SUMMARY:

• I have 11 years’ experience in the Health Insurance IT industry. Past 8 years I have been working with Anthem Inc on major healthcare initiatives.
• During this time I was working in the SOA middle tier team and has extensively worked on soap & REST based services (in XML & JSON format), APIgee, Swagger creation, Data modelling, wsdl creation, API mapping, Datapower, API goverance, soapUI & POSTman testing etc.
• My healthcare experience involves Claims processing, Membership Enrollment, Billing and Payment for members, Medicare/Medicaid migration projects, ACA Subsidy etc.
• The projects were executed in waterfall model and later in Agile methodology.
• I have been a key member of the HPS (Health Plan Services), Anthem, WGS (Wellpoint Group Systems) development and SOA services team. Last 4 years I have been working in SOA (Service Oriented Architecture) with wide range of experience on SOA concepts, web service design, REST and soap based services, APIgee configuration etc.
• Across the different projects my role included interacting with the customer to get the business requirements, translate it into technical design, and also includes preparing the design, coding and Testing. Working with different healthcare companies I have acquired a wide range of experience on Claims, Membership, ICD10, ACA Subsidy design, Billing, EDI, batch processing, Medicare, Medicaid etc.
• I have extensive experience with working in agile methodology - writing epics, user stories and developing a complete product through different sprints.
• I have also completed the SOA certification from SOA Schools.
• I was Involved in estimation of the projects using Complexity points. I was also involved in Automation improvements for the client, developing tools using REXX. I have played the role of Test Lead for 16 member team. I have been as a Trainer in Cognizant Academy for REXX, VSAM and DB2 Subjects.
• I have acquired in-depth knowledge of the technologies used in the system. I have mentored the newly inducted team members and co-coordinated the beginners. I have also successfully completed the AHM-250, COBOL and DB2 CCP’s.

TECHNICAL SKILLS:

Web:  Web service design, Service Oriented Architecture, COBOL, DB2, VSAM, REXX, JCL, IMS, Easytrieve

Databases:  DB2, IMS DB

Tools Used:  REXX, XMLSpy, SoapUI, Ignite

Management:  Onsite lead, Project Estimation

Domain knowledge: Healthcare

FUNCTIONAL TECHNOLOGY:

• WGS Claims online and Batch processing.
• Claim Adjudication, billing and membership processing.
• Individual and Small group quoting to determine the premium.
• Auto adjudication improvement for claims processing.
• Migration of commingle process to real time processing using MQ transactions.
• Automation improvements and Complexity point estimation.
• COBOL, JCL, IMS, DB2, VSAM, Easytrieve
• Databases - DB2, IMS
• Operating systems - Windows 95, XP,
• Tools - soapUI, XMLSpy, Ignite, Mainframe Dev Macros, Job automation
• Development Tools – REXX

PROJECT SKILLS:

• SOA middle tier team experience on soap & REST based services (in XML & JSON format), APIgee, Swagger creation, Data modelling, wsdl creation, API mapping, Datapower, API goverance etc
• Subject Matter Expert in the Claims, Subsidy, Billing and Payments areas in Anthem.
• Experience in Membership, Subsidy, Rating and Quoting related projects.
• Healthcare certification completed through cognizant.
• Experience in Data analysis and reporting of Healthcare data.
• Portfolio analyst for Member facing applications working across the SOA functional domains.
• Worked in Agile methodology - writing Epics, User stories and developing complete product in different sprints.
• Experience with Ignite, soapUI, POSTMAN, XMLSpy, Clear Case, ClearQuest, AWIM tool in Anthem.
• Has undergone SOA school training and is SOA certified.
• Involved in estimation of Projects, Change requests and Lights on items using Complexity points.
• In WGS projects, worked as an Onsite Developer for 4 - 5 change requests at a time, handling different offshore teams.
• Onsite Test Lead for 16 member offshore team.
• Guided the offshore automation team for project innovations.
• Involved in direct interaction with the client for process improvement innovations.
• Thorough Understanding of Software Development Life Cycle (SDLC), involved in various phases like Requirements, Analysis/Design, Development and Testing.
• Acted as liaison between management and development team for Requirements and QA.

PROFESSIONAL EXPERIENCE:

Confidential

Systems Analyst

Responsibilities:

• Played the role of Domain Analyst and Portfolio analyst
• Acquired enough knowledge about the different domains to become Subject Matter Expert in the Claims, Subsidy, Billing and Payments area of SOA services.
• Worked with Ignite, soapUI, XMLSpy, Clear Case, ClearQuest, AWIM tool in Anthem.
• Once the services are designed, it is configured in APIgee or Datapower.
• Interacted with Digital ML vendor in improving their product to make it useful for SOA team.
• Responsible for understanding the requirements for the development and enhancement work.
• Key liaison between the business and the Development, testing folks.
• Interact with the Business team and understand the requirements and does the feasibility study of the different request raised by the clients.
• Translate the functional requirements into technical requests and interact with the Development and testing team.
• Involved in the Unit testing and integration testing of the various enhancements involving the code developed.
• Utilize application knowledge and thereby provide methods that would improve the performance of the current system.

Application Developer 

Responsibilities:

• As an Onsite Lead handled multiple change requests involving offshore teams from different location.
• Process improvement and Checkout automation was handled from Onsite location by interacting with both the customers and offshore team.
• Developed tools using REXX which was widely used by both customers and offshore team.
• Played the role of Test lead handling offshore team with more than 15 members.
• Performed the analysis, design, coding and unit testing for various modules in the project.
• Involved in estimation and the work plan for the project and was also involved in Quality works in Cognizant 2.0.
• Conducted periodic knowledge sharing sessions in REXX for the teams.
• Coordinated discussions between offshore and onsite teams and has prepared and maintained the Test case and defect logs.
• Peer reviews for design and coding.
• Met with the different business users for WGS Process Renovation and was able to co-ordinate accordingly with the offshore to effectively improve the Auto Adjudication Rate. During the second tenure in onsite for WGS Claims SSCR, was able to effectively co-ordinate the entire team of Channel Integration testing and also was able to work on several software development activities which involves design, coding, testing and also post implementation activities.

Application Devloper 

Responsibilities:

• Was responsible for analysis, design, coding and unit testing for various modules in the project.
• Estimated the projects using Complexity points.
• Enhanced the COBOL Standardization tool and shared with the customer.
• I was involved in creating Knowledge Repository using Rainbow Framework.
• I was also involved in Quality works in Prolite like creation of MPP’s and Unplanned work items.
• Coordinated discussions between offshore and onsite teams.
• He has maintained Test and defect logs and has also created test case documents.