SUMMARY

• Highly - accomplished Sr. Application Development manager with excellent technical leadership abilities and management skills with a proven record of managing high- performance teams, strategic planning, functional transformation, change creation and management, budget and resource management, and personnel development.
• Strong expertise in managing multiple (Agile and waterfall) projects, deadlines and conflicting priorities in a fast paced environment. Experience developing and implementing IT policies and procedures, including those for Software Development methodologies, application security controls and disaster recovery.
• Knowledge of IT governance, compliance and risk management practices.
• Industry certifications include - Oracle Certification & Sun Certified Java Developer.

PROFESSIONAL EXPERIENCE

Confidential, GA

Sr. Application Development Manager

Responsibilities:

• Responsible for managing globally distributed IT application development teams supporting the technology strategy & innovation for the company.
• Currently delivering the E2K CadLite Application on an Android Mobile Platform applying the Agile SCRUM methodologies that reduced processing times and costs(using technologies such as .Net, Xamarin, CAGen Mainframe and using agile tool Team Foundation Server
• Transformed the Globally distributed team to Agile methodologies.
• Re-Built the TFS dashboard and streamlined the process to display the accurate project metrics.
• Migrated the E2K CADLite mainframe application to New Android Mobile Platform.
• Managed the budget of $2.19 million including hardware and software costs.

Confidential, FL

Sr. Application Development Manager - IT Claims Systems

Responsibilities:

• Responsible for managing multiple IT application development teams supporting the Health & Pharmacy Claims Adjudication Systems(using Java technologies- Java, J2EE, JSP , Servlets, XML, AQ/MQ, EJB, MVC/Struts Framework, Web Services, JavaScript, JSON, RESTful Services, ReactJS, Hadoop, Scala, HBase and Nifi, Kafka, Sqoop, Hive and Oracle/DB2/Mongo DB as the databases and using agile tools CA Agile Central & JIRA); managing the delivery of key system capabilities working closely with business partners, other internal IT departments and external vendors.
• Manage mission critical IT Health & Pharmacy Claims Systems supporting multiple business units.
• Expanded the technical capabilities to increase efficiency of Health Claim System to adjudicate 100 million health claims per annum with high availability(99.95%) and high performance sec) with an automation rate of 97%.
• Improved member satisfaction by delivering Monthly Health Statements for 5 million members.
• Managed the development and delivery of Cost Share Reduction application capability and generated an average cost savings over 300 million per annum.
• Improved customer experience by providing innovative Member 360 interface to provide real-time health claims information using ReactJS and MongoDB.
• Successfully Established and Optimized Off shoring model with US Technologies and achieved an average savings of 2.7 million dollars.
• Manage development and implementation for data land project using Apache HBase and Apache NiFi on Hadoop.
• Manage development and implementation for customer connect project using JSON and MongoDB.
• Migrated OPL Mainframe application to new technologies.
• Integrated Benefit Accumulator Exchange with PRIME Therapeutics.
• Active contributor to the development of the enterprise Business Continuity Plan and Disaster Recovery Plan.

Application Development Manager - IT Claims Systems

Responsibilities:

• Responsible for management of 30 - member software development team in alignment with overall departmental plans. Coordinated project tasks and work assignments to ensure quality deliverables. Valued as trusted leader/advisor providing complex technical and business decision support and building productive collaborative relationships with architects, development managers, and technical leads to arrive at the best technical and service solutions. Mentored team members and established performance objectives.
• Optimized achievement of organizational goals by using transformational technologies and managing projects for design and development of 30 Java Service Applications, 2 Web Services and 1 PowerBuilder Client Application with 50+ screens, 500+ Oracle packages, procedures and functions, as well as 75+ mainframe jobs.
• Increased efficiency of Health Claim Services and reduced annual TUX licensing costs by developing/ implementing architectural vision and blueprint for Diamond Claim Adjudication System through introduction of J2EE-based claim services, reducing dependency on TUX-based environment and improving process flow.
• Elevated business and technical performance by conceptualizing/implementing event-based Post-Adjudication Framework for asynchronous processing and centralization of post-adjudication claim actions for an ever-increasing number of services across multiple servers. Reduced development time/maintenance costs.
• Improved provider and member satisfaction in support of 1 Million transactions per year through overall project management and development of CareCalc web application enabling real-time determination of member eligibility and financial responsibility for rendered services.
• Expanded technical capabilities and serviced 500000 transactions/day providing accurate member eligibility and benefits (E&B) accumulator data to great numbers of clients by leading development/implementation of reusable and scalable E&B accumulator web service that executes dynamic logic to calculate benefits.
• Reduced IT development costs, from US$100K to $2,800, and time to migrate each new vendor by successfully managing project to develop Vendor Accumulator Exchange Service comprised of MQ-based standard interface for exchange of member benefit accumulators between Health/Pharmacy insurance companies."
• Served a pivotal leadership role directing 12-member Diamond design governance team which includes developers, analysts and architects and has made significant progress regarding Diamond modernization by establishing design guidelines, standards, best practices and process improvements for Diamond organization.
• Established new strategic direction for creation of a future accumulator hub through re-architecture of benefit accumulator synchronization between PRIME and Blue Cross.
• Implemented Medical Claims Monitoring Tools to guarantee claims delivery and DRSynch Tools for synching reason codes to multiple environments."

Technical Lead

Responsibilities:

• Responsible for leading the IT Claim Systems development projects in J2EE, JSP, PowerBuilder and Oracle Pl/SQL - including project planning, project execution and project closure; executing consultancy engagements as a software engineer.
• Contributed to leadership excellence by directing/mentoring development team and facilitating requirements analysis and design of Oracle packages/procedures, PowerBuilder changes and PL/sQl interfaces. Created system flow diagrams in Visio for business functional specifications.
• Demonstrated extraordinary ability to increase technical capabilities and enhance operational efficiency through successful completion of more than 25 projects, including:
• Automated Pricing Tool (API) Developed tool for pricing claims using Diamond pricing modules. Used PL/SQL, JSP for interface development and Oracle packages/stored procedures to process business logic.
• ITS Host/Home Plan Implemented Host Plan, completely bypassing benefits/ adjudication process, pricing claims based on provider contracts found using line of business pointer on system member contract.
• Special Payee Enhancement Provided ability to pay a special payee by modifying stored procedure logic to automatically create special payee vendor/subscriber pay records. Modified AP Update PL/SQL logic.
• Change Control Processed claim benefit accumulators under old and new benefit packages. Designed/ developed conversion/shell scripts and system flow diagrams for nightly batch process in PL/SQL.
• High Stay/Low Stay DRG Created enhancement to modify Diamond institutional claims pricing logic in PL/SQL to perform pricing calculations for low/high trim per diem cases. Designed 2 calculation methods.

Software Developer

Responsibilities:

• Create system flow diagrams, Tech Specs and Release Notes.
• Design of database objects(Tables,Stored Proc & Triggers) and MDI interface and control structure of the modules.
• Database performance tuning and query optimization
• Coding and Unit Testing.
• Substantially increased the performance of claims systems by implementing new critical system updates.
• Migrated Claim System from version 5.1 to 7.0