Pega CDH Decision Consultant - Healthcare Data Management Solutions (4-8 yrs)

Role Overview :

As a Pega CDH Decision Consultant specializing in healthcare data management solutions, you will be responsible for configuring and optimizing decisioning solutions within the Pega Customer Decision Hub (CDH).

Your role will focus on enabling efficient, data-driven decision-making processes that improve healthcare outcomes, enhance operational efficiency, and ensure compliance with regulatory standards. You will work closely with cross-functional teams to deliver high-quality, patient-centric decisioning frameworks and workflows tailored to clinical and operational requirements.

Key Responsibilities :

1. Decision Framework Implementation :

- Configure and implement Pega CDH decisioning components, including decision tables, strategies, and data flows.

- Support the design and execution of Next-Best-Action (NBA) strategies for clinical workflows like patient eligibility, treatment prioritization, and compliance management.

- Implement engagement policies and prioritization rules to ensure real-time, evidence-based decision-making in clinical scenarios.

2. Integration with Clinical Systems :

- Collaborate with IT teams and data analysts to integrate Pega CDH with healthcare systems, such as Electronic Health Records (EHR) and Clinical Trial Management Systems (CTMS).

- Support high-quality data ingestion and processing, adhering to FHIR and HL7 standards.

- Assist in utilizing AI/ML-driven analytics to improve decision-making processes and enable patient-centric care.

3. Development and Customization :

- Develop and configure reusable components, templates, and workflows to streamline healthcare decision-making processes.

- Define and implement decision rules for patient stratification, risk scoring, and treatment recommendations based on clinical guidelines.

- Ensure that all configurations are scalable, reusable, and aligned with project goals.

4. Performance Monitoring and Optimization :

- Monitor decisioning strategies and workflows to ensure they deliver desired clinical and operational outcomes.

- Support the analysis of performance metrics to identify optimization opportunities and refine decisioning strategies.

- Ensure continuous compliance with healthcare regulations such as HIPAA, GDPR, and FDA guidelines.

5. Stakeholder Collaboration and Support :

- Work collaboratively with business and clinical teams to translate requirements into technical solutions within Pega CDH.

- Provide user support, training, and documentation to ensure smooth adoption of decisioning solutions.

- Address stakeholder feedback to improve decisioning frameworks and maintain alignment with clinical objectives.

Qualifications and Skills :

Technical Skills :

- Strong hands-on experience in Pega CDH decisioning tools, including decision strategies, engagement policies, and NBA configurations.

- Familiarity with clinical data management systems, such as EHR and CTMS.

- Basic understanding of AI/ML models and their application in predictive healthcare analytics.

- Experience with REST APIs, FHIR standards, and HL7 protocols for data integration.

- Knowledge of data privacy and healthcare compliance standards, such as HIPAA and GDPR.

Certifications :

- Pega Certified Decisioning Consultant (PCDC) (Required).

- Additional certifications in Pega, such as Pega Certified System Architect (CSA) or Pega Certified Senior System Architect (CSSA), are advantageous.

- Certifications in healthcare systems or data management (e.g., FHIR, HL7) are a plus.

Soft Skills :

- Strong problem-solving and analytical abilities, especially in healthcare-related scenarios.

- Effective communication and collaboration skills to work with clinical and technical teams.

- Ability to prioritize tasks and meet deadlines in a fast-paced, regulated environment.

Experience :

- 4+ years of experience in Pega decisioning roles, with at least 1 year in healthcare or clinical data management.

- Proven experience in delivering Pega CDH solutions that address complex business challenges.

- Exposure to clinical workflows, patient engagement strategies, or healthcare analytics is a plus.

Additional Considerations :

- Familiarity with Agile project methodologies.

- Understanding of cloud-based healthcare platforms such as AWS HealthLake, Azure for Health, or GCP.

- Knowledge of healthcare data workflows and patient-centric engagement strategies.