Sharath Kumar Shetty Ulthoor

Information Technology Manager with 12+ years of IT leadership experience including oversight of infrastructure, application support and security services. Dedicated to customer satisfaction with focused delivery of technical solutions. Proven leader in directing operations, maintenance and support of complex systems. Develops creative business solutions, leveraging diverse methodologies and delivering engineering solutions for leading organizations. Highly adept in request for proposal development, technology needs assessments and staff training. Insightful Information Technology Manager with 12 years of IT leadership experience including oversight of infrastructure, application support and security services. Dedicated to customer satisfaction with focused delivery of technical solutions. Proven leader in directing operations, maintenance and support of complex systems. Develops creative business solutions, leveraging diverse methodologies and delivering engineering solutions for leading organizations. Highly adept in request for proposal development, technology needs assessments and staff training.

1. Project Name: RxHD - Prescription Solutions Help Desk (April 2012 – May 2017)

Description: RxHD application provides Member, Plan, claim information which will be primarily used by Help Desk advocates assisting Pharmacies, Members and Prescriber with Claim History, Prior Authorization, claim adjudication and plan related data among others. It connects with multiple source systems to get member and claim related data. It uses web service hosted by source systems or database calls to source systems to retrieve data. Connects to different source systems like CLAIMS, BENEFIT, MAIL SERVICE applications to fetch Member, Claim, product, prescriber and eligibility data, plan benefit information, Patient details and Order history details etc., Connects to FORMULARY and PHARMACY systems to fetch formulary information and for locating pharmacies.

Environment: Java /J2EE 6.0, GWT 2.0.3 framework, External systems: AS400 backend, Microsoft SQL server 2008 R2/ORACLE 11g, Hibernate 3.2, Spring 2.5, Eclipse 3.5/RAD 8.0

Scenario:

The RxHD application used primarily by Help Desk Advocates assisting pharmacies with claim questions. It is a real-time claims and eligibility system that is used for the following:

· Manually adding or updating member eligibility

· Viewing member claim history and individual claim transactions

· Accessing member deductible and benefit maximum information

· Accessing member physician information

· Accessing Medicare Part D and True Out of Pocket history

· Accessing notes to determine the status of a Prior Authorization

· Entering pharmacy overrides and authorizations.

· Accessing information on pharmacies and medications

· Access to Prior Authorization system

· Submitting Trial Claims to check the OOP of a patient.

2. Project Name: ODPT - Online Drug Pricing Tool (Jan 2013 – May 2017)

Description: It’s a web-based application which helps the members get pricing and its low-cost alternatives for a selected drug from different interfacing applications. It will provide the members with the latest information on required drugs which will minimize calls to customer service call centers. Using the web service calls the ODPT gets the pharmacy and drug data from multiple source systems like Member information System (Carrier/Account/Group/Plan/Benefit), Client Benefit Information System, Drugs Information System

Environment: Java /J2EE 6.0, GWT 2.0.3 framework, External systems: AS400 backend, Microsoft SQL server 2008 R2/ORACLE 11g, Hibernate 3.2, Spring 2.5, Eclipse 3.5/RAD 8.0.

Scenario:

The Drug Pricing Tool is accessed by RxHD, ICUE and ISET applications. The user must pass the member information from the calling application. The user can search for the product with various search options. The dosage, frequency and quantity must be selected before the drug has to be priced. The tool uses RxClaim webservices to get the pricing information of the drug against mail order and retail pharmacies. It is a powerful tool where the user can price more than one drug at a time. The tool also enables the user to select the product based on the member drug utilization history.

3. Project Name: RxIVR - ANI Auth service for OptumRx IVR (Nov 2013 – Till Date)

Description: RxIVR is an authentication web service which is consumed by OptumRx MST and SPT IVRs to authenticate Users, Providers and Pharmacy.

Scenario:

· Ani Authentication Service (Web service): Ability to provide patient information based on ANI web service call for member, pharmacy, and provider.

· Member Details: Ability to provide member information based on ANI.

· Pharmacy Details: Ability to provide pharmacy information based on ANI.

· Provider Details: Ability to provide provider information based on ANI.

4. Project Name: Omni Channel OptumRx MST & SPT IVR (June 2017 – May 2019)

Description: The OptumRx MST & SPT IVR provides self-service capabilities to numerous clients daily. It provides the ability to fulfill refills on demand, provide status of various Pharmacy claims and allows for dynamic routing to several call center teams.

Environment: Java /J2EE 7.0, Eclipse Mars, Jenkins, Maven 3.x, Log entries, Git, Maven, Ant, Cisco ICM, Avaya Aura Experience Portal 7.x, Java Script, Nuance ASR 10.x, Nuance TTS

Scenario:

· The application will extend ANI lookup capabilities to the Member and Physician caller types. Member ID and authentication will be overhauled.

· Features include pro-active Mail Order alerts, adjudication/pricing for prescription refill and the Hassle-Free program.

· Member features will now be offered in Spanish. Physicians will be able to submit new Prior Authentication requests.

· This creates the ability to improve the caller experience that is simple, smart, and seamless.

5. Project Name: Omni Channel OptumRx IVR Genesys (June 2019 – Current)

Description: The Omni Channel OptumRx IVR provides self-service capabilities to numerous clients daily. It provides the ability to fulfill refills on demand, provide status of various Pharmacy claims and allows for dynamic routing to several call center teams.

Environment: JavaSE, JavaEE, JDK 1.6, JDK 1.8, Windows 7, Windows 10, NetBeans, eclipse, SVN, GIT, HP ALM, Tomcat Server, Design Pattern, Log4j, Putty, WinSCP, JUnit, Mockiato, , Nuance Framework, HP Fortify, Genesys framework, Splunk

Scenario:

The Optum RX IVR (Interactive Voice Response) application offers tailored self-service functionalities for members, providers, and pharmacies. After authentication, users can access specific services relevant to their role, ensuring streamlined prescription management and efficient communication.

Mentioned below are the some of the important features that the IVR offers as per the role.

· Member Self-Services: Refill Prescriptions, Renew Prescriptions, Order Status Inquiry, Coverage/Benefits, SMS enrollment.

· Provider Self-Services: Prior Authorization Status, New Prior Authorization, Member Order Status.

· Pharmacy Self-Services: Prior Authorization Status, Rejected Claims Status, Member Data

6. Project Name: Omni Channel OptumRx Voice Bots (June 2019 – Current)

The Azure Voice Bots for Omni Channel OptumRx offers a range of self-service capabilities to clients daily. It enables users to easily refill prescriptions, Order the available refills and check the prices of their drugs that ought to be added to their orders. Once authenticated, users can access specific services tailored to their need, ensuring efficient prescription management and seamless communication.

We have the following skill BOTs under Root BOT supporting the RxIVR’ s capabilities:

Roles and Responsibilities:

- Leadership and Team Management:

· Lead and manage a team of software engineers responsible for developing and maintaining the application.

· Provide guidance, mentorship, and support to the team members in their day-to-day tasks and career growth.

· Collaborate with other managers, stakeholders, and cross-functional teams to ensure smooth project execution and alignment with business goals.

· Foster a positive and collaborative work environment, promoting teamwork, innovation, and continuous improvement.

- Application Development and Maintenance:

· Oversee the development, testing, and delivery of new features and enhancements to the Azure Voice Bots application.

· Ensure that best practices, coding standards, and software engineering principles are followed throughout the development process.

· Collaborate with product owners, architects, and other stakeholders to gather requirements and define the application roadmap.

· Conduct code reviews, provide technical guidance, and ensure high-quality and scalable code is produced.

· Proactively identify and address technical challenges, performance issues, and bottlenecks in the application.

Technical Expertise:

· Stay up to date with the latest technologies, industry trends, and best practices in the field of voice bot development and self-service capabilities.

· Provide technical guidance and expertise to the team, including architecture design, system integration, and scalability considerations.

· Collaborate with other technical teams and subject matter experts to address technical challenges and ensure efficient integration with other systems.

- Project Management:

· Define project scope, timelines, and resource allocation in collaboration with stakeholders.

· Monitor project progress, identify, and mitigate risks, and ensure timely delivery of milestones.

· Establish and maintain project documentation, including requirements, specifications, and technical documentation.

· Communicate project updates, challenges, and achievements to stakeholders and senior leadership.

- Continuous Improvement:

· Drive continuous improvement initiatives to enhance the performance, scalability, and user experience of the Azure Voice Bots application.

· Promote innovation within the team by encouraging the exploration of new technologies, tools, and methodologies.

Identify opportunities for automation, process optimization, and efficiency gains in software development and delivery.