Software Engineering Lead Analyst - HIH - Evernorth

Key Responsibilities:

• Lead the end-to-end design, development, and deployment of Pega applications focused on Rx Prior Authorization workflows.
• Collaborate with clinical, business, and IT stakeholders to gather and analyze requirements specific to drug coverage, formulary rules, and utilization management.
• Architect scalable and compliant solutions using Pega PRPC, Pega Healthcare frameworks, and decisioning capabilities.
• Integrate Pega with external systems such as pharmacy benefit managers (PBMs), claims adjudication systems, and electronic health records (EHRs).
• Mentor junior developers and conduct code reviews to ensure quality and performance.
• Drive automation of manual processes such as clinical review routing, real-time benefit checks, and appeals management.