer. The purpose for requesting a lead skillset is to strengthen the team with additional Pega expertise and support the existing Lead who is overseeing two Product Teams, both supporting the same application.

Daily Responsibilities/Job Description:

• Reviewing and recommending design solutions to meet business and operational value.
• Partnering with other engineers for code reviews and recommendations.
• Needs to work in partnership with existing Tech Lead: ability to step-in for and support the existing Tech Lead as needed and based on Product Team demands.
• Proactive and active daily engagement with Product team during sprint ceremonies and as needed outside of meetings.
• Collaborate cross-functionally with team members to achieve innovative, business-results driven technology solutions.
• Work with Product Owners and Analysts to vet and ensure Stories meet acceptance criteria and align with design solutions.
• Ensure on-time story delivery within 2-week sprint cycles, included Unit Testing is complete prior to QA.
• Partner with QA staff as they implement automated test scripts. Interaction level with Management/Team Members:
• Daily interactions with Product Team (Scrum Master, Product Owners, Analysts, Engineers, QA)
  • Monthly meetings with Manager

Must Haves:
Certified System Architect in version 8.4 or higher.

Technology Requirements:

• Pega development in a could environment (nice to have, not required)
• Event Streaming
• Exposure to Pega integration with APIs
• Robotics (nice to have, not required)