Senior Mainframe Developer - 9 Years Experience

Prabhakar Kallakuri

**** ******* ***** ***, *** G306, Torrance, CA- 90505 Phone:818-***-****

E-mail:******************@*****.***

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Professional Experience:

. Currently pursuing Masters in Computer Science ( Part Time) at Georgia

Institute of Technology, Atlanta.

. 9+ years of extensive experience in implementing several critical

healthcare and retail projects for clients in Europe, US and India.

. Strong focus over the past 4 years in healthcare industry with sound

knowledge of MMIS Medicaid Management Information System - MMIS,Pharmacy Benefit Management - PBM, Affordable Care Act (HIX)

environment.

and Health Insurance and Portability and Accountability Act (HIPAA)

within the Healthcare domain applications.

. Experience in Medicaid Management Information System (MMIS) with

expertise in various subsystems of MMIS- Claims, Provider, Recipient,

Procedure Drug and Diagnosis (PDD), Explanation of Benefits (EOB).

. Experience working with HIPAA ANSI X12 4010A EDI transaction codes

such as 270/271(Benefits Status Enquiry and Response), 275 (Claim

Attachment), 276/277(Health Care Claim status Request and Response),

834 (Benefit and Enrollment Maintenance), 835 (Health Care Claim

Payment/Advice) and 837 I (Health care Claim: Institutional) for

Inbound/outbound interfaces and up-gradation of ANSI 4010 to ANSI

5010.

. Exposed to using HL7, EDI ANSI X12 4010/5010, ICD 9/ICD 10, HCPCS and

CPT coding standards in Medicare and Medicaid domains of the

healthcare systems.

. Provider and Contract Relations - worked with Providers and Contract

SMEs to set up HMO/PPO contract database and provider interfaces for

HMO/PPO PCP assignment.

. Professional and Facility - worked with the Professional and

Facilities SMEs to document requirements related to Provider File

changes.

. EDI Claims Processing - Expertise in management and development of

Claims related applications. Worked extensively with applications that

dealt with Member Enrollment, Billing, payments and Eligibility of

Claims.

. Liaison between Business user groups/Business units, Technical system

groups/Technology teams and support teams to ensure proper translation

of Business Requirements to System Requirements.

. Experience in complete End to End Project life cycle (PLC): System

Analysis, Design, Development, Testing, Deployment, and End User

Training.

. Full Software Development Life Cycle (SDLC) experience including

requirements gathering, analysis, design and review of business

processes and Software Development as per Agile (SCRUM), RUP and

Waterfall methodologies.

. Experience in Conducting/facilitating the Joint Application

Development/Joint Application Requirement (JAD/JAR) sessions, Rapid

Application Development (RAD) sessions, workshops, walk through and

customer interviews with end-user/clients/stake holders and the IT

group.

. Experienced in creating high-quality designs that is acceptable to the

customer and feasible for the developers.

. Experience in understanding the AS-IS & TO-BE business processes and

performing GAP analysis.

. Expertise in Mainframe COBOL-DB2-IMS-CICS-Java programming under MVS Z

OS and Linux operating systems.

. Expertise in DB2 data modelling, DB2 performance tuning, and writing

materialized queries, triggers and stored procedures.

. Good knowledge in RDBMS concepts with solid hands on experience in

Data analysis through querying the relational data bases utilizing SQL

(TOAD).

. Experience in performing Unit Testing, Integration Testing, System

Testing and User Acceptance Testing.

. Involved in Test Planning, Test Preparation, Test Execution, Issue

Resolution and Report Generation to assure that all aspects of a

Project are in Compliance with the Business Requirements.

. Experienced with Software Version Control tools like SVN, Eclipse,

Clear Case and VSS.

. Highly motivated team player with excellent Interpersonal and Customer

Relational Skills, Proven Communication, Organizational, Analytical,

and Presentation Skills.

Core Skills:

. Domain: Healthcare -MMIS, PBM,Medicare Medicaid business knowledge

with focus primarily on claims adjudication, PCP assignment, member

enrollment, contract or product set up, and prior authorization.

Retail with expertise on Warehouse Management, Store Management,

Replenishment, and Merchandising.

. Programming Languages: COBOL, Java, Microfocus COBOL, CICS, JCL.

. Operating Systems: UNIX, Windows XP, NT, 2000, 98 & 95.

. Databases: DB2, IDMS, IMS, Oracle, Datacom, VSAM, SQL server 2008,

SSIS packages.

. Mainframe and Microfocus: Control-M, DB visualizer, SVN Version

controller, SILK radar,Query analyzer, TSO, File-AID, ISPF, Xpediter,

Abend-AID, Elipse, Endeavor, SPUFI, QMF, Comparex, DFSort, SYNC Sort,

Ice tool, Dataset utilities, ZEKE Scheduler, System Utilities,

Complier Utilities, Changeman, REXX.

. Process: Project Planning, Estimation, Implementation, Defect

management, System Support, CMMI level-5, SDLC process with a

thorough understanding of its phases like Requirements, Analysis,

Design, Development,Testing, experience in using Water-fall, Agile

and Iterative methodologies.

. Pursuing: Masters in Computer Science at Georgia Institute of

Technology, Atlanta,GA.

Certified Courses:

. Basics of Healthcare Claims processing.

. Introduction to Medicaid Management Information System (MMIS).

. Pharmacy Benefit Management -PBM.

. Academy for Healthcare Management 200.

. Basics of Retail and Advanced Retail Management.

. Advanced Consumer Produced Goods (CPG) concepts.

Training Courses

. Corporate Etiquette & Grooming.

. Defect and Problem Prevention.

. Configuration Management.

. Written & Business Communication

. Assertiveness Skills, Planning & Prioritizing.

. Time management.

Education:

. Currently pursuing Masters in Computer Science, Georgia Institute of

Technology, Atlanta,GA .

. Bachelors of Technology in Electrical and Electronics Engineering from

Jawaharlal Nehru Technological University, Hyderabad, India.

Experience:

. Cognizant Technology Solutions, US with internal designation as

Associate- Projects from January 2011 to Present.

. Infosys Limited, India with internal designation as Senior Software

Engineer from February 2006 to December 2010.

. Symphony Systems, Hyderabad as a software engineer trainee from June

2005 to January 2006.

Awards and recognition:

. Best Project Award for Walmart Pricing Gold Database Migration

project.

. Associate of the month award for the analysis on New Mexico Centennial

Care project.

. Most Valuable Player award for the testing effort as part of SWETS

Database migration project.

Project Experience:

Role: Senior MMIS and PBM Application Developer

Client: XEROX, Atlanta Duration: July 2013 - Till present

. Prepared high-level design documents, impact analysis and detailed

level design documents for implementing the NM MMIS Centennial care

changes.

. Developed batch and online COBOL -DB2-CICS programs, JCLs, PROCs for

testing Medicare, Medicaid and Cross over claims in Medicaid

Management Information System (MMIS).

. Worked on several PBM service requests in SILK radar handling fixes

for Montana, Colorado and DOL clients on MVS platform.

. Coded several claim adjudication programs for different states clients

and tested claim inquiry, validation adjudication, finalization and

remittance processes using batch as well as using GUI or front end

screens.

. Developed news programs to handle MARS or claim extract reports on OS+

/Golden gate for the state of Hawaii.

. Worked on provider and pharmacy interfaces for both FFS- fee for

service and Encounter clients, MCO Managed care affiliation processes

and

. Prepared DB2 table load and unload jobs, created views, stored

procedures and triggers on provider, eligibility and managed care

tables.

. Conducted various code reviews, design reviews to check for any

missing functionality throughout the analysis, build and testing

phases.

. Worked on Requirement Change Management System in Rational Requisite

Pro, SharePoint, OmniCaid and PowerBuilder applications for processing

encounter and fee for service (FFS) claims.

. Analyzed the defect reports, ensured that all the defects are logged,

tracked and resolved in Clear Quest.

Role: Claims And Product Specialist

Client: WellPoint Inc., Los Angeles Duration: Nov 2011 - June 2013

. Worked with SME's and database architects to gather business

requirements for IMS-Hierarchical database to DB2-Relational database

migration project.

. Performed feasibility analysis, gap analysis and formulate system

strategies to determine the exact changes that need to be made to the

STAR membership, billing and claim adjudication systems.

. Interacted with SME's from Claims, Payments, Provider and Enrollment

teams to understand existing IMS architecture and business process

flows.

. Involved in creating and updating product or contract set up tables,

product inquiry screens, subscriber and member enrollment screens.

. Involved in discussions with DB2 DBA's, data architects to create

mapping documents, DB2 tables, table spaces, indexes, and flow

diagrams.

. Document business requirements, technical specifications, and process

flows using Visio 2010, to be used by technical teams to design,

construct and implement solutions.

. Analyzed and developed batch and online COBOL-DB2-IMS programs, JCLs,

PROCs to test enrollment, billing, claims and provider

functionalities.

. Performed DB2 optimization, performance tuning techniques and Strobe

analysis.

. Provided pre and post implementation support for all mainframe and web

applications, DB2 performance issues and employer portal access

issues.

Role: Senior Database Migration Specialist

Client: Swets Inc., Amsterdam, NL Duration: Jan 2011 - Oct 2011

. Modified the applications that run on Mainframes under UNIX and Java

to access DB2 relational tables instead of IDMS network tables.

. Involved in Project Kick Off meetings, requirement analysis meetings,

and prepared estimates using Relativity and Function point estimation

tools.

. Onsite technical lead for a team of 45 working in typical Onshore-

Offshore delivery model. Involved in setting up of login credentials,

client proprietary software and share point access for the offshore

team.

. Conducted sessions for the offshore team on SWETS Subscription

business, project scope and on the requirements.

. Worked on PowerBuilder, Erwin data modelling tools and ER diagrams to

create mapping documents.

. Automated shell scripts to compile and execute batch and online COBOL-

DB2 programs and Cobol-Java programs to test customer, publisher and

subscriber modules.

. Worked on Cognizant Proprietary tools like Cognizant 2.0, PeopleSoft

for process management and time management

Role: Senior Database Migration Specialist

Client: Wal-Mart, Bentonville, AR Duration: Jan 2008 - Dec

2010

. Involved in software planning, estimation, status monitoring and

reporting.

. Performed gap analysis and identified the impacted modules or

potential sources that needs to be re-designed

as part of pricing gold IMS to DB2 migration project.

. Prepared high level and detailed level design documents for pricing

modules.

. Involved in Coding, Independent unit testing, System testing and UAT.

. Developed batch and online Cobol -DB2 CICS programs, prepared unit

test cases and system test cases.

Role: Cobol Db2 Developer

Client: Hannaford Bros, Scarborough, me Duration: Feb 2006 - Dec

2007

. Prepared detailed level design documents and unit test plans as part

of IDMS to DB2 conversion project.

. Coded several batch and online Cobol -DB2 CICS programs.

. Involved in unit testing, System testing, integration testing and UAT.

. Created REXX tools to generate re-usable cobol code and identify

standard coding errors.

. Worked on Debugger, Endeavor, File Aid tools and WinSQL for query

management.

Healthcare MMIS and PBM Specialist atabase Developer

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