Bangalore Kumar - IT Consultant - Chennai, Tamil Nadu, India

Manjula Bangalore Kumar

Chennai, Tamil Nadu, India

Services

IT Consultant

Work History

Manager of AD Projects

Cognizant Technology Solutions

From January 2013

Manager of AD Projects

Aetna Inc

From January 2013

Harford, CT, USA. My Work location - Chennai, India

• Manager of projects for Commissions (Sub-Domain under Corporate). The domain consisted of various applications which are being used to handle Sales, Track Sales and Calculate compensation for the Brokers.
* Innovation health merge as part of ACO foundation
* Internal & External broker Compensation systems
* Brokers Licensing & Appointment validation
• Managed a peak team size of 27 people in the Corporate domain working from multiple locations to provide on-time and quality deliverables focusing on customer requirements and satisfaction.
* Team involved mix of high and low experience members with different cultural back ground
• The projects involved technical and architectural solutions spanning majorly J2EE, DataStage and Business Objects technologies for the Broker License validation, Broker Agreements, Brokers Compensation, Sales Tracking, Reporting sales to customers, Applications used by Producers. Corporate domain also consists of many internal .Net applications used by Aetna business.
* Responsible for budget preparation, estimation, project planning, proposals and necessary implementation.
* Coached, mentored and lead personnel within a technical team environment.
* Excelled in gap analysis for all the projects there by avoiding rework, timeline issues and quality issues
* Identify new business development opportunities. Achieved partly by identifying value additions to the client
* Managed projects across technologies. Projects involved J2EE, .NET, ETL and Business Objects
* Responsible for resource utilization management and revenue forecasting. Maintained an average utilization of 85% during this year.

Program BA, Senior BA, Business Analyst

Cognizant US Corporation

January 2008 - December 2012

Business Analyst

Aetna Inc

January 2008 - December 2012

USA

• Benefitfocus integration in Enrollment & Plan Sponsor space
* Developed requirements to deliver self-service web-based system to be utilized by Individual & Small Group members for their enrollment administration
* Developed requirements to create Benefitfocus Plan Sponsor portal to access all Benefitfocus and Aetna applications thru Single Sign On (SSO)
* Lead BA team to create requirements to enhance the Benefitfocus enrollment system to deliver the service for Middle Market & National Account customers
* Rewrite of Traditional and HMO enrollment system for National Account customers to remove any manual intervention
* Automatic reconciliation process between Aetna and Benefitfocus member enrollment data
* Small Group, Middle Market and National Accounts Plan Sponsor data setup with Benefitfocus
• Acted as Program Business Analyst for the Benefitfocus & Allstate Integration program to include 2 Allstate Plans (Critical Illness and Accident Plan) for all Aetna customers (Individual & group) in enrollment process with Aetna and Benefitfocus

• Lead Innovation Health Initiative as Program BA for Enrollment & Plan Sponsor space - As part of ACO foundation Aetna formed a joint venture with Innova Health providers.
* Addressed the changes needed within General Ledger Pre-Processor to process Innovation Health reinsurance billing and premium data.
* Complete ownership of maintaining the new BPS and Legal Entity value stored in Enterprise Reference Tables
* Worked on ID card setup to include Innovation Health logo and details
• Medical Loss Ratio (MLR) - Analyzed Legal Entity and Business Portfolio Segment (Lowest level at which Aetna maintains a balance set of accounting records) based on existing mapping rules to incorporate the Medical Loss Ratio program in Aetna's healthcare framework.
• Business Analyst for Network & Provider domain. The domain consisted of various applications associated with these health insurance entities
* Member eligibility - Member...

Team Lead

Aetna Inc

February 2007 - December 2007

Harford, CT, USA. My Work location - Chennai, India
• Lead developer for the Medical management reporting application
• Provided architectural solutions for the new Aetna Total Clinical View reporting application
• Designed the medical management data flow and storage process
• ATV Reporting is the second-generation application for Aetna for medical Management reporting based out of UDB database and DataStage tool for ETL.
* First generation is eTUMS (Electronic Total Utilization Management) based out of mainframe DB2 and COBOL
• ATV and eTUMS application is Aetna application for various utilization programs, viz.
* Disease Management
* Women's Wellness
* Behavioral Health management
• ATV/eTUMS Reporting application generated various reports used by Wellness program managers and nurses to assess the outcomes of various wellness initiatives
• Designed and created reports that include
* The number of visits the member has done in a year for disease based on the ICD codes and CPT codes
* The number of cases assigned to a nurse. The reports show details and the associated summary of the case numbers and statuses.

Team Lead, Developer

Cognizant Technology Solutions

February 2005 - December 2007

Capabilities Include
Business Analysis Capabilities
✓ Business Analysis & Requirements Gathering
✓ User Interface Specifications
✓ Use Case Narratives
✓ Business/System/Data Flow Diagrams
✓ Facilitating Joint Application Development sessions
✓ Developing business needs/Project Sizing
✓ End User Training
✓ Creation/Update of Test Plans/ Scripts/Testing Strategy
✓ Contributing Defect Triage meetings
✓ User Acceptance Testing

Project Management Capabilities
✓ Project Scope & Management
✓ Process & Performance improvement
✓ Customer Contract and SOW management
✓ Resource Utilization and Cost Management
✓ Experience in outsourcing and offshoring model
✓ New business development
✓ Scrum Master
✓ Agile Methodology

Healthcare Domain Expertise
✓ Enrollment & Eligibility
✓ Benefitfocus (eEnrollment) & Allstate Integration
✓ Aetna & Innovation Health partnership
✓ Plan Sponsor setup
✓ Provider Networks
✓ Claim Adjudication
✓ Broker Agreement & Commissions payment
✓ Product Package/Quote Creation
✓ Utilization Management
✓ ICD 10 conversion
✓ HCR Exchange
✓ Medical Loss Ratio
✓ Accountable Care Organization

Others
✓ Rational tools - Clear Case, Clear Quest and Requisite Pro
✓ Excellent Presentation and Communication skills
✓ Team Building and Interpersonal skills
✓ Customer Management
✓ Working with International teams
✓ MS Visio, RTC, MPP, Planview

Developer

Aetna Inc

February 2005 - January 2007

Harford, CT, USA. My Work location - Chennai, India

• Developer for Sales, Rating and Quoting applications
• Maintained and provided production support for Quoting and Product Packaging systems.
• Enhanced the Rating/Quoting/Product applications as part of projects and perform integration testing.
• Perform periodic batch processing activities for the proper functioning of the Plan/Product domain.

Qualifications & Certifications

Madras University

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