Rekha Krishnan

Software Engineering Lead with extensive experience at Optum Global Solutions, specializing in T-SQL and C#/.NET. Proven ability to drive project success through collaboration and innovative solutions. Achievements include significant enhancements in system performance and process efficiency, utilizing SQL Server and ETL tools.

• Cognizant/ Trizetto AHM 250 Certified
• Cognizant Healthcare Delivery Wizard Award – Q4 2016
• Cognizant Healthcare Blue Diamond Award – Q3 2020 – for Delivery
• Optum Bravo award for designing the solution and leading the Team – Q2 2023

Project: Optimizer – Steady State Implementation Role: Feature Lead Client: OptumCare - Facets Environment: FACETS 6.10, SQL, .Net Responsibilities: Involve in Feature/User Story requirement gathering Sprint planning and stories estimation. Creation of functional artifacts for the stakeholders. Converts the requirement to functional specification for the development team for code change. Involve in On-call support, code review and guide the development team to resolve the issue. Identifying the gaps in the existing process and provides solution. Performs Proof of Concept with applicable changes in the system including config changes. Analyze the issue and identifying the root cause, impact and mitigate. Provide training to team members on the application., Project: Employer Enrollment Automation, Service Request, Prepayment Claims Role: Facets System Analyst Client: Blue Shield of California, CA Environment: FACETS 5.60, Oracle, INFA, SoapUI, Insomnia Responsibilities: Involve in User Story requirement gathering Sprint planning and stories estimation. Creation of functional artifacts for the stakeholders. Converts the requirement to functional specification for the development team for code change. Identifying the gaps in the existing process and provides solution. Performs Proof of Concept with applicable changes in the system including config changes. Analyze the issue and identifying the root cause, impact and mitigate. Provide training to team members on the application., Project: Supplement Benefits 407 Role: Facets Developer Client: Blue Shield of California, CA Environment: FACETS 5.60, Oracle, INFA, .NET, ESB Responsibilities: Identifying the gaps in the existing process and provides solution. Supports production issues reported by business team across all facets modules including configurations. Analyze the issue and identifying the root cause, impact and mitigate. Reviewing the production code and identifies the gap. Solution designing and mentoring team throughout the SDLC phase. Creation of technical artifacts for the stakeholders. Converts the requirement to functional specification for the development team for code change. Preforming Code review and validates unit test case execution. Reviewing SIT test plan and test case., Project: Facets Accumulator Enhancement, Care 1st Member Migration, ITS NPR, LandMark Role: Facets Designer Client: Blue Shield of California, CA Dated: Feb 2018 – Jan 2019 Environment: FACETS 5.60, Oracle, INFA, .NET, ESB Responsibilities: Identifying the gaps in the existing process and provides solution. Supports production issues reported by business team across all facets modules including configurations. Analyze the issue and identifying the root cause, impact and mitigate. Reviewing the production code and identifies the gap. Solution designing and mentoring team throughout the SDLC phase. Creation of technical artifacts for the stakeholders. Converts the requirement to functional specification for the development team for code change. Preforming Code review and validates unit test case execution. Reviewing SIT test plan and test case. Preparing User Test Cases and execute the same for business. Providing support during QA and UAT testing phase. Creating an implementation plan, coordinate with Release management team to implement the solution in production. Measuring the risk and mitigation plan to management regularly., Role: Tech Lead / Facets System Analyst Client: Wellmark BCBS Inc. Iowa / South Dakota Dated: Apr 2013 – Jan 2018 Responsibilities: Gathering business requirement from respective client business team through requirement sessions Creating Business Requirement Traceability Matrix to define the system scope Converts the requirement to functional specification for the technical team to implement Estimation of effort for each phase of the SDLC cycle Design the solution and will work with client architects for approval Walkthrough the design with business team and getting approval from stakeholders. Customize Facets or develop custom integration for the requirement having Facets limitation Enabling the infrastructure to enroll members, sending welcome letters or compliance correspondence, processing claims and billing. Monitor the Production batch performance trend to identify the process required for optimization. Coordinating performance testing with testing team. Involve in QA defect triage with business to discuss on the defects and make decision. Creating an implementation plan and work with Release management team to align the project release. Measuring the risk and mitigation plan to management regularly. Creating status report and reporting to client, Project: Facets Optimization / Enhancement Role: Tech Lead / System Analyst Environment: FACETS 5.40, MS SQL 2014,.NET, Windows Server, AGILE Project Summary: This project is to optimize the Facets infrastructure to make the production efficient. Batch run times, claim first pass rate, Members first pass rate, Group first pass rate, Member MTM are key factors measured and recommendations are applied to increase the efficiency., Project: Large Group business migration to Facets Role: Tech Lead / System Analyst Environment: FACETS 5.40, MS SQL 2014, Windows Server Project Summary: The objective of this project is to migrate Large group business from Legacy Mainframe system to FACETS. Automation of Group, billing setup, respective members enrollment and claim processing were the key development activities in this project., Project: Quantum Program Role: Tech Lead / System Analyst Environment: FACETS 5.40, MS SQL 2014, Windows Server Project Summary: The objective of this project is to extract the IFP and Small Group Members from Facets and send to Wellmark’s Vendor of Avesis, Catamaran, Delta Dental for member enrollment and changes., Project: CMS Reporting Role: Tech Lead / System Analyst Environment: FACETS 5.20, MS SQL 2008, Windows Server Project Summary: In order for Wellmark to administer its individual and group insurance plans and to comply with regulatory requirements, there is a need to capture and report on income data stored in Facets both at the contract and member level and to capture premium data stored in Facets only at a member level., Project: PBM Implementation – CVS Pharmacy Role: Tech Lead / System Analyst Environment: FACETS 5.20, MS SQL 2008, Windows Server Project Summary: This project will include all technical work streams and business process changes required to implement new PBM services and to integrate the PBM’s technology and processes with Wellmark. Enable the systems to share eligibility and benefits information to pharmacy systems. Accepting Rx claims and loading to Facets as History posting and maintain member accumulation across medical and Rx systems., Project: South Dakota Schedule pages (Letters) Role: Tech Lead / System Analyst Environment: FACETS 5.20, MS SQL 2008, Windows Server Project Summary: This project will develop more efficient processes for generating/triggering South Dakota Schedule Pages letters when there is a premium change that ensures compliance with legal requirements. This applies to only those SD IFP Contracts residing on Facets system, Project: Small Group Policy Renewals and Admin Role: Module Lead / Developer Environment: FACETS 5.10, MS SQL 2008, XML, Windows Server, Scriptella Project Summary: The objective of this project to develop automated data feed capabilities as needed to support maintenance and renewal activities for small group and Individual Members for an external system Connecture. It will also include updates necessary to support maintenance and renewal activities in the Facets system., Project: EMPIRE Role: Module Lead / Developer Environment: FACETS 5.1, MS SQL 2008, Windows Server, JAVA Project Summary: EMPIRE (Eligibility and Membership Preprocessing Interface and Rules Engine) is a framework which consists of scheduler, business rules engine, data loader, user interface screens and reporting components. User Interface to configure the types of files, view the dashboard and reporting features. This enrollment tool has been created to automate Small Group migration and policy maintenance in Facets, Project: Provider Migration to Facets Role: Module Lead / Developer Environment: FACETS 5.1, PL/SQL, Oracle 10 g, Cactus, PORTICO Project Summary: As part of Facets implementation, project was to migrate provider from different Provider Credentialing system (CACTUS, PORTICO) to Facets to facilitate Claims processing., Project: Facets Implementation Role: Module Lead / Developer Environment: FACETS 5.1, SQL Server 2008 Project Summary: Wellmark Inc was new client for Facets. As part of this project, Facets application was deployed and inventories been created to support Client’s Claim processing and Member maintenance in Facets., Project: BMCHP – Application M Role: Facets Developer Environment: Facets 4.X, SQL Server 2005, .Net Dated: Sep 2011 – Apr 2013 Project Summary: The objective of this project is to work on the incident ticket raised on the Production. Responsibilities: Interact with Client to get the requirement and understand it. Develop and review the stored procedures for optimal Performance. Understand the business requirements by doing a complete analysis of the client’s requirements and preparing possible approaches for the requirement. Develop test cases for the enhancement and perform extensive Unit and Assembly Testing. Review the code and design documents to ensure that they adhere to the standards. Provide support on the Development projects and the Production issues. Perform effort estimation for new requirements in the project., Project: COSMOS ICD10 Field Expansion Role: Developer Environment: SQL Server 2005, .Net Dated: Apr 2011 – Sep 2011 Project Summary: Impact Analyzer is the tool used by COSMOS team who worked in Mainframe. This tool is designed for finding the impacted lines in XGEN file where seed and XGEN files are input. The seed is nothing but variable which are used in the XGEN file and XGEN file contains fixed COBOL text. Responsibilities: Involved in requirement gathered and guided team members in the project. As a developer, my primary responsibility was to understand the business requirements, design, develop and test the extracts. Developed and tested the .Net C# code for the requirement. Also involved in Knowledge Transfer for the new joiner in the project. As a team member was involved in quality and defect prevention process., Project: TSYS Dispute Resolution Role: Developer Environment: ASP.NET 2.0, C#.NET, SQL Server 2005, AJAX, SSRS Dated: Jun 2009 – Apr 2011 Project Summary: TSYS make it possible for millions of people to make paperless payments safely and securely. Recognized as the market leader, it provides electronic payment services to financial institutions and companies around the globe. TSYS work behind the scenes to offer unmatched flexibility, control and service quality to their customers through a broad range of innovative issuing and acquiring payment technologies, including consumer-finance, credit, debit, healthcare, loyalty, prepaid, chip and mobile payments. Responsibilities: Involved in the development activities of Phase 9.3, 9.4, 10.1, 10.2, 10.3, 10.4, 11.1 and 11.2 and provided the solution at framework and business level. Developed and enhanced applications in accordance with our quality control standards and business practices, managed the team in development phases by guiding the developers for ensuring the quality deliverable on time and involved in quality and defect prevention process.