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 (Prime’s legacy Claims Adjudication system, Integrate with RxRenu (Prime’s 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 Prime’s 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 Senior is responsible for designing, developing, testing, deploying and
maintaining technology solutions.
Daily Responsibilities/Job Description:
- 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
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)
#DICE
zquinn@c4techservices.com
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