Bhakti Mahato

Reduced total operational costs by 51%: Led 2023 initiative to lower the variable costs per unit (VCPU) to fill a prescription from $10.52 to $2.30, by automating the top 25 out of 62 common pharmacy claim rejections.

• Developed an automation framework using machine learning algorithms based on NCPDP guidelines to predict claim outcomes, improving efficiency by offering customers self-resolution options via the customer experience (CX) platform.
• Reduced manual labor efforts from 51% to 19%, achieving a 3,200 bps reduction by December 2023.

Improved order conversion by 6%: In 2024, launched a new version of the Amazon Pharmacy app, streamlining the purchasing experience and reducing friction in the order journey.

• Centralized buying options into a unified platform, resulting in a more efficient claim adjudication process and reducing the ordering steps from four to two.
• Reduced average order dwell time from 3 days to 1 day for 70% of manual orders, contributing to a 6% increase in monthly order conversion (from 250,000 to 265,000).

Launched Copay Assistance Program - Generated $120,000 in monthly cost savings for partnered health plans by integrating manufacturer contributions toward drug costs.

- Conducted competitive analysis to understand the execution of this program

- Developed a solution that accounted for manufacturer contributions towards drug costs, positioning the health plan as the final contributor.

Partial-Fill Dispensing for Controlled Substances Monitoring Program | Sep '21 - Jan '22 - The program automated the process of monitoring the partial dispensing of controlled substance drugs within the state-mandated limits for Medicare and Medicaid plans.

Designed and implemented an automated monitoring system for partial dispensing of controlled substances, ensuring compliance with state-mandated limits for Medicare and Medicaid plans. Achieved 100% accuracy in adjudicating prescription drug claims, contributing to $20,000/month in cost savings. Led research and development using NCPDP guidelines to create a program that pre-validated partial fills before dispensing medications, enhancing patient safety and regulatory adherence.

Drug Overdose Regulation Program | Sep ' 20 - Feb '21Developed and launched a fully automated Drug Overdose Monitoring Program, resulting in 95% time savings and $300,000 per year in cost savings.Utilized CDC and First Data Bank statistics to rationalize and define the program's problem statement, resulting in the rejection of 580,000 overdose claims while ensuring correct payment for allowable dosages. Executed product vision and strategy, creating a user-friendly interface that minimized overdose risk and met state-defined limits for drug consumption. Successfully delivered a solution that exceeded the Minimum Viable Product (MVP) requirements and demonstrated significant measurable impact on patient safety and plan savings.

Optimized Vascular Access Database, Reducing Query Time by 83% Redesigned the Vascular Access database from a link-rel schema to a star schema, reducing query response times from 30 minutes to 5 minutes.

• Identified inefficiencies by analyzing query times and logs, simplifying complex nested queries into streamlined joins.
• Migrated 15 reports and 7 applications on to the new schema, achieving a 83% increase in efficiency.

• Cloud Data Migration - Contributed to the enterprise database migration to public cloud using Microsoft Azure for clients that resulted in 40% cost savings.

• ACA Membership Acquisition (5/2016 to 12/2016) - Achieved product implementation of Medical and Dental products offered to Small Group (1-50), Mid-market (51-299) and Large Group (300+) market segments.

• One time daily process (09/2011 - 11/2011) - Daily process consumed enormous amount of CPU utilization by running for long hours