Pega Lead Business Architect

Babu Ramachandran

Manager EY FSO

Advisory Services Practice

Contact information

Mobile: 949-***-****

Industry lines

HealthCare

Insurance

Retail Banking

Life Sciences

Telecom

Government Sector

Travel

Clients

Wells Fargo

TSYS

Celgene

United Health Group

Kaiser Permanente

Expedia

MCI WorldCom

NYS OCFS - NYS OCFS - Health and Human Services

Education

Bachelors of Arts in Mathematical Statistics (Delhi University 1993)

Post Graduate Diploma in Business Administration (Annamalai University 1996)

Certificate in Computing (IGNOU 1997

Certification(s)

Pega Certified System Architect

Pega Certified Methodology Black Belt

Pega Certified Business Architect

Pega 7.1 DCO Architect

Professional experience summary

Babu Ramachandran is a Manager in the FSO Advisory Services practice of Ernst & Young LLP. He is a Pega PRPC Certified Professional with 19 years of demonstrated Global IT experience. He has the following expertise

Hands-on experience working with Smart BPM Methodology and Direct Capture of Objectives tool (DCO Tool- Application Profile and Application Document) for capturing business requirements

Proficient in Object Oriented Analysis & Design Methodology, Agile Scrum Methodology, RUP and Smart BPM Methodology for executing projects across different industry verticals including Financial Services, Health Care and Insurance

Expertise in mentoring and customer enablement, business analysis, facilitating requirement gatherings sessions, use case documentation, process re-engineering and process improvement

Extensive experience working on Pega Frameworks supporting cross functional domain and industry verticals including, but not limited to, PMF, CPM for HealthCare, HCIF, IIF, Smart Dispute, Claims Workstation+, and Claims Repair

Technical Skills

Languages

C++, SQL, FoxBASE, Focus, FoxPro, Oracle Forms SAP R/3 4.6, Java Script, UML

Pega Tools

PRPC6.3, PRPC 6.2, PRPC 6.1, PRPC 5.5, PRPC 5.4, PRPC5.3, PRPC 5.2, PRPC 5.1, DCO (Direct Capture of Objectives), BIX 2.2

Pega Framework

HealthCare Industry Framework (HCIF), Customer Process Manager (CPM) for Healthcare, Insurance Industry Framework (IIF), Product Configurator, Smart Dispute, Project Management Framework, Test Management Framework, Claims Workstation, Claims Repair

Databases

Oracle 10g, Oracle 8i, Oracle 7.x, Sybase 4.0, MS Access 2003, MS SQL 2005, MS SQL 2008

Operating Systems

Windows NT, Windows Vista, Windows XP, Windows 98, Windows 7, HP-UNIX, SCO UNIX, MS DOS 6.22

Enterprise Technologies

Business Process Management (BPM), Enterprise Resource Planning (ERP), Customer Relationship Management (CRM)

Web Technologies

ASP, HTML, XML, SOAP

Tools & Utilities

SQR Report Writer, Load Runner 6.0, QTP 6.5, Mercury Quality Center 9.0 (Test Director), Win Runner 7.01, Autosys Automated Job Scheduler, Orbix 3.11, MS Project, MS Visio, MS Word, MS Excel, MS PowerPoint, MS SharePoint Server 2007, Toad 8.0, Visual Source Safe 6.0

Domain Knowledge

Health Care, Insurance, Financials, Life Sciences, Manufacturing, Health and Human Services, Court Administration, CRM, Human Resources, Telecom

Mainframe Tools

CICS, DB2

Methodologies

RUP, Pega Smart BPM, Waterfall, Agile (Pega Scrum)

Engagement experience

Ernst & Young LLP

Title: Manager, FSO Advisory Practice March 2014 – Current

As Lead Pega Business Architect, currently working on facilitating DCO session to capture requirements for an internal Tax Compliance and Reporting Engagement to build an asset based solution that would be provided as services to cater to different financial client. Was also involved with GTRS BPM prototyping initiative. He facilitated the working session with the EY internal tax business group to gather requirements around the FATCA reporting and validations

Involved with EMIR KYC Initiatives. Took upon multiple responsibilities including Business Analysis, Developer role for customizing KYC rules and fixing issues and QA role for testing the end product. Managed deadlines, timely reporting and fixing of issues and ensuring that product enhancements were delivered timely and successfully. Accomplished effectively managing engagement specific deliverables, deadlines, risks, and issues

Involved with a client engagement fora Oil and Gas sector client. He helped the client to capture current state process details, including but not limited to, business requirements, pain points, KPI’s, opportunities and Risk within the Pega DCO tool and leveraging the case management structure within Pega. He also produced to handbook guide document for mapping their process model to DCO and other one for accessing Motiva reports. He worked with his team member to produce proposal document including effort estimates

Worked on a client engagement for an Insurance client. As part of the engagement team performed assessment on workflow capabilities of an external workflow product to integrate with the Guidewire Policy Center package for Commercial Property Casualty Line of Business. He delivered a document on External Workflow Integration document that listed the different approaches to integration clearly identifying the boundaries in which they operator including the Pros and Cons

Involved with ABS (Asset Based Solution) building initiatives for internal clients, including but not limited to, Vendor Oversight, Complain Management, CCAR, and BPM Underwriting. During these initiatives Babu along with other team members worked with business sponsors to capture the scope and requirement for different ABS

Worked in the BA practice to develop and deliver a comprehensive BA competencies program. He was instrumental in mentoring; coaching, enabling and motivating fellow BA’s to attain the Pega Certification. He has actively worked to collaborate and contribute to provide a knowledge sharing environment particularly within BA practice. Babu has also made presentation on “Next Best Action” and “Case Management” as part of the lunch and learns sessions with the BA team

Outside of FSO practice, Babu has been actively involved in sales pursuit for very large client accounts in the Healthcare Practice. He has teamed with the Healthcare Sales pursuits team to look for potential opportunities especially in the Pharmacy Benefit Management, Prior Authorization, and Provider Contract Data Management space. Babu has leveraged his experience and contacts within the HealthCare space to build high impact client relationships and connect people

BPM Specialists Inc., Alpharetta, GA

Title: Lead Pega Architect Aug 2013 – March 2014

Projects:

CEDARS Sep 2013 – Feb 2014

Project Overview

CEDARS is a Pega PRPC based decision model banking application that relies on business logic as the foundation of the system and utilizes a single common workflow and standardized shared services for all subscribing line of business including Debit Card, Check, ATM and ACH

Key Responsibilities

Collaborating with the Scrum Master, Product Owner and Business SME’s to run Sprints gather business requirements and document user stories

Mentoring and enabling the Scrum Master in updating and maintain Project information in Pega PMF framework tool, reviewing and updating the Scrum Board and generating OOTB reports including the Sprint Burn Down charts

Providing PMF support and administration to resolve PMF related issues

Collaborating with technical team to debug PMF/PRPC configuration and communication issues

Provided guidance and oversight on best practices and standards for writing user stories

Provided an overview on PMF and PRPC Communication to business community and to how the project information is shared, maintained and updated between the two PRPC instances

Environment

PRPC 6.3 SP1, PMF 6.3.1, Oracle 11.2.0.3, WAS 8.0.0.6, MS One Note 2010, MS SharePoint, MS Excel, 2010, MS Word 2010

Global Credit Card Processing Aug 2013 – Sep 2013

Project Overview

Pega PRPC based credit card-processing application that processes merchant acquirers and bank credit card issuers’ transactions. It provides a wide range of payment solutions for all types of financial institutions including card issuance and payment acceptance solutions.

Key Responsibilities

Collaborated with the Lead Business Architect with establishing and documenting BPM Standards for CPM based applications

Helped the Lead Business Architect with establishing and documenting the PRPC Standards and Guidelines to support cross work stream functionality

Helped the Lead Business Architect with establishing and documenting the Error Handling Guideline Standards

Environment

PRPC 6.3 SP1, CPM FS 6.3.3, Pega Mobile 3.2.1, Oracle, 11i, WAS 7.0, MS WORD 2007, MS EXCEL 2007

United HealthCare Cypress, CA

Title: Sr. IT Sys Analyst (PRPC), - BSS, BPM COE May 2012 – June 2013

Project Overview

UBCS

UBCS project focuses on developing an enterprise wide prototype model that would support a wide of member benefits functionalities including setting up product, individual member plan, group plan and benefit eligibility for the plan. Customer Install, Claim adjudication and Claims Reimbursement

PhyCon

Phycon is a PRPC based Provider Contracting BPM application that supports provider maintenance related functionalities like Provider Demographics, Provider/Contract Terminations and Mass Contracting. It also supports loading of maintenance data across multiple platforms and downstream systems

Key Responsibilities

Identified and optimally defined process flows and user interface, use cases and requirement, conducting DCO session

Ensured delivered work product meets/performs to functional requirements

Established and implemented process and rules modeling methodologies

Conducted reviews and assessments as defined by BPM COE for program governance

Conducted workshops, requirements walkthroughs, stakeholder alignment sessions and demonstrations

Provided guidance and oversight on Pega best practices, design patterns and ensuring design conforms to Pega guardrail standards and application can be extended to promote reusability

Developed high quality deliverables across all phases of Smart BPM Methodology

Created and maintained repository of best practices and design patterns and ensured reuse of assets across guardrails and established key templates

Environment

PRPC 6.2, Oracle10g, WAS 7.0, MS Excel 2010, MS Word 2010, and MS SharePoint

United HealthCare Santa Ana, CA `

Title: Sr. Business Architect, BPM Application Team May 2010 – May 2012

Project Overview

Prior Authorization System (PAS)

Prior Authorization System (PAS) was a rule based automated BPM application that processes Prior Auth requests from Member and Provider over phone, fax, web and IVR. PAS is a rule-driven automated system that provides decision on a Prior Auth request based on pre-defined guidelines. These cases are later researched upon and correspondence is sent out on the decision appropriately

Appeals & Grievance (A&G)

Appeals & Grievance (A&G) workflow process provides automation of intake cases (via fax, phone, RxWeb & Letter) and review process for Part D and Commercial lines of business to resolve disputes resulting from rejection of a Prior Auth request

Clinical Management Program (CMP)

Clinical Management Program (CMP) utilized the Pega Care Management Framework to provide customer centric optimal level of wellness and improve coordination of care through Identification, Stratification, Prioritization, Intervention and Evaluation while providing cost effective non-duplicative service. The Care Management framework provided unified processes across Utilization Management, Case Management, Disease and Wellness Management and Patient Profile Management

Rejected Claim Review (RCR)

Rejected Claim Review (RCR) provides workflow automation to audit rejected claims based on pre-defined business rules to ensure that the rejections are valid. For rejections requiring human intervention the system would route the claim to the appropriate team for resolution

Key Responsibilities

Facilitated DCO session, as part of Elaboration phase to gather detail requirements

BRD, Use Case Documentation and follow-up with business team on needed basis

Documented Pega best-practices to follow from time to time

Supported the BPM COE on enterprise wide class structure design analysis

Provided gap analysis and recommendations on leveraging OOTB A&G workflow, as part of Pega HCIF Framework, to build OptumRx A&G processes

Provided feedback and recommendations on proposed enterprise wide UHG Smart BPM Approach Methodology (by BPM COE) for BPM implementations

Worked with BPM COE team to outline technology roadmap for upgrading PRPC environment across OptumRx

Supported BPM COE initiatives that include PRPC environment upgrade assessment for OptumRx and technology roadmap

Environment

PRPC 5.4, MS SQL Server 2005, WAS 6.2, BIX 2.2, MS Excel 2007, MS Word 2007, and MS SharePoint

Pegasystems, Inc. Cambridge, MA

Title: Business Architect Oct 2007 – Mar 2010

Project Overview

Worked on the multiple projects for multiple clients including Rev Assist Online, BOP Endorsements, New California Member Desktop (NCMD), TOC Pilot Agent Desktop CPM Application and Pega Internal projects like Acquirer Processing and Merchant Response, Account Information Application (AIA), Smart Staffer and ACE Exodus

Key Responsibilities

Performed and documented gap analysis between the requirement document and the existing application document to identify workflows for GRMP

Created new GRMP (Global Risk Management Portal) related detail use cases

Validated and updated existing use cases and process flows to eliminate gaps and ensure consistency

Assisted the Lead BA in conducting DCO sessions

Documented minutes of the meeting and assisted in updating the requirements document

Identifying redundant processes and suggesting process improvements

Reviewing uses cases and process flow with SME’s to validate the ‘To-Be’ process

Involved in Production Support and fixing production defects

Developed mockup flows and UI customization

Environment

PRPC 5X, MS SQL Server 2008, MS SQL, 2005, Smart Dispute Framework 5.5 SP1, PMF V3.2, IAC 2.0, Oracle 10g, WAS 6X, MS Excel 2007, MS Word 2007, MS Visio 2003, MS SharePoint

Prior Work Experiences

Company/Project

Position

Industry

Duration

Angarai International, Inc./DRS Case Management (NYS OCFS)

Business/QA Analyst

Health & Human Services

Jun 07 – Oct 07

Angarai International, Inc./E-ZW@Y ( NYS Office of Court Administration)

Business Analyst

Courts Administration

May 06 – May 07

Angarai International, Inc., Maryland, USA

Business/Operation Analyst

Management Consulting

Nov 04 – May 06

SIT Consulting Inc./Varian Medical System

Analyst Programmer

Life Sciences

May 04 – Oct 04

IBM Daksh, New Delhi, India

Specialist Customer Support

Customer Relationship Management

Nov 03 – Apr 04

Intellisys Tech Solutions Ltd, New Delhi, India

SAP Consultant

Manufacturing

Nov 02 - Oct 03

Angarai Technology Group, Atlanta, USA

Business Analyst

Human Resources

Jul 01 – Oct02

Dua Computer Resources, Inc., Florida, USA

Software Analyst /Programmer

Telecom/Insurance

Jan 99 – Jul 01

SG Agencies, New Delhi, India

Senior Programmer

Public Sector

Dec 97 – Dec 98

Sord System (P) Ltd, New Delhi, India

Software Professional

Export Manufacturing

Mar 97 – Dec 97

Fifth Generation Software Ltd, New Delhi, India

Programmer Analyst

Manufacturing

Aug 96 – Feb 97

Eastern Software System

Programmer

Manufacturing

Dec 95 – Aug 96

Contact this candidate