Pega PCS Consultant
- VRK IT VISION
4 Days Ago
60-65 per Hourly
W2, C2C
St. Louis-MO
10-30 Years
Required Skills: PCS, HEALTHCARE, MEDICAL, PHARMACY
Job Description
Required Skills:
✅ Strong hands-on experience with Pega Product Composer System (PCS)
✅ Healthcare Payer domain experience
✅ Expertise in product, benefit, plan, and group configuration
✅ Experience configuring:
✅ Healthcare Payer domain experience
✅ Expertise in product, benefit, plan, and group configuration
✅ Experience configuring:
- Benefit Plans
- Medical, Pharmacy, Dental & Vision Benefits
- Copay, Coinsurance & Deductibles
- Out-of-Pocket Maximums
- Accumulators
- Eligibility Rules
- Provider Networks & Tiers
- Claims Adjudication Rules
Responsibilities:
✔ Configure and manage healthcare insurance products and benefits using Pega PCS
✔ Collaborate with business stakeholders, product owners, SMEs, and technical teams
✔ Support product configuration, implementation, testing, and deployment activities
✔ Participate in Agile ceremonies including sprint planning, grooming sessions, and stand-ups
✔ Prepare functional specifications, configuration documents, and test artifacts
✔ Support integrations with claims, enrollment, billing, provider, and downstream systems
✔ Troubleshoot configuration issues and support QA/UAT activities
✔ Collaborate with business stakeholders, product owners, SMEs, and technical teams
✔ Support product configuration, implementation, testing, and deployment activities
✔ Participate in Agile ceremonies including sprint planning, grooming sessions, and stand-ups
✔ Prepare functional specifications, configuration documents, and test artifacts
✔ Support integrations with claims, enrollment, billing, provider, and downstream systems
✔ Troubleshoot configuration issues and support QA/UAT activities
Preferred Qualifications:
✔ Experience working in Agile/Scrum environments
✔ Strong analytical, communication, and problem-solving skills
✔ Knowledge of end-to-end Healthcare Payer processes, including enrollment, benefits, claims, and member/provider servicing
✔ Strong analytical, communication, and problem-solving skills
✔ Knowledge of end-to-end Healthcare Payer processes, including enrollment, benefits, claims, and member/provider servicing
