HARIT KAUSHIK

At Prime, I am currently working in Rebates-IT team. Rebates IT supports Prime's business partners through a single application called Prime One. Job duties include-

• Current State vs Future State Process Flow diagrams and documentation creation for business and IT.
• Data Analysis by querying database to build a business use case and system rules/constraints.
• Perform and facilitated where applicable User Acceptance Testing with business.
• Use case analysis with business and IT, documenting various scenarios impacting current system due to future state requirements.
• Creation of wireframes for providing UI changes to development team part of the artifacts.
• Introduced error handling validations and designed system-based constraints.
• Provide functional and technical solutions to key business problems outlined by the stakeholders.

Optum has built a community care network for the eligible veterans so that they can receive the needed medical services at a provider close to their location. The VACCN team handled data transfer of files between the VA medical center and other hospitals. Following were some of the job duties:

• Elicit requirements capture and summary documents creation explaining the functionality to operations team.
• Test stored procedures and other system functionalities in the TEST and STAGE environments via SQL queries.
• Create positive and negative use cases for performing system testing of the code in TEST and STAGE environments.
• Provide QA support in end-to-end testing of the code in Provider train with upstream and downstream partners.
• Create postproduction IT support technical playbook for troubleshooting issues in the system after project is live.
• Design swim lanes for continuous delivery and continuous integration DevOps based model of deployments.
• Implement new solutions for the automation of tedious manual processes for quicker and efficient deployment.

Medica Health, a mid size MN company was implementing the claim processing for few big healthcare providers from their legacy system to Medica Health Processing System (MHPS). On this platform, medical and certain dental claims will be adjudicated. I was involved in this project from the early project planning phase to hard code freeze on Benefits & Claims team and performed following job duties:

• Captured requirement documents defining the service codes and diagnosis codes for corresponding service categories under the benefits section on MHPS platform
• Created swim lanes and control points for the new processes consulting with appropriate business subject matter experts.
• Provided excel based solutions for particular ad hoc necessity like multiple plan document analysis and structure SharePoint
• Setup new Payor_Id for Mayo client with other claims adjudication rules
• Assisted in benefit configuration within HealthRules.

UHG (Optum), I got an opportunity to work on Payment Engine (PE) and ICUE team as Business Systems Analyst. While at Payment Engine team, required lot of communication with business and IT. The work in the ICUE team was more towards technical analysis and testing. Job duties assigned -

• Capture requirements from Business and help create the PRD (Project Requirement Document) clearly defining the need and interfacing applications including Payment Engine, TOPS and PSFE
• Created Web Service and Online Change Before Issue AI Spec with the design and logic to perform a CBI via web service once request arrives.
• Obtained familiarity with REST API and creating technical specification for such capability
• Utilized SOAP UI for functional testing web service call and response developed for the Conductor.