PROFESSIONAL SUMMARY:

• 10 years of IBM AS/400 (iSeries) Technology in healthcare management and Retail experience with Strong analytical skill and very good understanding of SDLC.
• Worked on various application Development and Production support projects as an AS400 consultant & delivery lead with responsibility of project delivery, quality reviews and achieving multiple phases of testing goals.
• Experienced in technically challenging assignments of integrating the upstream/downstream applications such as ETL Tools, Facets, CED & CDB (Mainframe applications), EODS with AS400 via different interfaces.
• Strong skills in SQL, DB2/400, Stored procedures, Performed Debugging, Troubleshooting and performance tuning.
• Experience in Application Integration with front - end applications via SOA and MQ Series.
• Extensive experience as a PMHS & Rx system Healthcare analyst in key application areas such as Preprocessing module, Claim Adjudication module and Post processing module.
• Intermediate in PySpark, Distributed file systems Hive, AWS S3.
• Worked extensively on JDA Application with the good knowledge of Inbound, Outbound and inventory management.
• Experienced in IT production support projects for leading Healthcare giants which predominantly involved support Incident Management, Problem incident management, Service improvements and enhancements and ensured on time support deliverables with utmost quality
• Worked collaboratively with business leaders, third Party Vendors, End Customers and Support groups across various technologies to manage support delivery objectives.
• Business Analysis experience with ability to quickly comprehend scope of business and recommend viable and cost-effective solutions
• Worked on complex system integrations, customizations, and delivered effective solutions on critical situations.
• Ability to multi-task and work under extreme pressure in a deadline driven environment.
• Working with Designers, SA’s and BA’s while gathering the requirements and converting those in work items.
• Good presentational and documentation skills. Reviewed Program specifications docs and test case docs with Clients for every release of work.
• Possess excellent skills to administer and monitor project plans, analyzing user requirements and suggesting hardware and software for their operations.
• Assisted business in service improvements and system enhancements using the latest technologies.
• Working extensively with the Onsite - Offshore model possessing good user communication skills and debugging skills.
• Assist in process planning and providing status reports to upper management on daily basis.
• Ensure smooth service delivery, proactively identify potential areas of service improvement.

TECHNICAL SKILLS:

Platform: IBM AS/400 (iSeries)

Programming Languages: COBOL/400, ILE RPG, RPG, SQLRPGLE, SQL, CL/400, SQLCLLE, CLLE, PYSPARK

Databases: DB2/400, SQL400, HIVE

Packages: PMHS, JDA-MMS, Rx CLAIM, GENASYS, SPARK

Interfaces: MQ Series, FTP, SFTP

Change Management Tool: ALDON CMS

File Utilities: DBU

Tools: Robot Scheduler, Benefit builder, Benefit Serv, IBM WebSphere App, Jwalk developer, HP ALM, Hawkeye, Oracle SQL Developer

PROFESSIONAL EXPERIENCE:

Confidential

Senior IT Developer

Responsibilities:

• Analyze Business, functional requirements and Functional Design Specifications.
• Prepare Technical specification document and high-level flow charts for programs.
• Co-ordinate with Client, SA’s and Designers to make sure all business requirements turned into Technical specifications and get it review.
• Conducts review for Technical design with Business Team and get it approved by Business solutions team.
• Develop programs using Embedded SQLs in COBOL ILE, RPGLE, Free format RPG, CLLE and COBOL/400.
• Prepare Production support documents.
• Create necessary Change Management tickets to migrate the code to Test regions as well as Production region.
• Code review and preparing check list for the project.
• Building/modifying complex SQLs to improve the performance.
• Prepare the quality documents and deliver them.
• Involved Performance testing.
• Responsible for performing the requirement analysis for test scenario and test design preparation.
• Accountable for creating test plan based on the impacted applications.
• Creating test scenario’s and test cases based on the requirements and functional design document shared from the stakeholders.
• Executing the created test cases for the applications/modules/database which includes unit testing, system testing and Acceptance testing.
• Performed data accuracy, data validation, and data integrity testing by querying the database using SQL Queries to check the data tables and generated reports.

ENVIRONMENT: & TOOLS: Cobol/400, RPGLE, SQLRPGLE, CLLE, DB2/400, ALDON, Jwalk developer, Hawkeye, Connect Direct, MQ, RTC, Quality Center QLM, Control-M

Confidential

System Analyst

Responsibilities:

• Ensure overallclaimsadjudication in accordance with State, Federal and Health plan regulatory requirements and departmental guidelines.
• Gathering requirements from Salesforce.com to update plan & pricing for each Benefit ID and using the NDC and GPI information for each benefit ID we update the pricing depends on client requirement.
• Rx Claims is a claims adjudication system for CVS Caremark Confidential . RX claim is used for building Benefit Plans, set-up the copays and pricing, Pharmacy Reimbursement and client billing.
• Managed client setup information for specialty benefit design, created new Benefit Id’s using client requirements for the pricing updates.
• The process begins when a member goes to the pharmacy to have the prescription filled; the pharmacy submits a claim using the member’s information as well as a BIN/Process or control/group number (BPG).
• RX claim (AS400) uses the BPG to identify the claim and begins checking eligibility and the Benefit plan for coverage.
• Setting up the Pharmacy networks for different allowances by the client and adding the retail Logics to the Drugs.
• Creating and providing initial manual testing for the claims in pre-production environments for the networks.
• Involved in requirement analysis, design, development, testing, and maintenance with working experience in Different environments.
• Participated in requirement review meetings with Business Analysts, Developers and Business Users to review the main business processes, workflow, tasks, user roles, input, and output.

ENVIRONMENT: & TOOLS: AS400, Salesforce, Benefit builder, Benefit serv, EZtest, Sequel, EDI/HIPAA, SQL Server.

Confidential

System Analyst

Responsibilities:

• Eligibility loading is the process, which loads all the medical & pharmacy eligibility data into Genasys system.
• Confidential is the process, which handles pharmacy claims from TPAs and send to Cigna's third party Confidential vendor.
• Handling Third Party Administrators, Maintaining and supporting Members Eligibility, claim processing.
• Setup and Maintain the Hierarchy for various Third-Party Administrators as and when requested, to ensure seamless Benefits for all members.
• Responsible for work allocation, prioritization, metrics collection and analysis of trends, identifying improvement opportunities in conjunction with Offshore Track Lead

ENVIRONMENT: & TOOLS: HPSM, Cobol/400, CLLE, DB2/400, Genasys.

Confidential

Associate - Projects

Responsibilities:

• To provide 24/7 support to the client and maintain the Database, Applications and Transactions keeping all the applications active and fixing any error that occurred during transactions or within the system.
• Working as a Technical and functional Lead for IBM iSeries (Cobol/400 ) PMHS application team
• Responsible for application issues and enhancements fixes on Cobol 400 code logics.
• Single point of contact from offshore for all application issues within PMHS applications and responsible for end-to-end support of it.
• Responsible for incident and problem management on all Cobol/400 coding fixes.
• Manage SLA-bound delivery of application support services across various technologies/business functions.
• Responsible for Document repository management, Metrics Planning etc.
• Responsible for all application issues on PMHS tool such as claim adjudication errors, financial issues, inbound/outbound issues and EOB/EOP issues.
• Responsible for Weekly Status Report and weekly ticket triage call to present & explain RCA for important incident tickets.
• Responsible to provide Assessment of Service request for Maintenance & development of Client's applications.
• Responsible for developing and delivering support enhancements and customization in PMHS application that coded on Cobol/400 logic.
• Work collaboratively with Third Party Vendors, Customers and Support groups across various technologies to manage the Support delivery objectives.

ENVIRONMENT: & TOOLS: Cobol/400, RPGLE, SQLRPGLE, CLLE, DB2/400, HPSM, Aldon CMS, Robot scheduler, PMHS, MQ Series, EDI, SQL Server.

Confidential

Programmer Analyst

Responsibilities:

• Responsible for supporting key applications related to Retail core business
• Manage risks and draw out risk mitigation plans to keep the impact low during support delivery.
• Manage SLA-bound delivery of application support services across various technologies/business functions.
• Responsible analyze/identify opportunities to set up monitoring mechanism wherever it is potential business impact and participate in testing, assess performance, review results and support model preparation.
• Responsible for delivering enhancements and managing services whilst maintaining the quality in delivery and constantly reviewing the cost efficiency for the customer.
• Responsible for Incident monitoring and resolution as part of regular support tasks using incident management tool

ENVIRONMENT: & TOOLS: RPGLE, RPG400, CL, CLLE, DB2/400, HPSM, JDA, SOA, COGNOS.

Confidential

Programmer Analyst

Responsibilities:

• The purpose of the project is to show up Comet products in eBay website. This project involves send/receive CSV feeds between JDA and Merchant Integration Platform (MIP) that communicates with eBay.
• Took the ownership for Range and order module Project Development
• Responsible for requirements gathering, generation of Technical Specification Documents, Project Design, Development and Unit Testing.
• Preparation of Technical specifications for enhancements/bug fixes and release documents
• Responsible for performing the requirement analysis for test scenario and test design preparation.
• Accountable for creating test plan based on the impacted applications.
• Creating test scenario’s and test cases based on the requirements and functional design document shared from the stakeholders
• Performed data accuracy, data validation, and data integrity testing by querying the database using SQL Queries to check the data table on the Server.
• Executing the created test cases for the applications/modules/database which includes unit testing, system testing and Acceptance testing.
• Reporting defects encountered during the execution to the concern stakeholders.
• Preparing the test closure document upon completion of execution.

ENVIRONMENT: & TOOLS: RPGLE, RPG400, CL, CLLE, DB2/400, HPSM, JDA, SOA, COGNOS.