Manager Health
Resume:
Raja Sandeep Akkireddy
E-mail: ********************@*****.*** Mobile: +1-847-***-****
Professional Summary
·An accomplished technocrat with overall 10+ Years of experience in both Development and Testing, mainly in Health Care & Insurance (CVS Health RxClaim application, Omnicare).
·Extensively worked 9+ years in CVS Heath - RxClaim Application.
·Sound understand of Software Development Life Cycle (SDLC), Water fall and Agile methodologies, information management life cycle and Software Testing Life Cycle (STLC).
·Expertise in Functional Testing, Data quality management in the Software Development industry and with a proven ability of mentoring and working with cross-functional teams located both on-shore and off-shore.
·Expertise in RxClaim Functionalities like STCOB, MIC, DUR, COB, FIR, In Network/Out of networks, Plan Setup, Eligibility, Network pricing profile(NPP), Benefit pricing profile(BPP), CSR claims, Manufacturer copays, Manual Adjustments, Smart PA, Member PA, Refill, Prior Authorization setups, Transition fill setups, Anthem SBOR setups, MOCK Claims, N1 transactions, Specialty Rx(SRX), Stand alone module (SAM) setups, Xref plan setups, Mchoice etc.
·A versatile team player, ambitious self-starter with strong analytical and problem-solving skills.
·Expertise in AS400 technologies like SYNON (Cool 2E), RPG (Report Program Generation), RPGLE, CL (Control Language), CLLE, COBOL/400, DB/400, Query/400 and SQL.
·Skillful in gathering and documenting requirements, conducting technical analysis and managing all stages of software development and implementation.
·Good understanding of customer requirements, GFS (General functional requirements), DFS (Detailed functional requirements) .
·Expertise in analysis, maintenance, application development, flowcharting, system analysis, technical design documentation, Production support, testing and test plan preparation.
·Creating and executing of the Test scenarios, Test cases to check the functionality and performance of the project, which involves different testing methodologies like Unit testing, Performance testing, System testing, integration testing and User acceptance testing.
·Have excellent communications and strong interpersonal skills, which provide ability to interact with business users, managers, team members etc.
·Expertise in attending project meetings and working with large/small teams, internal customers and end users.
·Expertise in leading team and providing technical support and handling multiple tasks.
·Demonstrated ability to work independently and flexibility to adapt in an ever changing business environment.
·Flexible and versatile to adapt to any new environment and work on any project and excellent ability to learn new things quickly.
Technical Skills
Programming Language
RPG/400, RPGILE, CL, CLLE, COBOL/400, QUERY/400, SQL/400.
Development Tool
SYNON 2E, ADVANTAGE/2E, COOL 2E.
Environment
AS/400
Operating System
OS 400, Windows.
Databases
DB2/400
Change Management Tools
ALDON, Implementer
Impact Analysis Tool
HAWKEYE
Service desk solution tracking tool
HP Service Manager and Service now.
Defect Tracking Tools
HP Quality Center.
Other Tools
MS Office, Word, Excel, Outlook and Share Point.
Professional Experience:
Project Title
RxClaim Applications - Adjudication
Organization
Genpact, Richardson, TX, USA
Client
CVS Health (Caremark)
Duration
12/08/2016 – Till date.
Role
Principal Consultant - Production support & QA Tester
Project Description:
RxClaim adjudication system adjudicates all claims (paper, mail and pharmacy claims) for enrolled
beneficiaries. It provides access to the information such as deductible, co-payment, prior authorization,
drug coverage, claim history etc. RxClaim provides member eligibility and claim data feeds to
downstream applications i.e. EDW, QL System, Specialty etc.
Roles and Responsibilities being a Prod support engineer:
·Leading and Assisting the Tier-2 Production support team in Root cause analysis determination and ticket resolution.
·Perform the Root Cause Analysis to find out the Reason for the Problem/issue/Defect. It also includes the possible code change suggestions to resolve the issue.
·Debugging the programs using ISDB and STRDBG to find the Root cause. Running the Queries using Query/400 and SQL to fetch the Impacted Data from Production.
·Attended Weekly Status meetings, Walkthrough meetings, Business meetings, and RCA review meetings.
·Involved in analyzing the SYNON, RPG, CL, COBOL programs to determine the root cause for the issue/defect. Doing Impact analysis using SYNON Case tool, HAWKEYE and FNDSTRPDM tools.
·Delegating the work among team members and help them throughout the RCA execution till Closure. Provide 24x7 application support to all clients.
Roles and Responsibilities being a QA tester:
·Reviewed the Business Requirement Documents and the Functional Specification.
· Performed full QA Life Cycle Testing for CVS Health care’s RxClaim Functionalities like STCOB, MIC, DUR, COB, FIR, In Network/Out of networks, Plan Setup, Eligibility, Network pricing profile(NPP), Benefit pricing profile(BPP), CSR claims, Manufacturer copays, Manual Adjustments, Smart PA, Member PA, Refill, Prior Authorization setups, Transition fill setups, Anthem SBOR setups, MOCK Claims, N1 transactions, Specialty Rx(SRX), Stand alone module (SAM) setups, Xref plan setups, Mchoice etc.
· Responsible for creating manual test scripts to include Functional Test, Regression Test, UAT, Migration Test and Study Configuration Test.
· HP Quality Center to perform Manual Testing and logging and tracking bugs.
· Closely worked with software developers on projects to design and execute Functional, Integration, Regression, and System (End to End), UI Testing, Browser Compatibility, Backend (Database) Testing.
· Selected and implemented agile QA best practices according to the application requirements for each projects.
· Created Manual Testing strategy and performed Database Testing using Query/400 and SQL Queries by retrieving data from DB2/400 Database.
· Involved in writing test scripts and functional Test Cases for the QA team and getting sign off from engineering team.
· Involved in user training sessions and assisting in UAT (User Acceptance Testing).
· Performed validation tests to ensure that the developed functionality meets the specifications prior to UAT testing.
· Analyzed massive and highly complex data sets, performing adhoc analysis and data manipulation.
·Performed UAT (User Acceptance Testing) and executed to verify requirements, UI look and feel of the applications.
Project Title
Security Remediation & Migration.
Client
Omnicare Inc.
Duration
07/04/ 2016 – 10/31/2016.
Role
QA tester
Project Description:
Omnicare Inc. is an American company working in the health care industry. Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. Senior care is an Omnicare specialty. I have handled the below projects in Omnicare for Legacy application development
Roles and Responsibilities:
·Executed and maintained Test Plans, Test Case, Test Scripts, and Test Data for manual testing approaches using track & defect management tool HP Quality Center (QC).
· Performed Load and Volume testing, Conducted the Functional, System, Regression, and Performance testing.
· Responsible for Running manual tests on software ensuring it conforms to design and set standards. Raised any issues / faults identified via HPQC.
· Liaise with the product test manager and test stakeholders to plan and priorities tasks in a timely and transparent manner, ensuring deadlines are met.
·Environment: Word, Excel, Outlook, Quality Center (QC)
Project Title
Pharmacy Benefit Management
Organization
IBM India Pvt Ltd, Bangalore, India.
Client
CVS Health ( CVS – Caremark)
Duration
08/26/ 2010 – 3/16/2016
Role
Technical Team Lead / Sr. QA Tester
Project Description:
RxClaim adjudication system adjudicates all claims (paper, mail and pharmacy claims) for enrolled
beneficiaries. It provides access to the information such as deductible, co-payment, prior authorization,
drug coverage, claim history etc. RxClaim provides member eligibility and claim data feeds to
downstream applications i.e. EDW, QL System, Specialty etc. I have handled multiple projects in
CVS Health for Legacy application development.
Roles and Responsibilities:
·Participating in Requirements Gathering and Requirement Analysis sessions. Works with business analyst in translating business requirements into functional requirements document and to detailed design document.
·Convert project specification and statements of problems and procedure to detailed logical flow charts for coding into computer language.
·Doing Impact analysis to find the Programs/Objects involved in the project using SYNON Case tool, HAWKEYE and FNDSTRPDM tools.
·Involved in creating the technical design as per the functional requirements and developing the SYNON, RPG, CL and COBOL code as per design. Building Estimates for the projects. Involved in creating Unit Test Case Plans and executing the Test cases.
·Working with Quality Analyst (QA) team to help them understand the key areas of QA testing and provide the necessary support during the QA window of the projects.
·Delegating the work among team members and help them through the Design, Coding, preparation of Unit test plan and unit test execution.
·Monitoring the production deployment by writing SQL Queries to fetch the production data.
·Provides Level 2 and Level 3 technical support. Monitor production job schedules. Involved in debugging the issues \ defects related to project to find the root cause.
·Recommending the changes in programs and improve process efficiency in the performance of system.
·Setup and create Aldon task for code configuration and release management in compliance with CVS Health’s Aldon tool. Provides support during development and post deployment.
·Coordinate with CVS Health IS Release and Change management teams for software validation and implementation in staging and production environments. Provide project/ Incident status to CVS Health project managers.
·Performed full QA Life Cycle Testing for CVS Health care’s RxClaim Functionalities like STCOB, MIC, DUR, COB, FIR, In Network/Out of networks, Plan Setup, Eligibility, Network pricing profile(NPP), Benefit pricing profile(BPP), CSR claims, Manufacturer copays, Manual Adjustments, Smart PA, Member PA, Refill, Prior Authorization setups, Transition fill setups, Anthem SBOR setups, MOCK Claims, N1 transactions, Specialty Rx(SRX), Stand alone module (SAM) setups, Xref plan setups, Mchoice etc.
· Responsible for creating manual test scripts to include Functional Test, Regression Test, UAT, Migration Test and Study Configuration Test.
· HP Quality Center to perform Manual Testing and logging and tracking bugs.
· Created Manual Testing strategy and performed Database Testing using Query/400 and SQL Queries by retrieving data from DB2/400 Database.
·Environment: AS400, DB2/400, RPG, CL, SYNON, SQL/400, Query/400, OS/400, HP Quality center, HPSM.
Education:
·Bachelor of Technology in Electrical & Electronics Engineering from SASTRA University, Thanjavur, India, Year of Passing: June 2010
Awards:
·Got Silver awards continuously in 2019 and 2020 from Genpact for contribution towards a successful CVS Health welcome season 2020 & 2019.
·Got Bronze awards continuously in 2017 and 2018 from Genpact for contribution towards a successful CVS Health welcome season 2018 & 2017.
·Got a Combined Certificate of appreciation from Sr. Vice president of CVS Health & Genpact for contribution towards a successful welcome season 2017.
·Got the Best project Award for the year 2016 for the CMS - CVS Health project.
·Recognized with the Manager’s Choice Awards – Continuously on 2013,2014 and 2015 for demonstrating the Practice: Put the Client First & Show Personal Interest.
·Recognized for demonstrating highest standards of employee excellence and rewarded for exemplary performance in the team. Presented with the Eminence and Excellence Orion Award for demonstrating the IBM practices.
Professional References:
Reference Name. : Chandresh Bhandary
Title : Sr.Manager
Company Name : CVS Health
Telephone : 972-***-****
Email : *********.********@*********.***
Relationship : CVS Health manager during my tenure at CVS Health from 2016-2019.
Reference Name. : Rohit Kumar Sharma
Title : Sr.Advisor
Company Name : CVS Health
Telephone : 972-***-****
Email : **********.******@********.***
Relationship : Team lead during my tenure at IBM India Pvt ltd from 2011-2015.
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