Case Management Business Process

Vishnuvardhan reddy Kaluvayee

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Professional Summary

•8+ years of experience as a Pega Developer, with expertise in Business Process Management (BPM) and Business Rules Engine (BRE) applications using Pega PRPC.

•Lead Architect managing a 15-member development team, overseeing design, development, testing, and implementation.

•Proficient in Pega Implementation Cycle, including installation, development, and optimization.

•Strong expertise in case management, class structures, process flows, and integrations (SOAP, REST, HTTP, File, Email Listeners).

•Experienced in authentication services, UI/UX development, and security application design (Access Groups, Roles, Work Groups, Operators, etc.).

•Skilled in debugging tools (Tracer, Clipboard, Live UI) and performance tuning (PAL, DB Trace, PRPC OOTB functions).

•Adept in Agile & Scrum methodologies, with strong documentation and reporting capabilities.

•Experience in Enterprise Kafka for data processing and integration.

Education

•Master of Science in Electrical Engineering – University of Bridgeport, Connecticut

•Bachelor of Technology in Electrical and Electronics Engineering – Anna University

Technical Skills

•BPM Tools: Pega PRPC (v8.x, 7.x, 6.x)

•Operating Systems: Windows

•Methodologies: Agile, Scrum

•Web Technologies: HTML, JSON, XML, Apache Tomcat, WebSphere

•Databases: Oracle 11g, SQL Server, DB2, MySQL, AWS

•Testing Tools: SOAP UI, Postman

•Documentation: MS Office, Open Office, MS Visio

Certifications

•Certified PRPC System Architect

•Certified PRPC Senior System Architect

Professional Experience

Lead Architect

Evernorth by Cigna Sep 2021 – Present

Project: OnePA (One Prior Auth)

Technologies: Pega PRPC 8.8, XML Web Services, SOAP, REST, JavaScript, Oracle 11g, enterprise Kafka.

•Led a team in designing and implementing OnePA, an application handling millions of prior authorizations.

•Integrated GenAI for document reading and navigation in case management.

•Developed external API integrations for data retrieval and processing.

•Enhanced decision and declarative processing for automated workflows.

•Provided technical leadership, code reviews, and performance optimizations.

•Delivered status reports to stakeholders and ensured on-time project execution.

IT Senior Architect

Express Scripts Inc Sep 2018 – Present

Project: SCR (Smart Coverage Review)

Technologies: Pega PRPC 8.3, SOAP, REST, Oracle 11g, Amazon RDS(AWS)

•Designed automated prior authorization workflows for seamless ePrescribing integration.

•Built REST connectors to fetch external medical data.

•Conversion of on-perm database to cloud using Amazon RDS

•Implemented auto-approval logic to reduce physician intervention.

•Developed UI components, decision tables, and reporting dashboards.

•Conducted code reviews, documentation, and performance analysis.

IT Senior Architect

Express Scripts Inc Nov 2017 – Present

Project: ePA (Electronic Prior Authorization)

Technologies: Pega PRPC 7.2.2, REST, SOAP, Oracle 11g • Designed a real-time ePA system integrated with EMR systems.

•Led external vendor collaborations for seamless data exchange.

•Created RESTful API services to streamline case processing.

•Developed business logic using activities, data transforms, and declarative rules.

•Conducted peer reviews, performance tuning, and production support.

PEGA Senior Systems Architect

Express Scripts Inc Sep 2018 – Jan 2019

Project: SNOW (ServiceNow Integration)

Technologies: Pega PRPC 7.2.2, XML Web Services, SOAP, REST

•Developed an automated ticketing system with ServiceNow integration.

•Designed email notification services to alert production teams in real-time.

•Conducted system monitoring, debugging, and issue resolution.

•Led documentation and training efforts for the development team.

PEGA Developer

Win2Lead IT Services Corp Mar 2017 – Oct 2017

Project: AIS (Account Information System)

Technologies: Pega PRPC 7.2, HTML, SOAP

•Developed PEGA-based account management applications for financial transactions.

•Designed rulesets, UI components, and data validation rules.

•Integrated SOAP connectors for external data exchange.

•Conducted unit testing, debugging, and system enhancements.

Key Highlights

Proven leadership in team management & project execution.

Expertise in PEGA architecture, integrations, and performance tuning.

Strong analytical and problem-solving skills in BPM solutions.

Excellent communicator with experience in stakeholder management.

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