Senior Pega System Architect - Enterprise BPM

https://www.linkedin.com/in/sujata-pegadev/

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Sujata Devarakonda

Dallas–Fort Worth Metroplex

Cell: +1-240-***-****

Email: ************@*****.***

Professional Summary:

Senior Pega System Architect with specialized experience delivering enterprise-scale BPM and Case Management solutions using the Pega Platform across Healthcare, Insurance, Banking, Financial Services, Utilities, and Public Sector organizations. Extensive experience designing and implementing scalable Pega applications supporting Claims Processing, Appeals & Grievances, Customer Service, Loan Origination, Workflow Automation, and Case Management, with expertise spanning solution architecture, application design, development, integration, deployment, production support, and performance optimization. Strong hands-on experience with Pega Platform versions across multiple releases, including Case Management, Data Pages, Data Transforms, Decision Rules, Declarative Processing, REST/SOAP integrations, Queue Processors, Job Schedulers, Security, Guardrails, Rule Resolution, Enterprise Class Structure, reusable component design, and high-volume transaction processing. Proven leader experienced in technical design reviews, mentoring developers, code reviews, Agile delivery, stakeholder collaboration, and enterprise solution delivery. Currently preparing for Pega Lead System Architect (LSA). Strategic Influence:

• Led technical design discussions for enterprise Pega implementations.

• Mentored junior developers and performed code reviews.

• Collaborated with Product Owners, Business Analysts, QA, and Infrastructure teams.

• Participated in architecture reviews, sprint planning, estimations, and production deployments.

• Ensured guardrail compliance, reusable design, and application performance. Core Competencies:

• Pega Solution Architecture • Enterprise Case Management • Healthcare Claims • Appeals & Grievances • REST/SOAP Integrations • Enterprise Integrations • Performance Tuning • Production Support • Agile Delivery • Technical Leadership • Code Reviews • Design Reviews • Mentoring • Pega Healthcare Framework • Single Sign-On (SSO) Integration using SAML 2.0 • Implementing seamless authentication using Okta SSO • Pega Cloud Services including log analysis (PDC), AES/PDC monitoring Technical Skills:

Architecture: Enterprise Class Structure, Integration Architecture, Performance Optimization, Reusable Components, Code Reviews, Design Reviews.

Languages Pega PRPC 5.5–8.x, Case Management, Data Pages, Data Transforms, Activities, Flows, Decision Rules, Queue Processors, Job Schedulers, Report Definitions, Security, Guardrails, Rule Resolution, PAL, Tracer, DB Trace. Integration: REST, SOAP, Kafka, JMS, Oracle, SQL Server, DB2. Healthcare: Claims, Appeals & Grievances, HIPAA, EDI 837/835/270/271/276/277, Facets, QNXT. Methodologies: Agile, Scrum, SDLC, Production Support. Education:

• Bachelors of technology in Mechanical Engineering from JNTU. Passed out in 2003. https://www.linkedin.com/in/sujata-pegadev/

2/7

PROFESSIONAL EXPERIENCE:

Client: Elevance Health- Norfolk, Virginia (Previous Name: Anthem-Inc) Senior Sr. System Pega Architect Jul 2021 – till date Worked on a healthcare claims processing project using Pega Platform for a leading Health Insurance client supporting Commercial, Medicare, and Medicaid lines of business. The project involved automating end-to-end claim intake, validation, routing, adjudication support, exception handling, and integration with downstream systems. Responsibilities:

• Managed Pega implementations, ensuring adherence to best practices and coding standards.

• Designing and configuring claim workflows using Pega Case Management.

• Implementing business rules for claim validation, eligibility verification, provider checks, COB, accumulators, and benefit configuration.

• Developing integrations with EDI gateways, Facets/QNXT, provider systems, and payment systems.

• Handling HIPAA X12 transactions such as 837 Institutional, 837 Professional, 837 Dental, 835, 270/271, and 276/277.

• Creating SLA-driven work queues for pended, rejected, and manual review claims.

• Supporting high-volume batch processing and claim exception management.

• Working with business teams for UAT, production support, and process optimization.

• Improving claim turnaround time and reducing manual intervention through workflow automation. Environment: Pega PRPC 8.3.1, JSON, SOAP, REST, Oracle, SQL Server, Tomcat Server, Kakfa, Queue processor Client: Molina Healthcare - Long Beach, CA

Senior Sr. System Pega Architect Feb 2020 – Jun-2021 Molina health care needs to find an alternate solution to the legacy Appeals & Grievances application which supports all lines of businesses. This has become impressive since the existing system was built 10+years ago lacks in technology and flexibility needed to support existing and new requirements including in the areas of regulation and compliance. Pega healthcare platform and its A&G application was determined as the future solution. Responsibilities:

• Participated in Requirements, Design and Development phases.

• Analysis, Design and implement the data migration process

• Develop a mechanism of data extraction from Pega database to external SQL database

• Work on creating declare index rules and activities for extraction process

• Support production issues relating to Pega

• Identifying Properties and Activities, designing the Sections and Harness.

• Implementation of PRPC components like Decision tables, Decision Maps, Declarative Expressions, Constraints and Indexes etc.

• Worked on Activities and Flows to meet the requirements.

• Used RDB Method to created Database Connection and Created Web services using Connect-SOAP.

• Created Data-Admin-Product to migrate rules across various environments.

• Managed accessibility to users by creating Portals, Access Roles and Access Groups for Analysts, Data Managers and Chair departments.

• Identified and documented test conditions/scenarios from the business requirements and functional design for Rating Management.

Environment: Pega PRPC 8.1, MS Visio, HTML, XML, SOAP, JavaScript, SQL Server, Java, CSS, Java Script and HTML Client: Southern California of Edison (SCE) - Los Angeles, CA Senior Sr. System Pega Architect Feb 2019 – Jan-2020 Southern California Edison-(SCE) has recognized that a unified set of tools need to be developed and deployed to streamline the customer experience with SCE in the general area of program and project application intake and review. Any application intake and review will require an integrated workflow between many SCE internal stakeholders and applications. The application intake and review currently targeted for improvement is in the functional area of Load and Generation Interconnection applications. https://www.linkedin.com/in/sujata-pegadev/

3/7

Responsibilities:

• Participated in Requirements, Design and Development phases.

• Analysis, Design and implement the data migration process

• Develop a mechanism of data extraction from Pega database to external SQL database

• Work on creating declare index rules and activities for extraction process

• Support production issues relating to Pega

• Identifying Properties and Activities, designing the Sections and Harness.

• Implementation of PRPC components like Decision tables, Decision Maps, Declarative Expressions, Constraints and Indexes etc.

• Worked on Activities and Flows to meet the requirements.

• Used RDB Method to created Database Connection and Created Web services using Connect-SOAP.

• Created Data-Admin-Product to migrate rules across various environments.

• Managed accessibility to users by creating Portals, Access Roles and Access Groups for Analysts, Data Managers and Chair departments.

• Identified and documented test conditions/scenarios from the business requirements and functional design for Rating Management.

Environment: Pega PRPC 8.1, PRPC 7.3, MS Visio, HTML, XML, SOAP, JavaScript, SQL Server, Java, CSS, Java Script and HTML Client: Anthem- Richmond, VA Jul 2017- Jan 2019

Senior Sr. System Architect

Anthem created Solution Central. The desktop service guides back-office associates through processes, making it easier for them to offer a better, frictionless experience to Anthem’s customers. Customer service representatives are given the right content, instructions, and links at the right time, reducing the dependency on training and experience. Solution Central intelligently centralizes and organizes data so that each customer service call is contextual and exceptional. Responsibilities:

• Working with the Business Leads, and Business Analysts to define business requirements for designing and analyzed those requirements.

• Creating Decision Rules, Map Value, Decision Table, Decision Tree and Declarative Expressions.

• Creation of activities and steps for implementing core business logic.

• Bug Fixing Activities with System Architects.

• Update the Agents that run activities to create work objects.

• Working with Rest, MQ, JMS Connectors and Services.

• Involved in the High Level Analysis, estimation and in the preparation of High Level Design Documents and detailed design documents.

• Working with Clipboard, Rules Inspector, DB trace and Tracer for troubleshooting the issues.

• Testing and debugging using tracer and Rules Inspector. Environment: PRPC 7.1.8, MS Visio, HTML, XML, SQL Connectors, HTTP, SOAP Services, Oracle 10g, Java, J2EE, CSS and Java Script, Web Logic Server 6.1/7.

Client: World Bank- Washington, DC March 2015- Jun-2017 Senior System Architect

Project Budget Approval System: World Bank funds for New Project Initializations like Dams, Bridges etc. across the globe, New project creation undergoes several stages and each stage got its own approval process flow which spans across multiple levels for budget estimation and approval process from multiple users for collaboration across the organization for the approval of the project and get enhanced using PDF Documents, they have 71 different templates and 40 different flows to handle different stages of the project. There are 4 systems Integrated like SharePoint, Documentum, PEGA and IPortal Systems, the project will be initiated in I Portal and final document will be saved into Documentum System. Responsibilities:

• Involved in the High-Level Analysis, estimation and in the preparation of High-Level Design Documents and detailed design documents.

https://www.linkedin.com/in/sujata-pegadev/

4/7

• Worked with the Business Leads and Business Analysts to define business requirements for designing and analyzed those requirements.

• Created Decision Rules, Map Value, Decision Table, Decision Tree and Declarative Expressions.

• Creation of activities and steps for implementing core business logic.

• Involved in Bug Fixing Activities with System Architects.

• Updated the Agents that run activities to create work objects.

• Experienced working with Rest, MQ, JMS Connectors and Services

• Creation of search reports using List view rules of PRPC.

• Actively involved in the User Interface solutions for the clients.

• Worked with Clipboard, Rules Inspector, DB trace and Tracer for troubleshooting the issues.

• Always considered performance, used PLA and had an eye on Pega logs.

• Testing and debugging using tracer and Rules Inspector. Environment: PRPC 7.1.4, MS Visio, HTML, XML, SQL Connectors, HTTP, SOAP Services, Oracle 10g, Java, J2EE, CSS and Java Script, Web Logic Server 6.1/7.

Client: Parexel International Waltham, MA Sep 2012 - Mar 2015 Senior System Architect

Metis Business Problem: The Metis system is being developed to create a Pricing and a proposal tool, this tool should help in computing a competitive price for a Clinical Research Project. It should be able to arrive at the rates by calculating the cost of each and every task performed for that research along with the timelines taken into consideration. The tool should be able to predict profitability of the study and map the revenue to various cost centers to understand the distribution of income. The main function of this tool is to replace the existing process which is happening through excel. Responsibilities:

• Extracted the logic from existing system and participated in creating business documents.

• Implemented the rule in PRPC V6.3

• Designing the class structure and taking part in high level design of the application.

• Dealt with multiple work objects.

• Involved in scrum calls and implemented the user stories

• Customized the JS and CSS.

• Developed process flows, business rules, and decision rules.

• Integration service and various connectors to integrate with external vendors.

• Created various kinds of reports to view the performance of the enrollment team.

• Developed application Components like Activities, Decision trees, Decision tables, Maps, Declarative Expressions, Classes, Connectors, Correspondence, properties, Sections

• Take part in the Scrum sprint planning and implement the requirement as user stories.

• Implementation, unit testing and integration testing of the user stories.

• Design of Flows, User Interface, Track Security changes, Integration, Report Definition

• Part of defect fixing for the defects created after code move to SI and QA. Environment: Pega Rules Process Commander V6.3, Web sphere Application Server, Oracle, Java, J2EE, CSS, Java Script and XML. Parexel International Waltham, MA Sep 2011 – Aug 2012 Senior System Architect

Customer Support center focuses on maintaining the bus routes, master schedule and daily schedule for National Express, one of PWC’s clients for USA, Canada & Australia. Master Schedule is a template for day-to-day operation of the routes after the routes are imported from the contract. Daily schedule keeps track of the routes and the employee and the vehicle assigned to the particular route. The system also keeps track of the employee and vehicle information associated to each of the CSC’s Responsibilities:

• Done the analysis of the issue raised in both the new business and Quote applications.

• Follow-up with the BA and business people for the clarifications on to the issues raised in the JIRA for each issue. https://www.linkedin.com/in/sujata-pegadev/

5/7

• As part of the analysis, done the investigation/root cause of the issue and provided the solution.

• Done the impact analysis and fixing the issue after approval for the solution and applying the fix and performed the unit testing wherever the fix is applied.

• As part of fix Modified the User Interface Rules (Harness, Section, and Flow Action) as needed.

• Done the low-level design

• Developed process flows, business rules, and decision rules.

• Integration service and various connectors to integrate with external vendors.

• Created various kinds of reports to view the performance of the enrollment team.

• Take part in the Scrum sprint planning and implement the requirement as user stories.

• Implementation, unit testing and integration testing of the user stories.

• Design of Flows, User Interface, Activities, Integration.

• Part of defect fixing for the defects created after code move to SI and QA. Environment: Pega Rules Process Commander V5.5, Web sphere Application Server, Oracle, Java, J2EE, CSS, Java Script and XML. Lumley Private Motor, NSW July 2010 – Sep 2011

System Architect

This Application is used by the Australian client to offer their insurance products to the customers in Personal Lines, which offer Vehicle Insurance. The product is configured using the Product Configuration Framework. The application also supports the under-writer referral functionality based on the risk involved. The underwriters use this application for their underwriting work. Responsibilities:

• Done the analysis of the issue raised in both the New business and Quote applications.

• Follow-up with the BA and business people for the clarifications on to the issues raised in the JIRA for each issue.

• As part of the analysis, done the investigation/root cause of the issue and provided the solution.

• Done the impact analysis and fixing the issue after approval for the solution and applying the fix and performed the unit testing where ever the fix is applied.

• As part of fix Modified the User Interface Rules (Harness, Section, and Flow Action) as needed. Environment: Pega Rules Process Commander V5.5, Web sphere Application Server, Oracle, Java, J2EE, CSS, Java Script and XML. Loan Originating System Sydney, NSW Dec 2008 – Jul 2010 System Architect

Pega Trained and Certified and Involved in Developing a Loan Origination System where a customer requests for a Personal Loan or Car Loan to the Bank for the details of Eligibility. After customer request’s, the CSR of the Bank will calculate the eligibility of requestor according to his/her personal information for the loan and then contact the customer. System has been designed for multiple lines of business such as Home, Auto, personal Loans and has followed the Enterprise Class hierarchy principles and Pega guardrails is Application is used by the client to offer their insurance products to the customers in Personal Lines, which offer Vehicle Insurance. The product is configure using the Product configuration Framework. The application also supports the underwriter referral functionality based on the risk involved. The underwriters use this application for their underwriting work. Responsibilities:

• Creating Harnesses, Flow Actions and Sections.

• Implemented Decision tables, Decision Maps and Declarative expressions

• Created using List view and Summary view rules of PRPC.

• Creating Activity, Services and Connectors Rules.

• UI Navigation

• Testing the application using Tracer / Clipboard.

• Involved in Bug Fixing Activities with System Architects.

• Updated the Agents that run activities to create work objects.

• Experienced working with Connectors and Services

• Creation of search reports using List view rules of PRPC.

• Actively involved in the User Interface solutions for the clients.

• Worked with Clipboard, Rules Inspector, DB trace and Tracer for troubleshooting the issues.

• Always considered performance, used PLA and had an eye on Pega logs. https://www.linkedin.com/in/sujata-pegadev/

6/7

• Testing and debugging using tracer and Rules Inspector. Environment: PRPC 6.1 SP2, MS Visio, HTML, XML, SQL Connectors, HTTP, SOAP Services, Oracle 10g, Java, J2EE, CSS and Java Script, IBM Web Sphere Application Server 6.1/7.

ACS Government Health Care Solutions Dearborn, MI Mar 2007 – Nov 2008 Java Developer

ACS is a leader in Medicaid program administration. It operates customized systems for more than a dozen states and offers the industry's most comprehensive set of services, including managed care enrollment, eligibility administration, claims processing, provider relations and third-party liability. Our Medicaid Management Information Systems (MMIS) have all received Centers for Medicare and Medicaid Services (CMS) certification. This is a development project based on RUP guidelines complying with SOA and HIPAA framework. Project divided into four modules viz., Member, Provider, Operations and Program. As part of this project MMIS will be developed based on SOA based architecture compliant with HIPAA guidelines. Responsibilities:

• Involved in Coding, Unit Testing, writing Junit test cases.

• Responsible for analyzing the detail design.

• Responsible for finishing the code as per the time lines.

• Responsible for debugging and bug fixing.

• Developed the Code of business components and view components using Stateless session beans, Delegates and JSF framework.

• Designed and developed business process using WID and BPEL.

• Took sessions to the new team members regarding BPEL and WID. Environment: Windows-XP, Oracle10g, WebSphere Portal Server, WebSphere Application Server, WebSphere Process Server, BPEL, Java, JavaBeans, JSF, EJB (Session Beans), Win SVN, WPS, WID, RAD, RSA, Clear Case, and CVS. Shell Oil Company Houston, Texas Mar 2006 – Feb 2007 Java Developer

CIF-Core Integration Framework: The Core Integration Framework (CIF) provides the components and services needed to support one integrated global trading business. It is a collection of frameworks, components, services and standards That form the foundation for Shell Trading Architecture. The Integration Framework provides the standards, governance, and underlying technical facilities and environments necessary to design, Develop and deploy the services. With it, Shell Trading can adapt to business changes more quickly, as it Allow for new applications and services to be incorporate more quickly and with ease. Architecture is SOA. It is an Integration project. Integration of J2EE and TIBCO services and components. Some of the services developed in J2EE (WebSphere) and some in TIBCO. Components developed in J2EE.To develop Services EJB’s (MDB and Session bean) are used. Components were developing as standalone java Classes. Services are using SOAP over JMS (TIBCO EMS) vs. the more internet common SOAP over HTTP. Using JMS as the transport provides the underlying mechanisms, we need to ensure delivery, queuing Up of message, etc.

Responsibilities:

• Played active role in Architectural Design, Development and Testing of the application.

• Implemented the Business logic in Standalone Java classes using core java.

• Designing of the user interface

• Data modeling

• Developed the user interface in swings

• Procedures in PLSQL to validate the data

• Xml files and schema to transfer the data

• JMS connections

• Servlets to access the data for further processing

• Deploying the war files into WebSphere Server(Test Environment)

• Fixing the bugs, which were updated by test team.

• Involved in the meetings to demonstrate about the product to production BSA’s and end users. https://www.linkedin.com/in/sujata-pegadev/

7/7

• Written properties files and ant script

Environment: Windows 2000, Oracle10i, WebSphere 6.1, Java, JavaBeans, JSP, EJB (MDB and Session Beans), JavaScript, and HTML, Tortoise SVN, Ant, RAD, RSA

Pitney Bows Stamford, CT Dec 2005 – Feb 2006

Java Developer

Supplies OTC: Using Broad Vision ‘My Account’ website, customers can inquire on their order status for supply orders placed in past 90 days through any channel. This project involves development of the functionality to be developed on Broad Vision side to fulfill the order status inquiry screens. It is dependent on a real time call to SAP via middleware MQ series to retrieve most of the data presented.

Responsibilities:

• Played active role in Architectural Design, Development and Testing of the application.

• Implemented the Business logic in Standalone Java classes using core java.

• Used Struts Validator framework for generation validation code.

• Used Struts Tiles libraries for easy template management

• Used Struts tag Libraries to generate the views.

• Developed the object/relational persistence Java classes and query service for Java using the Oracle Top link framework

• Deploying the war files into Broad vision Server(Test Environment)

• Fixing the bugs, which were updated by test team.

• Involved in the meetings to demonstrate about the product to production BSA’s and end users.

• Written properties files and ant script

Environment: UNIX, Oracle8i, Broad vision Server, Struts, Java, JavaBeans, JSP, JavaScript, and HTML. Clear Case, Ant

Pitney Bows Stamford, CT Oct 2005 – Nov 2005

Java Developer

The Mail Stream site is entirely based on the CSS approach. The application gives an overview of Mail Stream, impact of Mail Stream, which includes the Facts and figures, Audit tools, White papers; it also speaks about the optimization of Mail Stream, the Executive perspective, presentations, News, Events and all the other things happening in Mail Stream. Responsibilities:

• Played active role in Architectural Design, Development and Testing of the application.

• Implemented the Business logic in Standalone Java classes using core java.

• Used Struts Validator framework for generation validation code.

• Used Struts Tiles libraries for easy template management

• Used Struts tag Libraries to generate the views.

• Developed the object/relational persistence Java classes and query service for Java using the Oracle Top link framework

• Deploying the war files into Broad vision Server (Test Environment)

• Fixing the bugs, which were updated by test team.

• Involved in the meetings to demonstrate about the product to production BSA’s and end users.

• Written properties files and ant script

Environment: UNIX, Oracle8i, Broad vision Server, Struts, Java, JavaBeans, JSP, JavaScript, and HTML, Clear Case, Ant

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