Bhakti Mahato

Reduced total operational costs by 51% (Cost-to-fill reduction): Led the 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 a self-supervise learning model that intelligently identifies Days Supply rejection reasons, and resolution methods by using historical data and learning algorithms. The model learns and evolves over time utilizing the best method to approve rejections without human intervention, leading to 100% accuracy and 97% efficiency.

- Through this model, reduced manual labor efforts from 51% to 23%, achieving a 2,800 bps reduction by December 2023.

Improved order conversion by 6% (Launch of Unified Buying Layer): In 2024, launched a new version of the Amazon Pharmacy application integrated with UBL, a new centralized platform, streamlining the purchasing experience and reducing friction in the order journey.

- Centralized eligibility, price offer, and claim APIs onto a new tier-1 NAWS Coral API service - UBL, hosted on HEX-AWS.

- Removed redundant API calls, achieving cost efficiency of 34% and reducing the shopping time by 50% (from P50 14s to 7s).

- 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.

Launched 1-click intake process reducing intake creation from 7 minutes to 5 seconds: In 2025, enabled 1-click intake for AWS sellers to engage with the AWS program teams to expedite deal velocity.

- Created an prompt-based interactive experience using Amazon Bedrock and Q to synthesize user responses and using historical and customer data, auto-generate intake form.

- Using RAG framework, created a conversational experience with providing relevant resources and links.

Interoperability for healthcare (2022) - Designed and launched a cloud-based product enabling secure, seamless access, exchange, and transfer of patient health information across all devices and locations.

- Using Fast Healthcare Interoperability Resources (FHIR HL7 v2) framework, built a secure network that integrates EHR systems with cloud platform through private APIs - patient access API and provider access API.

- Provided secure single-sign on access to patients and providers on their computer or handheld devices through tokenized session authorizing using OAuth 2.0 + SMART on FHIR.

- Provided secure connectivity to developers through SWAGGER APIs.

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 drug monitoring system for partial dispensing of controlled substances using rules engine that conducts checks on dispense limits, patient history, and timeline.

- 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.

Optimized Vascular Access Database, Reducing Query Time by 83%. Revolutionized the Vascular Access database structured on a complex linked relationship model (link-rel) to a simplified snowflake schema, that reduced query response times from 30 minutes to 5 minutes.

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

- Developed programs for Humana Vitality using Mainframes and DB2.

- Developed reporting by using ETL tools Informatica and SSRS.