Pega Healthcare Systems Analyst 

Location: Remote – USA
Experience: 10+ Years Preferred
Domain: Healthcare / Health Insurance – Payer

Job Summary

We are seeking an experienced Pega Healthcare Systems Analyst with strong healthcare payer domain expertise and hands-on experience with FACETS.

The ideal candidate must have experience analyzing healthcare payer systems, gathering business requirements, and supporting processes involving claims, membership, enrollment, providers, benefits, and billing.

Key Responsibilities

• Analyze business and system requirements across healthcare payer applications.

• Work extensively with FACETS and related healthcare payer systems.

• Translate business requirements into functional specifications and system requirements.

• Analyze claims processing, membership, enrollment, provider, benefits, and billing workflows.

• Develop process flows, data flows, and impact analysis documentation.

• Coordinate with business stakeholders, development teams, and QA teams.

• Support UAT, defect analysis, issue resolution, and production support.

• Identify system dependencies and assess the impact of enhancements.

• Participate in Agile ceremonies and SDLC activities.

Good to Have

• Previous Elevance Health / Anthem experience.

• Experience supporting enterprise healthcare payer transformation projects.

• Knowledge of integrations between Pega, FACETS, and other healthcare applications.

Must-Have Skills

• Healthcare / Health Insurance Payer Domain – Mandatory

• FACETS – Strong Hands-On Knowledge – Mandatory

• Pega – Healthcare Systems Experience

• Systems Analysis / Functional Analysis

• Claims Processing

• Membership & Enrollment

• Provider, Benefits & Billing

• Requirements Gathering & Functional Specifications

• Process Flows / Data Flows / Impact Analysis

• UAT / Defect Analysis / Production Support

• Agile / SDLC