Business Analyst with Pega and Medicaid/Healthcare

Role: Business Analyst with Pega and Medicaid/Healthcare
Location – Atlanta, GA (100% Onsite) 

Note: Client is looking for minimum of 15 years of experience with strong expertise in both Pega and Medicaid/Healthcare

 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.