SUMMARY:

• Business oriented technology leader with global experience in Enterprise Solution & Integration Architecture by collaborating across all business units to deliver value driven applications.
• Experienced in delivering solutions for Organizations in Medical Devises Manufacturing, Prescription Benefit Manager, Medicare/Medicaid BPO, Health Insurance Plans & Exchanges and Health Information Exchanges
• Experienced in delivering solutions in the areas of Application Development, Business Process Improvement, Service Oriented Architecture, Analytics, Security and Infrastructure.
• Deep expertise in evaluation and adoption of tools & technologies to address the business need.
• Strong leadership and management skills in building teams with ability to motivate and coach to deliver quality solutions

COMPETENCIES:

• Solution Architecture Strategic Planning Cloud Delivery & Service Models
• Service Oriented Architecture Team Management Cloud Adoption & Migration
• Business Process Management Cross - functional Team Leadership Information Security
• Big Data Relationship Building DevOps/Agile
• Application Development Resource Forecasting & Planning Global Network Delivery
• Project Management Cost Optimization Vendor Management

TECHNICAL SKILLS:

Business Process Management: Confidential WebSphere Process Server(BPEL), PEGA Healthcare BPM/BRE, Oracle Fusion Middleware

Enterprise Service Bus/SOA: Confidential WebSphere ESB, DataPower, MuleSoft

EAI: Web Methods, Interchange Server (Bought by Confidential ), WebSphere Message Broker

ETL: Informatica, Oracle Data Integrator

Business Rules: Confidential Operations Data Management

Business Intelligence: Yurbi

COTS: hCentive, HealthShare, SIEBEL, SAP, Oracle Apps

BIGDATA: HealthInsight, HBI Analytics

Modelling: UML, BPMN, ArchiMate

Logging & Monitoring: Splunk, Logic Monitor

Network, Storage & Compute: CISCO, VMWare, NetApp

Information Security: MFA, SOC, Vulnerability Management, IDPS, Configuration Management, MDM

Overview of New Tech: AI/ML, Block Chain, IoT, Hadoop, Spark.

PROFESSIONAL EXPERIENCE:

Confidential, New York

Director - Architecture & Engineering

Responsibilities:

• Executed merger of BHIX Confidential successfully becoming the nation’s largest Confidential with 16 Million Patient Population
• Executed Planning sessions with internal business unit stakeholders preparing as is Business Processes, Applications, Integrations, Data and Technology Architecture.
• Identified gaps and presented Roadmap with projects, costs and timelines.
• Organized and streamlined IT into Integrations, Development, Data Analytics, Engineering and Support Services
• Architected & Implemented Business Intelligence application for internal business units Business Development, Account Management, Compliance and Customer Service providing self service capabilities with 360 Degree view of customers.
• Developed standardized Integration & application development services
• Institutionalized Architecture Review process for Information Security, Compliance and manageability
• Evaluated & Implemented cost effective Enterprise Cloud Monitoring Solution for Compute, Storage and Networking.
• Implemented High Availability & Load Balancing capabilities improving SLA Compliance and customer satisfaction.
• Implemented Applications Monitoring with Splunk creating end to end visibility.
• Implemented Proof of Concept with Confidential Watson Health for Clinical Trial Management module
• Partnered and Collaborated in implementing solutions for improved clinical workflows at Healthcare Providers by embedding Confidential services
• Successfully lead the IT to achieve SOC Type 2 Certification and specific security controls to partner with large Healthcare Payers United Health Group and Anthem resulting in development of new service offerings.
• Architected and advised Population Health Initiatives by implementing Big Data Analytics platform.
• Standardized and Implemented Confidential Models for rapid onboarding of customers increasing the daily transaction volumes from average 22 Million to 60 million monthly in exchange.
• Architected and Implemented AWS Cloud for Data Backups
• Successfully lead performance, availability and security incidents guiding the war room activities.

Confidential

Solution Architect

Responsibilities:

• Successfully facilitated cross-functional internal and external teams and communications driving analysis and documenting the key features of system.
• Lead sessions with Product Vendor, Carriers and Payment Gateway Providers identifying gaps, remediation plans.
• Architected Business Processes of Eligibility, Enrollment, Billing and Noticing for Statewide Health Exchange for Medicaid and Qualified Health Plans(QHP’s) integrating multiple internal and external systems
• Architected and Implemented Generic Rules Engine for Health Exchanges making it customizable for state specific policies for Medicaid
• Managed the Middleware Team for all integrations with Payers participating in exchanges

Confidential

Architect & Product Development Lead

Responsibilities:

• Successfully Delivered an Enterprise Transformation Initiative of creating a product from the ground up with similar capabilities of TriZetto Facets offering Business Process-as-a-Service.
• Collaborated with Business Process Analysts to capture requirements producing use case documents for Enrollment, TRR, Billing, Refunds and Customer Service for Medicare Line of Business.
• Designed high level workflows with integration touch points with internal and external systems.
• Decomposed the use cases into service candidates by module & identified the reusable services.
• Lead design sessions with Application Development, Services and Integration team.
• Prepare work break down and estimates.
• Devise the Sprint Schedules by Feature by balancing the available resources and time constraints.
• Communicating with key stakeholders on Progress & Risks.
• Managed 55 Resources comprising Business Process Analysts, Architects, Technical Leads and Development Resources and QA Testers

Confidential

Enterprise SOA Services Lead

Responsibilities:

• Successfully executed the vision of COE for Enterprise Services to promote Service Ownership and Reuse.
• Assist & define all enterprise initiatives of Consumer Interaction and Customer Service applications for integrating with internal and external systems.
• Design of Reusable Assets for Security, Membership, Benefits, Claims and Prescription Orders
• Lead all B2B Integration Initiatives integrating Insurance Providers, Credit Card Processors, Generics Pricing and Eligibility providers.
• Maintain Service Catalogues, worked with QA team in setup of regression scripts.
• Created and implemented performance standards, metrics, and key reporting
• Management of Development Teams across geographies
• Successfully Implemented Tool Evaluations for bringing in new technologies.
• Member of SOA Governance for reviewing the requirements, identifying the service candidates for reuse and development of new services

Confidential

Solution Architect

Responsibilities:

• Worked with multiple customers in identifying the issues/bottlenecks by conducting Architecture Discovery workshops
• Analyze and Identify customer pain points
• Develop the Solution Architecture and present to customers
• Demonstrated “To Be” Architecture Solution Options
• Design and Development of Proof of Concepts
• Showcase the POC to Customer Stakeholder demonstration solution value proposition
• Assisting Sales Directors to provide inputs on Software required and licenses
• Document Migration Process steps, development efforts and cost of migration
• Prepare implementation plan and deliver solution working with delivery teams.

Confidential

Integration Architect

Responsibilities:

• Lead EAI and ETL teams spread across globally.
• Executed integrations for various programs reengineering many business processes.
• Design, Development and Implementation of interfaces connecting SAP, Oracle Applications, Siebel, B2B Portals, Partner ecosystems with shipping vendors.
• Design and Development of Batch Interfaces using Informatica.
• Implemented Event driven interfaces triggering downstream business processes in Pre-Sales, Order Management, Shipping and returns.
• Successfully managed and delivered many Integration & B2B Initiatives.
• Worked on Enterprise, Region and Country Specific application integrations.