Pega Lead Business Architect

2 days ago

Remote, Canada Aarorn Technologies Inc. Full time

Dear Connections,

Greetings from Aarorn Technologies

We are Hiring For Pega LBA (with health care experience) Position

Experience: 8+ years

Location - Remote (Canada)

Job Description: Pega Lead Business Architect (Healthcare)
Position Overview

We are seeking an experienced Pega Lead Business Architect (LBA) with strong hands-on experience in Pega PRPC and deep knowledge of healthcare processes, payer systems, provider workflows, and regulatory compliance. The LBA will lead requirement discovery, solution architecture from a business perspective, and ensure alignment between business stakeholders and technical delivery teams. This role involves guiding the design of end-to-end Pega solutions, ensuring best practices, and contributing to roadmap planning.

Key Responsibilities
1. Business Architecture & Requirements
  • Lead requirements gathering, process analysis, and business modeling using Pega best practices.
  • Conduct workshops with business stakeholders, SMEs, and product owners to define business rules, decision logic, data models, and workflow requirements.
  • Translate business needs into Pega functional specifications, case designs, and user stories.
2. Solution & Design Leadership
  • Collaborate closely with Pega System Architects to design case structures, stages, processes, and decisioning rules.
  • Ensure solutions follow Pega guardrails, healthcare regulatory guidelines (HIPAA, CMS, ICD-10, etc.).
  • Provide guidance on Pega features like Data Pages, Integrations, UI, SLA, Decision Tables, Flows, DCO, etc.
3. Stakeholder Management
  • Act as the bridge between business teams, product owners, QA, and engineering.
  • Present solution options, drive alignment, and ensure traceability from requirements to delivery.
  • Lead DCO (Direct Capture of Objectives) sessions and maintain high-quality documentation.
4. Delivery Governance & Quality
  • Review user stories, acceptance criteria, and test cases for completeness.
  • Ensure adherence to Pega best practices, project guardrails, and healthcare domain guidelines.
  • Provide functional oversight during development, testing, and UAT.
5. Healthcare Domain Focus

  • Apply domain experience in areas such as:

  • Claims processing

  • Member & provider management
  • Prior authorizations & utilization management
  • Eligibility & enrollment
  • Care management
  • Encounter data, EDI transactions (837/834/835/270/271)
Required Qualifications
Pega Skills
  • Pega Certified Business Architect (PCBA) or Pega Certified Lead Business Architect (PCLBA) is mandatory.
  • 5–10+ years of experience as a Business Architect in Pega PRPC.
  • Strong knowledge of Pega case management, user interface, decisioning, and integration features.
Healthcare Skills
  • 4–8+ years of experience in payer or provider ecosystems.
  • Hands-on involvement in healthcare workflows (claims, UM/CM, membership, billing, EDI).
  • Understanding of compliance frameworks (HIPAA, CMS guidelines).
Professional Skills
  • Strong communication, requirements facilitation, and documentation skills.
  • Experience working in Agile/Scrum delivery environments.
  • Ability to guide teams, mentor junior BAs, and lead cross-functional discussions.
Preferred Qualifications
  • Experience in Medicare/Medicaid programs.
  • Knowledge of Pega Customer Service for Healthcare (CSHC) is a plus.
  • Experience with API integrations, BPM systems, or enterprise transformation programs.
  • Familiarity with cloud deployments (Pega Cloud / AWS / Azure).

Interested candidates send resume on

daQKnhci5Z

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