About this role
Subject Matter Expert
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. Please find the updated JD below for your reference. Key Requirements • 15+ years of Technical Functional Analyst or Business Systems Analyst experience. • Mandatory Healthcare OR Eligiblity & 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 preferred. • Pega certifications (PBA/CSA) are highly preferred.