Naga Praveen Kambhampati

ac1pe7@r.postjobfree.com 916-***-****

Summary:

Certified Lead System Architect (CLSA) and Java/J2EE Developer with 11 years of progressively responsible experience in BPM using Pega PRPC around 7 years of experience.

Possess excellent skills for team building, team leading and mentoring and excellent exposure of onsite-offshore project execution models and building COE team

Has expertise in building framework layer, application layer & reusable components, reporting features, performance tunings etc.

Have worked for clients like Pega Systems Inc., United Health Group, Healthnet Inc. and Anthem-Amerigroup.

Liaison with other development teams and QA teams in planning and delivering quality product in time

Proficient in Pega Implementation life cycle like modeling of business process, PRPC tool installation, build and deployment, development, testing,

Sound skills on PRPC tools such as Tracer, Clipboard and System Management Application (SMA).

Developed Activities, Properties, Decision Rules, Declarative Rules, Process Flows and User Interfaces like Harness & Sections.

Experienced Developer for defining class structure and hierarchy based on Pega best practices and guardrails, security based on role and privileges, configuring agents, connectors, data model, process flows, business logic definition and user interface Design.

Worked on Management Dash Board Reports using Report Definition, List View and Summary View.

Expert level experience in software development life cycle (SDLC) best practices and Written documentation

Experience in phases of Smart Build BPM life cycle like model, build, execute and monitor using PRPC.

Good Experience on Warranty Framework

24x7 production (on-call) support on a weekly rotational basis

Experience with LEAN Agile Methodology and Waterfall

Extensively used Connectors and SOAP Services in Pega PRPC to integrate with external systems.

Good experience in Java Messaging Service (JMS), IBM MQSeries for Message-Oriented Middleware.

Solid Experience in Oracle 10g / 9i /8i and MS-SQL Server 00/05, stored procedures and triggers.

Strong working experience in leading J2EE framework like spring, Hibernate, Struts.

Excellent Analytical & Problem-solving skills with attention to detail and Persistence, Teamwork and Communications.

Proven success in interacting with customers, business members worldwide and providing project status reports to the stakeholders

Certification:

Pega Certified Lead System Architect CLSA V7.1

Pega Certified User Interface Specialist V7.1

Pega CSSA Exam V7.1

Pega CCA (CPM) Certification

Sun Certified Java Programmer V1.4

Cleared internal Health Care Domain Certification (AHM)

Education: Bachelors in Information Technology from Andhra University.

Technical Skills:

BPM Tools: PRPC 5.5, 6.1, 6.2, 7.1, 7.2

Frame Works: Pega, CPM HC Frame work, PCS Framework, Care Management Framework

Operating systems: Win-2000/NT/XP, MS-DOS, LINUX

Programing Languages: PL/SQL, Core Java

Databases: MS-SQL Server, MS-Access, Oracle 10g, BIX

Application Server: Tomcat, WebSphere

Markup & Scripting: HTML, XML, Java Script

Debugging Tools: PAL, Fiddler, DB Tracer, Log Analyzer

Bug Tracking Tools: Pega Rule Pro, PSC

Modeling Tools: Rational Rose, TOAD, MS-Visio

Professional Experience

Client: Anthem-Amerigroup Virginia Beach July 16 to Till Date Projects: Next Gen Appeals- Medicare and Medicaid.

Role: Sr. Pega Developer

Next Gen Appeals system is used by staff in Medicaid and Medicare to raise different kinds of appeal requests for the Medicaid and Medicare claims i.e. Inquiry, Grievance, PQI/QOC, Authorization Appeals etc.

Roles & Responsibilities:

Upgraded the code from PRPC 6.1.2 to 7.1.8

Fixing the change logs and new enhancements given by business

Analyzing the Requirements given by Business and proposing the user-friendly fixes

Implemented integration with Web services to fetch Provider information through Connect-REST and Connect-SOAP with Security Profiles

Worked on analysis of the prod Pega logs and alert logs, fixed the exceptions

Enhanced the Enterprise Class Structure for high reusability

Correcting the existing rules i.e. Data Model, Data Transforms, Data Pages, Activities, Sections, Harness, Flow actions, Flows, When, Declarative trigger, Declare on change, Decision Table and Decision Tree etc.,

Creation of Stages and steps for business logic implementation

Creation of the Agents to monitor the background rules which are already built in application

Done code reviews

Requirement gathering & Analysis and estimating the hours for the defects/Enhancements

Achieved very good Guardrail Compliance score

Followed Agile – Scrum implementation

Performance Testing Using PRPC-PAL Tool

Prepared Role Based Access group and Control document for the Pega Workflow team.

Rules for validation and Integration pertained to Rule-Connect and Rule-Service.

Environment: Pega PRPC 7.1, Pega HC 7.22, Oracle, JBoss

Accomplishments:

Implemented end to end business usable product (Phase) in 60 days

Worked with IT architect to make this application as a platform of claim processing system bringing other claim processing solutions into the fold

Built business configurable components enabling & empowering Business and reducing IT intervention

Able to leverage OOTB Pega functionalities, features and Data Model to maximize and only customized wherever it is needed

Client: Healthnet Rancho Cordova CA Nov 2014 to May 2016 Projects: RMC

Role: Sr. Pega Developer

RMC streamline Project will enable the business to configure an RMC by answering a series of questions that are targeted for each business unit. The business is given the flexibility to ask questions that will enable a smooth RMC configuration. To aid a configurable RMC a reverse engineering of ABS program is under way to provide a set of rules that will guide program execution.

Roles & Responsibilities:

Requirement Analysis & Design

Upgraded code from PRPC 6.1 to 7.1.7

Coding (involves Creation of rules, design flows & developing code)

Unit Testing

Enhancements & Fixing defects

Customer interfacing

Involved in Production Deployment and Post Production support

Involved in Designing High Level Class structure, Workflows and Rule sets in Pega PRPC.

Created the Business Process Flows and flow actions in Pega PRPC.

Implementation of Decision tables, Decision Maps and Declarative expressions.

Identified reporting requirements to general business functionality, non-functionality needs and required data attributes for BPM specific workflows

Environment: Pega PRPC 7.1, HTML, XML, SOAP, JavaScript, SQL Application Server, Java, CSS, Java Script and HTML.

Accomplishments:

Provided consultation and demonstrated the solution and know-how sessions for customer requirements like Archival and Purging Strategy, Infrastructure requirements, Migration strategy from Pega Works to PRPC Environment and other pain points which end user raised concerns.

Demonstrated 7.x PRPC and its advantages.

Client: Healthnet Rancho Cordova, CA Sep 2015 to May 2016 Projects: KIT Information Management (KIM) System

Role: Pega Developer and Onsite Production support

The Kit Information Management (KIM) application manages the configuration of Bill of Materials (BOM) and their mapping with members. It provides functionalities to manage KIT jobs, configure components, generate reports, bulk component management, bulk data upload, and audit trail and system administration. The biggest lift for instituting KIM for management of BOMs and Kit Jobs is the alignment of Electronic & Hard-Copy Distribution Processes. Currently it is taking users a long time to get the specs set up (I believe in part due to the learning curve of the new process & tool) but over time, this should lead to a large time savings for customer.

Roles & Responsibilities:

Involved in Use Case conception, Design and requirement analysis.

Configured end-to-end solution for automated account opening process i.e, processing xml file and creating Account opening cases and routing it to suitable work basket.

Identifying Properties and Activities, designing the Sections and Harness.

Implementation of PRPC components like Decision tables, Decision Maps, Declarative Expressions, Constraints and Indexes etc.

Worked on Activities and Flows to meet the requirements.

Used RDB Method to created Database Connection and Created Web services using Connect-SOAP.

Created Data-Admin-Product to migrate rules across various environments.

Managed accessibility to users by creating Portals, Access Roles and Access Groups for Analysts, Data Managers and Chair departments.

Identified and documented test conditions/scenarios from the business requirements and functional design for Rating Management.

Environment: Pega PRPC 7.1, HTML, XML, SOAP, JavaScript, SQL Application Server, Java, CSS,

Client: United Health Group Irvine, California Aug 2012 to June 2014

Projects: Producer Contact Log

Role: Sr. Pega Developer

Producer Contact Log Project is an application for addressing agent queries and maintenance processes. Agent can make a phone call to CSR or even send an email and take up the issue with the service representative. The representative will do a verification of the agent and will initiate a Service request based on the request that the agent has raised. The application provides a 360 degree view of the producer information which makes the processing of the request quicker and easier. The request will be processed and reviewed by different roles in the system and the system would be sending notification to the agents once the issue is addressed.

Roles & Responsibilities:

Requirement Analysis & Design

Coding (involves Creation of rules, design flows & developing code)

Unit Testing

Enhancements & Fixing defects

Stake holder management, Interacting with the customer

Involved in Production Deployment and Post Production support

Involved in Designing High Level Class structure, Workflows and Rule sets in Pega PRPC.

Creation of Rules for Validation, Integration rules like Rule-Connect-SOAP.

Created the Business Process Flows and flow actions in Pega PRPC.

Implementation of Decision tables, Decision Maps and Declarative expressions.

Identified reporting requirements to general business functionality, non-functionality needs and required data attributes for BPM specific workflows.

Created Activities for implementing core Business logic.

Environment: Pega CPM 7.2 SP2, Pega HC, Pega PRPC 6.2 SP2

Accomplishments:

Improved the performance of the service methods by reducing the DB calls and checked the response time from the SOAP UI

Integration with external web services with PEGA using SOAP Connectors, File listeners to read the files placed in an external location

Client: United Health Group Irvine, CA Jan 2012 – July 2012

Project: Central Client Repository -OptumRx Project

Role: Pega Developer

UHG currently enrolls 14 million members in pharmacy plans, wants to start their own PBM services named as Fresh Start (FS), by the vertical integration of OptumRx acquired by UHG. An enterprise-wide project has been established to migrate all its commercial business to OptumRx under (FS) Program. This project has been identified to ensure the Central Client Repository (CCR) application is ready to accommodate and maintain new required Client and Benefit data to support Fresh Start (FS) Business

Roles & Responsibilities:

Provide an Implementation UI to capture changes made to Client Implementation.

Provide maintenance UI to process changes. Provide ability to route information between the two accountability & liability between the parties.

Requirement Analysis and Design

Used Decision rules like the Decision tables and Map Values.

Retrieved information from declare pages at node and thread level for fast processing.

Worked on task creation based on the application and assigning them to the concerned user effectively and maintaining their status effectively.

Environment: PEGA PRPC 6.1, DB2, Microsoft Visio, Java, HTML

Client: United Health Group Irvine, CA Aug 2011- Dec 2011

Project: Rejected Claim Review

Role: Pega Developer

The purpose of the project is to automate the current manual audit process of reject claims for all OptumRx clients by scrubbing the claim rejects received via M&R through automatically identify and tag appropriate rejects as “Valid” rejects, or Route to queue as a workflow transactions for human intervention. To implement a process that would allow it to audit the rejected claims and ensure that these were correctly rejected by the Claims engine (Rx Claim) used by various pharmacists. While the immediate need is to implement a streamlined process to audit selected group of rejected claim transactions received from UHG Medicare & Retirement division, the process/system should be designed such that it can be used for other lines of business/clients, namely nonM&R part-D and Commercial business

Roles & Responsibilities:

Requirement Analysis and Design

Design & Development of the Business Process Management (BPM) components that includes PRPC Flows, Business Rules for application flow.

Design and develop Data Model, Class structure, Access Group, Process flow, Activities and UI properties.

Customize CSR portals

Creating quote request and sending the quote to the customer for approval.

Build functionality to Create and send PDF to Contract generation system using SOAP service.

Implementation of Decision tables, Decision Maps and Declarative expressions.

Design and develop User interfaces using Harness, Sections and Flow Action rules.

Developed search reports using List view.

Participated in creating validation rules.

Used DB operations using RDB save, RDB Open, RDB list.

Environment: PEGA PRPC 6.1, DB2.

Client: Pega Systems Cambridge, MA Feb 2010 - Jul 2011

Project: Pega Sustaining Engineering

Role: Pega Developer

As part of the Sustaining Engineering Team, we are managing and maintaining the Pega Systems PRPC versions that start from 5.1 to 6.1. As part of this work we are responsible for producing the Service Packs for different PRPC versions, producing the Fix Packs, Fixing the Customer bugs and fixing the hot fixes for that bugs for different customers. Any service Request raised by a customer is converted to Eng Item then we will go through the issue deeply study the issue and try reproducing it and start debugging, if it is reproducible. Find the root cause of the issue and fixing it.

Roles & Responsibilities:

Responsibilities:

Issue reproducing and fixing

Installing Environment 61sp1using Dartmouth Eclipse

Replicating the customers’ issue in local environment

Providing local changes, if possible

Unit testing the Hot-fix. UI features like Dynamic Select, auto complete, and auto populate

Worked on SLA’s worked on Email Correspondences and Service Email rules

Worked on different types of Agents, Integration concepts: SOAP, Listeners

Environments: PRPC 5.5 SP1-PRPC 6.1 SP2, WebLogic.

Application Servers: WebSphere, WebLogic, Tomcat, Dartmouth Eclipse

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