KRISHNA POTLAPELLY Kilberry Way Parker CO (C)

Transcription

1 KRISHNA POTLAPELLY Kilberry Way Parker CO (C) Professional Summary Highly Skilled software development professional brining more than 17 years in software design, development and integration. Specialized in customizing software to meet client specific needs for a given products Multi-faceted, Self-directed and results-driven Solution Delivery Manager with deep level of technical knowledge, experience and people skills. Dynamic Technical Delivery Manager skilled at completing complex assignments possessing strong creative thinking skills, high energy and integrity Expertise in all aspects of the software development life cycle, including requirement analysis, architecture, design, development and support Involved in developing wide variety of custom solutions such as Enterprise applications / Standalone applications/ Interfaces / Extensions / Data Extracts / Business Rules using various platforms. Technical Skills Management Languages Database Web EDI Rules Engine IDE ETL Rules Engine Methodologies Health Care Products Microsoft Project, MS CRM, Microsoft Visio, Microsoft Office, SharePoint C#, Java, C, C++, PERL, SQL, PL/SQL, VB, MVC MS SQL Server, Sybase, Oracle.Net technologies, MS WPF, XAML, JSP, Servlets, EJB, Web Services, XML, XSD, XSLT, Java Script 834 Enrollment, 837 Claims, 278 Authorizations FICO Blaze Advisor, RMA IBM Web Sphere Studio, Rapid SQL, Toad, Visual Studio, SQL Server Enterprise Manager, EC Gateway Informatica, SQL Server Integration Services FICO Blaze Advisor, RMA Iterative, Agile, Scrum and Water Fall IHMF (Integrated Health Management Framework), Facets (Claims Management Enterprise System), QNXT (Core Claims Administration System), CAE (Care Advance Enterprise System), ICD Admin System (Export codes into CAE), CAP (Provider Portal), TCS (Letter Management System), PCA (Member Portal), CA (Clinical Analytix), CE (Content Editor), CMU (Content Migration Utility), MSA (Operational Data Store), ARE (Analytical Rules Engine Stratification Engine), UMBRS (Utilization Management Business Rules Server), MIMS (Member Information Management System), TriZetto HIPAA Suite, Commerce Broker

2 Educational Qualifications: Masters in Computer Applications Work Status: Green Card Professional Experience TriZetto Corporation Systems Integration Manager July 11 to Present Manage and Drive custom solutions needed by all TriZetto clients that implement / upgrade CAE and QNXT products Work closely with clients to identify the requirements and provide the solutions to meet their business needs Provide Order Of Magnitude (OOM), assist sales team to complete SOW / create Change Requests Manage development teams, enable quality deliverables by defining clear roles / responsibilities and set expectations Ensure team to follow guidelines / best practices in utilizing Data Integration Framework solution and enable repeatable solutions Involved in integrating QNXT system with various vendors such as VSP, Envision, McKesson, 3M, Micro-Dyn, Trapeze Platform, HCI (claims Editing software) Involved in various EDI transactions such as 834 enrollments, 837 Claims, 835 claim payments, 278 Authorizations. Involved in providing custom solutions to load into QNXT Systems after BizTalk transforms HIPPA transaction to XML Familiar with QNXT architecture DH and EU and databases such as Plan Data, Plan Integration, QCSIDB etc Attend onsite kick off session with client, provide capabilities presentations to bring the business, strategize the implementation plan and procedures Resource management: provide staffing, ensure staff utilization and create periodic performance reviews Conduct design / code reviews to ensure quality outcome to meet client satisfaction part of Delivery Management Directed internal toolkit / reusable solution development effort to increase return of investment (ROI) while remaining focused on client needs Modified existing software to correct errors, upgrade interfaces and improve performance Ensure Return Of Investment (ROI) by closely monitoring estimated vs actual effort Solutions include SQL server 2008, SSIS Packages, Web services MS.Net Frame work, MS WPF, XAML, C#, XML, XSLT, EDI X Some of the clients are : VPHP, AultCare, COA, Denver Health, WellPoint, WellCare, BCBS NC, BCN, LAcare

3 TriZetto Corporation - Advisory Consultant Nov 10 to June 11 Involved in implementing CAE UM module for WellPoint, Involved in gathering requirements, technical solution design using FairIsaac Blaze Advisor Managed developments tasks, resources and delivery time lines Drove Technical issue triage meetings, follow up thru resolution Coordinated with Core development team and Hosted team Solutions include FICO Blaze Advisor Business Rules Management, SQL Server 2008 TriZetto Group Inc - Technical Delivery Manager Aug 09 to Oct 10 Client Cambia Health Plans Project: CAE 4.61 Upgrade Involved in designing Solution, providing estimates and being CAE technical Subject Matter Expert Managed developments tasks, resources and delivery time lines Coordinated with Core development team and Hosted team Helped to build offshore model to augment resource capabilities Participated in data load, code migration and cutover planning sessions Advised PM on approaches to communicate to Client Advised Client on best practices This upgrade includes as below: o Upgrade to SQL Server 2005, All data interfaces upgraded to SSIS o Redesigned UMI outbound interface using C# and.net frame work o Support SIT, UAT and 30 days Post Go live o Conduct Design and Code reviews o Transition to Hosted for production support TriZetto Group Inc - Custom Development Team Lead Jul 06 to Aug 09 Client: The Regence Group Project: Care Advance Enhancements Managed developments tasks, resources and delivery time lines Communicated & escalated resource issues to PM and Management Involved in Architecting solution called Prepublisher using SQL Server 2000, to integrate legacy systems and Facets with Care Advance. This solution enables data validation; error logs, status reports and finally it produce clean set of data. Created programs to integrate solution end to end o Extract data from FTP systems, Load into Prepublisher using SQL Server DTS packages o Publish into Multi System Adapter (MSA) using Java

4 o Stratify Member and Claim Data in Analytical Rules Engine (ARE) using Informatica o Load into Care Advance Enterprise (CAE) Systems using.net technologies. Care Advance Enterprise custom enhancements include o Facets 4.61 Upgrade, FEP Integration with CCA o MESA 1.0 and 1.5 integration with CCA using SQL Server DTS packages o Hosted Go-To-Green sub project for CCA using.net technologies o Integrate 4 different legacy Membership and Claims systems such as Oregon ACPS, Oregon CAS, UT and WA with Care Management system called Care Advance Enterprise (CAE). o Integrate 2 Facets systems o Export ICD codes from claims system to CAE TriZetto Group Inc - Technical Consultant Jan 06 to Jun 06 Client: Humana Project: CAE Utilization Management Business Rules Assisted and guided Third-party (FairIsaac) consultants to develop business rules and integrate with CAE application at onsite for Humana Provided CAE Utilization Management Business Rules training to customers Designed and implemented custom Utilization Management Business Rules using FairIsaac Blaze Advisor. TriZetto Group Inc - Sr Consultant May 05 to Feb 06 Client: The Regence Group Project: Care Advance Enterprise Involved in design, development and testing of custom solutions for implementation and usage of the Care Advance Enterprise (CAE) system. Designed and implemented custom web services using J2EE technologies. Around CAE product Designed and implemented the Operational Data Source (ODS) database schema in Oracle using normalization concepts. Designed validation functionality to Adapter and lead the team of three to implement. Involved in creating C++, Java coding and documentation standards for company-wide usage. Involved in code review meetings to review the code standards which were done by developers through out the professional services area. TriZetto Group Inc - Consultant April 02 to May 05 Client: Multiple Projects: Custom Applications around Facets Product Involved in playing multiple roles such as technical analyst, developer, and team lead in enhancing custom applications such as Membership Enrollment

5 Editing Toll (MEET), Medicaid Inbound Solution (MIS), Netcap, IDCard using Visual Basic and Stored procedures. Implemented ABF interface to provide outbound claims payee checks, EOB (Explanation of Benefit) and EOP (Explanation of payment) to Advanced Business Fulfillment (ABF) TriZetto s print vendor in their 028 proprietary specifications using Perl, Sybase stored procedures and EC Gateway technologies. Designed and Implemented interface to provide the ability to make TriZetto HIPAA Gateway transactions (ASC X12 Standards) such as enrollment & benefit maintenance (834), claim payment remittance advice (835), claims & encounter (837) inbound outbound data submission and premium payment (820). Designed and implemented the translator to convert claims data from UB92 format to 837 Facets keyword file format using PERL. Implement the custom stored procedures to produce the letters from Facets letter server. Enhanced the Subscriber Identifier sorting mechanism in the ZDI interface. Worked on Facets hosted support issues and help other developers in technical complexities of their assigned work. Solutions developed using PERL, SQL, PL / SQL, Stored Procedures, EDI Gateway Channel Point - Developer June 99 to Mar 02 Project: Commerce Broker Designed and Implemented the Commerce Broker rating calculator using Java. Involved in UHC market roll outs by design and implement the custom enhancements. Developed the portals using Oracle, this serves as an entrance to the Channelpoint web front. Developed the Carrier resources which have to be display on the UI, using JHTML & HTML. Designed and Implemented a Knowledge Base tool, this catalogs frequently occurring problems.