Tarun K. Ghosh, Ph. D.

Nashville, TN ad2g8o@r.postjobfree.com 615-***-****

https://www.linkedin.com/in/tarun-k-ghosh-ph-d-a6b15215/

Over twenty-five years of experience in information technology, delivering end-to-end solutions that meet client expectations of business requirements (RTM) in deal pursuits, enterprise architecture, and product management. In recent years, provided payor technology solutions to Medicaid payers including Medicaid state agencies, Managed Care Organizations (MCO), and Insurance companies. Enhanced efficiency in processes and the operation of IT systems to improve patient care with optimal cost-effectiveness.

Key Skills and Expertise:

Business and Technical Strategy: RFP, Costing/Staffing model, P &L, Risk management and mitigation, win to bid.

Sales and Deal Solutions: Infrastructure, In-house and COTS products, Managed service, DR, cost optimization.

Architecture and Modeling: SPARX-EA (Enterprise Architecture), TOGAF framework.

Security and Compliance: Nessus report, CrowdStrike, Dome9 report, Veracode, Red hat ACS.

Healthcare Industry Knowledge: Payer Technology, Medicaid, IR (Immunization Registry), MMIS (Medicaid Management Information System), TMSIS (Transformed Medicaid Statistical Information System), Claims Processing and clearing house, SLA (Service Level Agreement), KPI (Key Performance Indicator), SOW (Statement of Work), MCO( Managed Care Organization), EB (Enrollment Broker), Fraud and Abuse prevention, SI (System Integration ), FHIR (First Healthcare Interoperability Resources), EDI (Electronic Data Interchange), BPO (Business Process Outsourcing), CPOE (Computerized Physician Order Entry), EHR (Electronic Health Record), Incident Response (IR), DW (Data Warehouse), Data Analytics, AWS Cloud Solutions.

PROFESSIONAL EXPERIENCE

Gainwell Technologies 03/2023 – Present

Principal Product Manager - Business Architect

Overseeing the comprehensive System Integration (SI) product for modular, cloud agnostic solutions.

Coordinating Azure DevOps sprints for product development in an AWS OpenShift/Kubernetes cluster.

Assisting in the security Operational Readiness Review (ORR) and obtaining approval from Architecture Review Borad (ARB) for System Integration (SI) and Fast Healthcare Interoperability Resources (FHIR).

Providing demo to potential clients on products and Sales solution.

Technology – EC2, Java, RDS, RedHat OpenShift/Kubernetes, ACS security Vulnerability and Compliance.

Gainwell Technologies 04/2021 – 03/2023

Principal Sales Solution Lead Architect – Solution Executive

Responded to Request for Proposals (RFPs) for Medicaid Enterprise Services (MES), including Claims processing, Eligibility & Enrollment, Provider Management, Immunization Registry (IR), and Fraud & abuse.

Led pursuits of deals ranging from $50M to $600M, and multiple wins totaling $1B in the last two years.

Achieved 30% cost savings with Medicaid Management Information System (MMIS) solutions in AWS.

Achieved cost saving and efficiency with automation of provider enrollment using Bot from UiPath.

Successfully negotiated with clients to minimize the number of Service Level Agreements (SLAs) and implemented effective solutions with Key Performance Indicator (KPI) dashboards.

Delivered solutions for complex Request for Proposals (RFPs), showcasing effective collaboration with Business Process Services (BPS) and other cross-functional teams.

Conducted risk analysis to include appropriate mitigation costs in the solution, reducing impact on profit margins and optimizing win-to-bid strategy.

Initiated cross-sell of Claim Clearing House for efficient payment processing of Medicaid claims by payer.

Introduced Enrollment Broker as self-service tool for patients via portal to improve enrollment efficiency.

Improved solutions with Value Based Care predictive analytics tool to detect provider over-payment.

Negotiated pricing for cost-effective solutions through Business Process Outsourcing (BPO) strategies.

Reviewed commercial viability to support cross-sell, Artificial Intelligence (AI), and other sales initiatives.

Collaborated on business objectives and presented sales initiatives to C-level leaders (CIO, CTO, CFO).

Gainwell Technologies 09/2018 – 03/2021

Chief Enterprise Architect – TennCare Medicaid account

Designed the architecture of the Core MMIS product for Claim processing, TMSIS to enhance the efficiency of CMS reporting, and Analytics to improve the cost of care.

Architected SFG (Sterling File Gateway) and EDI to enhance efficiency in exchanging data with Managed Care Organizations (MCO), CMS, and other payor-related partners.

Oversaw MMIS infrastructure modernization initiative for databases, OS, Security, and Network.

Supported architecture in both DDI and O & M phases for various Medicaid IT systems including Claim processing, Eligibility and Enrollment, Provider Management, LTSS, and CHIP.

Managed the migration of MMIS analytics data from on-premises data center to Azure cloud.

Developed Proof of Concepts, prototyping applications using cutting-edge technologies.

Used SPARX EA to create architecture models for TennCare and managed the EA model repository.

Assisted TennCare in developing STS Design Packages and System Security Plans.

Conducted weekly meetings with TennCare CIO and CTO.

Sertainty 04/2016 – 08/2018

Chief Architect

Pioneered the development of innovative security technology and facilitated the creation of an IPO.

Directed the corporation in achieving FIPS certification for data security of the application.

Conducted market analysis on Blockchain and its implication in the security market.

HealthDigit 01/2012 – 03/2016

CEO Founder

Signed Business Service Agreements (BSAs) with several clients including McKesson Corporation, Hunt Regional Medical, Southeastern Health, and Baptist Health.

Implemented Electronic Health Record (EHR) and Computerized Order Entry (CPOE) products, including Horizon Expert Order (HEO)/VGR-iForm, Meditech, Epic, and CERNER.

MaxIT Healthcare 01/2010 – 01/2012

Program Director

Led the implementation of large-scale CPOE order entry project as Program Director.

Passport Health Communications 2008 – 2009

Senior Software Architect

Led the architecture of Financial Product applications for hospital revenue collection from patients.

Informatics Center/Vanderbilt University Medical Center 2004 –2008

Health System Software Architect

Pioneered the architecture of the first-generation CPOE product for inpatient care and outpatient cancer treatment. Subsequently, the product evolved into HEO (Horizon Expert Order) at McKesson.

Vanderbilt University, Nashville TN 2002 –2004

Senior Lecturer of Physics

Kernfysisch Versneller Instituut (KVI), Groningen, The Netherlands 1996 –1998

Senior Researcher

EDUCATION

Vanderbilt University, Nashville, TN

Post-Doctoral – Physics Computer Simulation [PHENIX experiment at BNL, NY], 1998-2002

University of Calcutta, Calcutta, India

Ph. D. Physics, [CERN-Switzerland/ WA93 Collaboration/ VECC-India], 1996

Jadavpur University, Calcutta, India

B. S. & M.S. Physics, Computer Science, Mathematics, 1989

Certification and training

AWS Partner: AWS Cloud Practitioner Essentials; AWS Foundations Technical; 2021.

TOGAF August 2011,

Sun Microsystems Certification- Sun Certified Programmer for the Java 2 Platform. Certified 07/02/2007.

ILOG Certification- ILOG JRULES for Developers Training Course. August 21-25, 2006.

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