Serve as a Technical Functional Analyst bridging business and technology for Medicaid/Healthcare eligibility and enrollment. Provide hands-on Pega case management, workflows, integrations, production support, UAT/SIT, defect triage, root cause analysis, and stakeholder coordination. Support large-scale systems and work with architects, developers, integrators, and state agencies. SQL and Power BI skills and Pega certifications preferred.
Role: Business Analyst
Location – Atlanta, GA- Onsite
Note: Client is looking for minimum of 15 years of experience with Healthcare background with Pega skills.
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.
Hexaware Technologies Chicago, Illinois, USA Office
Chicago, United States, 0
Similar Jobs
Information Technology • Consulting
Serve as the claims domain lead for Medicaid and Medicare MMIS healthcare projects. Analyze requirements, document and configure claims processes, support adjudication and benefits programs, troubleshoot issues, perform queries and root-cause analysis, and coordinate with clients, development, architecture, and design teams. Lead demos, resolve feedback, support implementation decisions, and guide claims-module delivery across the lifecycle, including professional, dental, institutional, pharmacy, encounter, and capitation claims.
Top Skills:
CmdsEdi X12FacetsGhsMmis
Big Data • Fintech • Mobile • Payments • Financial Services
Develop and ship full-stack web and mobile experiences across Affirm’s consumer app and website. Collaborate with product, design, analytics, and engineering teams to break down projects, make technical decisions, write tested and extensible code, launch scalable APIs, monitor service health, support on-call operations, review code, and participate in team development and interviewing.
Top Skills:
APIsKotlinPythonReactReact NativeVue
%20copy.jpg)
Software
Manage the full collections and accounts receivable lifecycle, including recovery strategy, balance holds, ACH returns, write-offs, journal entries, forecasting, and risk controls. Lead collections analysts and specialists, monitor aging and recovery KPIs, handle escalations, and partner with Finance, Risk, Sales, Operations, Disputes, Underwriting, and Engineering. Use AI to automate correspondence, triage cases, identify delinquency patterns, reduce manual work, and improve cash flow and operational efficiency.
Top Skills:
AdyenAi ToolsExcelGoogle SheetsSalesforceTsysWorkday
What you need to know about the Chicago Tech Scene
With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.
Key Facts About Chicago Tech
- Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
- Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
- Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
- Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory
