SRI SENDIL RAJA PALANISAMY

Experience

• 

  UST Global

  Nov 2007 - now

  Voyager 2020 - TestingThe Voyager 2020 program is supporting the changes needed to launch IngenioRx, a new Pharmacy Benefit Manager for Anthem Business. Testing includes Cert and Parallel testing of Claims processing in the new IngenioRx PBM system. CERT testing is a claims comparison process; that compares historical claims processed at ESI and CVS to identify any claims adjudication output differences. Parallel Processing is a claims comparison process; that compares production claims processed at ESI and CVS.Duration: (Nov 2018 – CURRENT)Roles & Responsibilities:• Review Medicare and Medicaid plans and validate the benefits setup in destination system.• Validate that IngenioRx migrated benefit setup in production with live members and selective criteria of claims from the original adjudication platform to the future adjudication platform. • Validate claims adjudication in IngenioRx to ensure the processing is same as that of existing PBM system.• Validate the drug Formulary and Utilization management migration and processing of Claims in the new PBM system.• Certifying explainable differences and/ or performing root cause analysis of mismatched claims.• Access matched and mismatched transactions in Lighthouse• Review and certify explainable differences. Review issues and perform root cause analysis• Collaborate with IngenioRx SMEs to certify explainable differences (IngenioRx internal meeting)• Collaborate with CVS to validate specific questions (IngenioRx – CVS Joint Review Meetings)• Collaborate with CVS to confirm root cause analysis (IngenioRx – CVS Joint Review Meetings)• Provide daily status updates to the test lead – Number of claims by review status• Provide daily status updates to the test lead – New issues opened and updates on resolution for existing issues Show less Anthem IngenioRx Test Data Management project has been defined as a result of market forces and compliance challenges that have identified the need for Anthem, Inc. to streamline business processes and consolidate administrative systems used in Anthem PBM Services. This project will focus on requirements, enhancements, redesigning the system, installing system and Quality control activities for test data management in all IngenioRx Anthem Pharmacy Business Service that are currently being developed and maintained for the functionalities of Pharmacy Benefits Management.Duration: (June 2018 – Nov 2018)Roles & Responsibilities:• Review and deep dive on the business requirements for Claim Creation and Smart Sampling tool • Prepare System, Technical Architecture document and related UML Diagrams• Work closely with Project Manager and client stakeholders to identify risks and mitigation plan associated with the project• Test Execution and Management activities (Test Design, Reviews & Test Execution, Team Coordination, Regression Testing, Defect Management & Tracking, UAT Support, Triage Calls)• Conduct weekly test status report review with client stakeholders to communicate the status, progress, planned activities, risks and issues, challenges, topics requiring attention and help from Anthem management to avoid impacts to the overall project schedule and quality• Work closely with testing team/Dependency systems/Dev Team to ensure smooth SIT phase• Testing Support, for UAT, Post Production/Warranty support• Conduct technical sessions for the developers and the core members of the project to follow best practices and standards; Show less NetApp provides cost-effective technical support for data storage, scaled and priced for organizations of all sizes. This is a migration project from Salesforce to C4C. C4C application at NetApp to enable the Customers, Resellers and other supporting partners of Net App. Through Support site users can request for the parts and view the status. If any fault in the products delivered, they can create a request for Replacement and view the status of that case.Duration: (June 2017 – May 2018)Roles & Responsibilities:• Reviewing the requirements and analyzing the requirements to ensure the smooth and quality delivery and provide inputs for estimating the time required for QA completion and preparing QA schedules.• Coordinating with business clients, onsite team and offshore team, thereby supporting the application and implementing QA process as per the specifications provided.• Monitor System Testing and Regression Testing activities for the application during each test cycle and identify the areas of system enhancements. Preparation of test suites in Service Now tool• Gathering the requirements by directly interacting with the onsite team and estimating the effort required for each task. Defect strategy preparation with boundary systems in align with C4C• Coordinating with the Automation team and monitoring the execution.• Analyze the various project requirements and transferring the knowledge to team to build effective Test scripts.• Clarifying the issues of the team members and helping them in the proper execution of the project. Contributed reusable test cases to the QC regression test cases suite• Providing trainings to business folks and end users on the application and documenting the learning.• End to End testing on Data Migration from Salesforce to C4C Show less Integration Operations is a part of migration project from Legacy systems of Membership, ECC and FICO to SAP systems. Integration strategy at Costco wholesale involves utilizing a set of technologies called the Costco integration architecture or CIA. This is used for integrating different modern SAP enterprise systems with internal legacy systems and third party systems. This Operations project provide triaging operations and support for modernization systems and its integration architecture.Duration: (April 2014 – June 2017)Roles & Responsibilities:• Troubleshoot problems in batch process for Membership, HR and Finance across different interfaces including AS400, Data power, MQ, Informatica and SAP.• Informatica cross reference maintenance and support• Analyzing and triaging issues in Batch Job scheduling in UC4 and SAP systems• Analyzing/Reprocessing error messages in MQ• Triaging issues in different layers of integration like MQ, WMB, Datapower, UC4, Informatica• Support Idoc processing in SAP CRM Application for Costco Membership System• Reprocessing of Membership Idocs in SAP CRM• Identifying and Reprocessing/Deleting Idocs based on membership numbers in SAP CRM processing• Documenting the Points of integration and different systems for online and batch transactions between SAP CRM and other systems in the architecture• Provided troubleshooting support for CRM and Middleware errors in landscape.• Monitored number of Inbound and Outbound Idocs and the processing time.• Support batch SAP ABAP Programs and Idoc processing jobs in SAP ECC (HR&Payroll)• Worked in SAP PI for FTP Jobs Show less BJ’s Wholesale Club, Inc. is a leading warehouse club operator in eastern United States offering an assortment of brand name food and general merchandise items within a wide range of product categories. BJ’s provides its members with high-quality brand name merchandise at prices that are consistently lower than the prices found at supermarkets, supercenters, department stores, drug stores and specialty retail operations.The Mainframe Applications Maintenance and Support Project have been defined because of market forces and compliance challenges that have identified the need for BJ’s wholesale to streamline business processes and consolidate administrative systems. This project focuses on maintenance and support of BJ’s Membership systems on Mainframes. This includes the enhancement of existing systems and monitoring of the executing jobs and fixing the abends to improve productivity. The design, coding, testing and deployments will be carried out by the UST Global team.Duration :( July 2012 – March 2014)Roles & Responsibilities:• Understanding the existing system and the new requirements.• Working with business team in identifying different requirements based on existing systems and new system.• Preparing design documents for various requirements.• Documenting various scenarios for new membership options across different enrollment systems.• Identifying regression testing scenarios for Online screens.• System Integration testing and regression testing.• Guiding the new resources in Technical, domain and process.• Analysis of the system and identifying the gaps in the system• Production support and maintenance Show less WellPoint, Inc. is the largest managed health care, for-profit company in the Blue Cross and Blue Shield Association. Medical management lights on is an IT wing to manage Client based applications which deals with benefits/claims for the patients associated with the company.Duration: (June 2010 – June 2012)Roles & Responsibilities:• Manage production support activities for two applications under WellPoint care management area• Responsible for all communications regarding enhancements/defect fix with client and timely deliverables• Responsible for monthly releases and release management process of web applications • Coordination with different teams to resolve issues found in production• Manage team in offshore and coordination with Onsite/client for prioritizing tasks• Resourcing/distributing tasks among the team• Effective use of project management tools proper for task allocation • Ensure quality deliverables by reviewing the tasks• Ensure process compliance for the tasks assigned to the team Show less The project involves a series of phases enabling our client to migrate existing clients in their claim processing system (Mainframes – IMS DB) to another claim processing system (Oracle) after the merger of both systems (Pharmacy Benefits only). Our project also includes the implementation of New Clients in the Oracle system (All backend processing like eligibility are done in Mainframes). The scope of the project includes the migration of Formulary data, Prior Authorizations, Step Therapy, Historical Claims, Group/Member Eligibility, and ORTF. The main tasks were on the Formulary data migration to ESI.Duration: (Nov 2009 – May 2010)Roles & Responsibilities:• Working with business team , Understanding the existing system and the new requirements.• Preparing the requirements document.• Preparation of high and low level design documents.• Checking and update the formulary from drug sources.• Validating the formulary update among the systems.• Updating and validationg PA,Step therapy,Claim history, Eligiblity details in the new ESI system.• Designing the Test plans and Test cases. • Coding the programs as per the specifications and doing Unit testing.• Guiding the new resources in Technical, domain and process.• As a configuration Controller, I was involved in Configuration Control activities Show less The objective of this project is to update Pharmacy Claims Systems (ProPBM/ProServ) with Daily Price and Product information (new and existing NDCs) to comply with state mandates and ensure pharmacy providers are reimbursed with the most accurate drug pricing information. Currently, ProPBM and ProServ receive weekly MediSpan and FDB price and product updates (respectively) on a weekly basis. The enhancement of this project is to provide the ability to add brand new NDCs to the drug lists on the Drug List Management System and generate the daily additions report for review by the Clinical Formulary Management teamDuration: (Mar 2008 – Oct 2009)Roles & Responsibilities:• Analysis of daily additions to new brand/generic drugs into the druglist.• Add/Modify drug details• Calculation of drug price based on AWP, drug Tier and formulary details.• Analyze daily dosage limits for drugs• Updating quantity limit, days suppy limits, step therapy details for drugs.• Preparation of high and low level design documents.• Walkthru development team with various requirements.• Designing the Test plans and Test cases. • Guiding the new resources in domain and process.• As a configuration Controller, I was involved in Configuration Control activities Show less

  • Business Analyst

    Nov 2018 - now

  • Quality Analyst

    Jun 2018 - Nov 2018

  • Quality Analyst

    Jun 2017 - May 2018

  • Operations Analyst

    Apr 2014 - Jun 2017

  • Business Analyst and QA

    Jun 2012 - Apr 2014

  • Maintenance and Support & QA

    Jun 2011 - Jun 2012

  • Software Developer

    Nov 2010 - May 2011

  • Software Developer

    Nov 2007 - Oct 2010