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Updated on October 5, 2021

Pega Sales Automation for Healthcare provides a rich set of features designed to enhance the customer experience, improve user productivity, and increase customer satisfaction. This section describes key capabilities and features of the application that you can use as-is or extend to meet your business needs.

Note: Features marked with an asterisk (*) sign in this section are optional. Additional license fee may apply.

With Pega Sales Automation for Healthcare, you can fine-tune your customer acquisition operations to outperform sales and growth targets. Deployed on premise or in the cloud, the application makes it easy to update sales processes, business rules, and even user experiences across sales devices, channels, and markets. This means tailored support for internal sales teams, field agents, external brokers, self-service shoppers and insurance exchanges alike. Sales Automation for Healthcare optimizes the efficiency and effectiveness of your entire sales organization at every stage in the sales lifecycle. Pega Sales Automation for Healthcare offers Artificial Intelligence--based guidance, process automation from lead to fulfillment, and gives business users the ability to adapt your sales process. With Pega, you can quickly standardize and automate the sales processes across Group Account (B2B) as well as Individual Consumer (B2C) lines of business, medical as well as ancillary (dental and vision) products, internal direct sales and broker agency sales teams, and provide management with insights across multiple business units, products, team members, geographies, accounts, and channels.

  • Guided selling via Artificial Intelligence - Through a blend of predictive analytics, automated decisioning, and business rules that you can configure, Pega systematically recommends the next best action to take, offer to make, and proactively drives these insights to reps throughout the sales cycle.

  • Sales process management - Industry-leading process and workflow management ensures leads and opportunities are intelligently routed, tracked, and progressed, and the end-to-end sales cycle is optimized with errors removed.

  • Reporting and forecasting - Dashboards and forecasts offer a real-time view into your team's pipeline and forecasts as well as what it will take to make quota. Easily modify reports to give you the insights you need, exactly when and where you need them.

  • Mobility & collaboration - Empower your teams to be productive everywhere by seamlessly delivering the sales experience on mobile devices such as tablets and smartphones. Through Pega social capabilities, Pulse and Co-Browse, encourage reps and managers to collaborate with customers and one-another.

  • Build and specialize applications quickly - Built on the world leading Pega Platform, Pega Sales Automation for Healthcare allows you to manage your enterprise's complexity, develop and change applications 7x faster than Java coding, and configure and run the ultimate variety of sales process or instances on one application platform. Pega Platform also allows you to maximize existing technology investments and ensure the fastest time to value by easily integrating with and orchestrating legacy systems.

  • Cloud or on-premises - You choose the best deployment option to most effectively manage your business. Run your application with confidence with an application that is proven to securely scale to meet the needs of the world's most demanding organizations.

Cosmos UI


Cosmos landing pages

In addition to being able to set and save your own preference and defaults, all landing pages can group, sort, filter, show and hide fields. The example below is the Companies landing page grouped by Industry (SIC Code Section or "top level").

Companies landing page
A grouped view of the Companies landing page in Cosmos

Cosmos panel view

To see a preview of data for an item, you can hover on any hyperlink and select preview. The preview panels have three tabs, the contents will vary depending upon the object.

Preview pane view
The preview pane view in Cosmos

Clicking on the object title (Multi Masonry Company) in a preview panel will open the object. Each object has several tabs, the Pulse tab is the default. The utility panel is on the right and the contents vary by object type as well. Actions in a preview panel are launched by clicking on the pencil icon.

Cosmos company view
A company view in Cosmos

Cosmos Edit mode

Taking an action or clicking edit opens the object in a modal in the work area in the center of the screen.

The Edit organization view
The Edit organization view in Cosmos

Company, account, and contact management

Pega Sales Automation for Healthcare provides a 360-degree view of Companies, Accounts, and Contacts, including current and past deals, communication history including emails and appointment, documents, and relevant social insights. Built-in duplicate detection and external data enrichment services can be leveraged to keep data current and accurate. You can personalize the landing page table views at the end user level by changing or rearranging the columns. End users can also discard the last saved view and go back to the original application-level view. The Company landing and details pages are show in the Cosmos UI section above.

Contacts landing page

The Contacts landing page gives you the ability to know who you should be contacting (AI assisted optional feature) and a way to find Contacts with a physical address near you.

Contact landing page view
A contact page view in Cosmos
Contact page view
A contact page view in Cosmos

Activity management

Activity management allows sales organizations to track and monitor important customer communications and tasks. Sales representatives and managers can create activities to capture details and outcomes of customer interactions including phone calls and meetings. Keep the sales team aware of customer interactions by associating activities to the relevant account, contact, or opportunity. Sales representatives can view their upcoming tasks by priority, and managers can delegate tasks to their team.

Activities tab on the Contact page
Activities tab on the Contact page

Lead management

Pega Sales Automation for Healthcare enables organizations to manage leads from initial capture and routing, through the qualification process, and ultimately transitioning to an opportunity.

Leads can be sourced via bulk import, Web forms, campaigns, or manual entry. Lead management dashboard widgets offer insight into lead conversion rates and where leads fall out of the qualification process. Leverage Pega decision logic to set up routing rules to assign leads to correct individuals in your sales team. Leverage push notification to alert sales representatives of new leads on their mobile devices.

Next Best Sales Offer*

Pega Sales Automation for Healthcare uses Pega Customer Decision Hub to identify the top offer for the population of contacts within a sales rep's book of business. Using customer lifetime value (CLV) and Win score (Opportunity Amount and Close Date) adaptive models, the AI engine generates the offers that have the highest relevance to the current sales situation and propensity to close. After an offer is accepted, an Opportunity is automatically created.

Mobile support

Design your sales process once, for internal and external users such as brokers, then use the dynamic, responsive user interface (UI) on desktop and tablet devices as-is for most business functions. Supported browsers are IE, Chrome, and Firefox. Customize as needed for mobile phones.

Predictors and dashboards based on artificial intelligence

Artificial intelligence--based insights can predict the probability of a deal closing, when it will close, and even the odds that a deal will close or move to the next stage. The new Sales Futurecast widget leverages these insights to predict sales for the quarter and whether a representative will attain their quota.

Local campaigns*

Local Campaigns allow sales representatives to send personalized B2B and B2C campaigns to their contacts. Representatives create, send, and track campaigns from a simple, intuitive UI in the Pega Sales Automation for Healthcare application. Flexible segmentation allows sales representatives to target subsets of their contact to receive the campaign and can then monitor the open rate, click rate, and acceptance rate via dashboards. Responses to campaigns will automatically route leads back to the sales representative.

Dashboards and reports

Visual, interactive dashboards enable teams to make smarter decisions from anywhere. Pega-provided widgets allow sales users to easily track next-best-actions, next-best-offers, lead volume, conversion rates, forecast analytics, and any part of your pipeline that is instrumented for a real-time view of the state of your business. Teams can view B2C and B2B dashboard reports in one instance. Each salesperson dashboard provides a personal summary while the sales manager dashboard gives a team view with the ability to analyze the details of each team member.

Pega for Outlook

The Pega for Outlook plugin gives sales representatives contextual insight into Pega Sales Automation for Healthcare right from their Outlook client. As emails and appointments are selected in Outlook, Pega for Outlook dynamically updates and gives a complete view of leads, opportunities, associated contacts, and recent activities. Emails and appointments can be synced in Outlook back to Pega Sales Automation for Healthcare with a single click to allow for tracking of activities and for audit purposes. The quick create function includes the ability to add contacts, leads and opportunities, and the global search gives you access to all your sales automation data without having to leave Outlook.

Pega for Outlook dashboard view
Pega for Outlook dashboard view

Exchange integration

Integration with Microsoft Exchange allows managers and representatives to manage calendar appointments across sales teams, customers, prospects, and subject matter experts from directly within Pega Sales Automation for Healthcare while synchronizing with the Exchange server. For example, representatives can view sales team attendee availability in real-time and sync appointments to Exchange. Additionally, external system users can see free/busy time for a representative so that sales appointments may be setup.


Global search performs an indexed, optimized search across all the work objects that the logged in user can access. By combining Lucene search with territory security, the sales team can easily find the data they need from a single search dialogue on any device, displayed in order of relevancy.

Search functionality
Search functionality view

Agency (Partner) relationship management

Empower your agencies to leverage the benefits of Pega Sales Automation while gaining insight into their deals, sales activities, and forecasts from a single application instance. Model a agency organization's tiered structure and grant granular access using territory security. Global sales ops can easily set up and administer agencies or brokers as well as delegate user and territory administration to the local sales ops users at the agency organization.

Share information with agencies (partners)

Channel managers can share organizations, contacts, accounts, and collateral with agency brokers in read-only mode. Channel manager can also use Spaces to share important announcements, or product updates. These capabilities allow in seamless exchange of information between the parent organization and the agency organizations.

Agency (Partner) Community view
Agency (Partner) Community view

Avoid channel conflicts with deal registration

Deal registration capability helps agency brokers get the most value out of their time by letting them work on the best deals. This is how it works:

  • Agency broker gathers information on deals and submits to channel manager to approve.

  • Channel manager easily handles conflicts with visibility into potential duplicate deals.

  • Post-approval from a channel manager.

  • Partner sellers start working on the deal.

  • Timely notifications throughout deal registration provide fluid process.

Sales chatbot

The Sales chatbot replaces online registration forms by interactively capturing data and qualifying prospects. Once qualified, a lead can be automatically created and routed to the appropriate sales rep and a meeting scheduled based on the sales rep's availability. Other relevant entities like organization, contact, task, activity, pulse post is also automatically created by the sales chatbot.

B2B and B2C selling models

Whether selling to individuals through agencies and organizations in the commercial small, medium, or large business market segments, or directly to individuals in the commercial or Medicare market, Pega Sales Automation for Healthcare supports your B2B and B2C selling modes in one instance. The user interface and data model dynamically adapt based on the type of customer to whom you sell.

Social media interaction

Pega Sales Automation for Healthcare integrates with Twitter and Facebook by allowing sales representatives to associate the Lead, Contact, Company, and Account information in the application to online profiles.

LinkedIn Sales Navigator integration

Pega Sales Automation for Healthcare integration with LinkedIn Sales Navigator enables sales reps to find new contacts with recommended leads. This widget also helps finding icebreakers to get commonality between sales reps and their prospects without leaving the Pega Sales Automation for Healthcare application. This information, coupled with Sales updates, news mentions, etc., enables sales reps to efficiently gather the intelligence on a contact necessary to move the deal forward.

LinkedIn Sales Navigator pane
LinkedIn Sales Navigator pane

Pega Call

Integration with Pega Call make sales reps more effective with both Inbound screen pops as well as Outbound click-to-dial from any phone number field in the application. In-call modal dialog facilitates easily logging call notes, with auto-creation of an activity when the call completes.

Supports open CTI as well as Avaya, Cisco, and Genesys CTI products.

Territory and security management

Territory and security management capabilities allow for granular and flexible access permissions for sales representatives and managers. Using a hierarchical territory structure, Sales Operators can grant create, read, and update access based on the user, territory, and case type. Use territories to structure access for external users like brokers, within an agency or within a hierarchy of agencies.

Team selling

Team selling for accounts and opportunities allows sales representatives to access work objects (for example, leads, contacts, opportunities) that are not within their territory. Representatives on a sales team act as co-owners and have full access to the Accounts and Opportunities.

Sales collaboration with Pulse

Pulse in an internal social collaboration tool that allows sales representatives to track important notes and posts in the context of Sales Automation work objects. Whether sharing a file or requesting a discount, teams can collaborate and make the selling process a social experience.

Opportunity pulse
Opportunity Pulse view

Reference objects in Pulse

Users can now reference users, spaces, and documents in a pulse post. You can now also view the pulse post attachments inline. This applies to images, videos, and PDF files attached to a pulse post.

Pulse post
A Pulse post view


Sales reps and other application users can now create Spaces to collaborate with other reps. They can create public and private groups, thereby controlling visibility. Spaces can also be tagged across the Sales Automation application in pulse posts.

Spaces dashboard
Spaces dashboard view

Private posts

Sales reps can now send private pulse posts to selected recipients. These posts will be visible only to the sender and receiver. This increases personalized collaboration across teams.


Sales reps can now set their preferences to receive notifications on the work objects they follow. These notifications are also available on mobile.

Sales coaching

Sales Coach in Pulse is designed to enable sales managers to seamlessly deliver efficient coaching. The widget displays coaching recommendations for all the sales reps reporting to a manager in different areas. Manager can then devise personalized Coaching plans for each of these coaching recommendations. Sales Coach will also follow-up with sales managers and reps by providing them an update on the rep's progress in a coaching recommendation.

Coaching plans
Coaching plans view

Engagement maps

Sales Organizations typically use Pega Sales Automation for Healthcare systems to nurture and manage the deals in their sales pipeline. Engagement Maps help promote conversations around what is not in the pipeline by analyzing your product penetration levels across your territories and accounts to identify "white space." Representatives and managers can then focus their selling and marketing teams on these accounts for optimization of pipeline and share of wallet.

Lead capture forms

Lead capture forms can be branded and embedded into any website to facilitate lead capture directly into Sales Automation for Healthcare. Once submitted, the lead is immediately created in the application and can be routed to the appropriate sales rep using lead routing decision table and rules.

Lead form
A new lead form view

Workforce Intelligence

First in industry ability to optimize how work gets done across the enterprise by humans and robots from a central platform. Coach sales teams based on insights captured by Workforce Intelligence and Robotics and optimize application usage across the desktop.

Workforce Intelligence dashboard view
A Workforce Intelligence dashboard view


The Pega Sales Automation for Healthcare Co-Browse feature allows users to instantly collaborate using the web browser of customers and prospects. Easily launch a co-browse session from any contact in the application. Sessions can be initiated by a customer with a session code, or by a sales rep via email. Modes include view only, highlight, and full keyboard control.

Multilingual support*

Language packs support localization by translating text values for buttons, prompts, labels, etc. The following language packs are available for Pega Sales Automation for Healthcare: Italian, French, Japanese, German, and Portuguese.

End-to-end customer relationship management*

As part of the Pega Customer Relationship Management suite, Pega Sales Automation for Healthcare can work with Pega Marketing and Pega Customer Service for Healthcare to support the entire customer journey. Pega powers a full transformation of the customer experience--- incrementally integrating with existing assets at first, and then eventually replacing existing legacy Customer Relationship Management applications to take full advantage of Pega single, unified platform. Pega Marketing and Customer Service for Healthcare are licensed separately.

Quote to close

Use Sales Automation for Healthcare's quote to close functionality to process opportunities after lead conversion through closure for groups and individuals with pre-built healthcare rules reflecting current requirements for such things as eligibility, rating, and standard health insurance plans.

Group & Individual sales opportunity management

Guided, end-to-end quote management for individual as well as small and large group sales opportunities including managing and converting leads, managing contacts and accounts, uploading and maintaining group census, shopping for eligible plans, comparing plans, quote management, rate generation, proposal generation, and application processing for sold opportunities.

Opportunity page
An opportunity page

Guided selling

Pega intelligently guides healthcare consumers, brokers, and inside sales agents through the sales cycle, simplifying and personalizing every sales journey. Context-driven navigation tailors and simplifies sales across all marketplaces, communication channels, and devices.

Opportunity insights
Opportunity insight view

Census management

Guide brokers and other sales agents to easily upload census information for fast quoting and rating results. Mapping of their Excel columns to census fields simplifies census upload for those who prefer not to enter information manually. Pega Sales Automation for Healthcare users can store and use multiple census records concurrently for quotes as needed. Finalize the census during application processing for member enrollment.

add alt
add alt

Quote management

Automated multi-tier rate quote generation based on rating tables that are maintained in the application. The capabilities include initial quick quote generation as well as final quote management. Quotes are grouped by plans and rating tiers as well as detailed member rates at the family and individual level.

Quote request
Quote request view
Member rates
Member rates view

Plan Benefits integration

Sales reps, brokers, and underwriters can browse the plan benefit catalog from their portal and lookup plans by multiple parameters including sold accounts. Plan views include browsing by benefit categories as well as searching for benefits by keywords. The application provides a 'shopping cart' user experience when selecting eligible plans for a given opportunity. Pre- configured APIs provide ready integrations with Pega's Product Composer System.

Plan Benefits view
Plan Benefits view
Plan Benefits side menu
Side menu of the Plan Benefits page

Proposal generation

Create and maintain PDF templates for automated proposal generation of quotes that can be shared with the prospect contacts. The proposal includes dynamically generated sections with quote information.

An example proposal
An example proposal
An example proposal
An example proposal

Application processing

Guided data collection and validation for application processing prompts users to gather and validate group information, collect multiple addresses and billing requirements, associate contacts with locations for sales finalization activities such as fulfillment ordering/processing, and submission to membership system for contract/ID number.


Use Sales Automation for Healthcare's Renewal functionality to reduce the churn by retaining your existing accounts using our batch renewal case.

Operator-originated renewals

Renewal user can create renewal batches manually using our simplified Renewals UI based on standard and advanced criteria's: Month(s), Year, Market Segment, Territory, Plan type(s), Agency(s).

Batch renewals
Batch renewals view

Automated renewal creation

Automate your group renewals using configurable system agents. Control the maximum size of the batch. Run renewals based on renewal month, year, market segment, and territory. Isolate and deliver exceptions for further work to a Mapping Error workbasket.

Automated renewal processing (straight-through-processing)

Deliver final applications to sales reps and brokers for straight-through-processing (STP) renewals where successful plan mapping has occurred, and premium rate changes are within acceptable limits. Renewal work items show old and new plans and rates for easy comparison and permits changes as necessary.

Renewal exceptions

Review and manage exceptions more easily through Mapping Error identification, prioritization, and processing.

Product mapping

Map renewal plans and generate renewal rates. Manually select new plans for renewal opportunities that have no automated plan match.

Plan mapping view
Plan mapping view

Renewal APIs

Integrate with existing systems of record for account and census information using the included renewal APIs for account, census, and renewal. Migrate current account information to Pega Sales Automation for Healthcare during renewals.

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