Karthik Subramanian
Naperville,IL
Summary
A leader in healthcare payer domain with extensive product development experience. Experience working in both Business and IT organizations focusing on value realizations and delivery
Overview
28
28
years of professional experience
1
1
Certification
Work History
Manager, IT Operations (BlueCard Modernization, Operations)
Blue Cross Blue Shield Association
01.2024 - Current
- Responsible for overseeing the migration of ITS SaaS Plan Profile Application to AWS cloud
- Management of external data connectivity and exchange
- Creates and maintains metrics for project team and Sr
- Leadership
- Establishes strategy through an integrated portfolio to measure product implementation success
- Creates and manages Release calendar, cadence, for feature delivery
- Spearheading AWS service cost optimizations, saving $15k+ in monthly costs across multiple Applications
Technical Lead (BlueCard Modernization, Clinical Data Exchange)
Blue Cross Blue Shield Association
01.2021 - 12.2023
- Played a key role in leadership discussions on Build vs Buy strategy for modernization initiatives
- Led the full lifecycle delivery of Clinical Data Exchange (CDE) interoperability solutions for ADT (CY 2021) and CCDA (CY 2022) employing HL7, FHIR standards
- Developed strong guiding principles to align priorities and ensured transparent project status reporting to maintain a strong business partnership
- Actively led Scrum team activities with business stakeholders for help realizing business case and ensuring a successful product delivery
- Enforced rigorous security standards, including vulnerability tests and code scans, for all releases
Business Design Manager, Value Based Care & Consumer Transparency
Blue Cross Blue Shield Association
03.2013 - 12.2020
- Led a dedicated team to develop and implement BCBS Axis Cost Data solution, improving cost transparency for 100M+ members
- Managed policy and advocacy responses for federal transparency regulations (Transparency in Coverage Proposed Rule)
- Developed a fee-for-service payment model enhancing provider reimbursements based on patient service outcomes
- Partnered with the BCBSA UX team, developed, and curated Open Enrollment member personas
- Drove a 10% YOY reduction in vendor management expenses through strategic contract negotiations
Business Solutions Lead
Blue Cross Blue Shield Association
10.2004 - 03.2013
- Spearheaded the development and implementation of CAQH CORE Phase I and Phase II requirements
- Chaired industry workgroup to enhance inter-Plan transactions and provider services for HIPAA ANSI X12 standards
- Managed ITS software release cycles, ensuring compliance with BCBSA proprietary claims processing
Delivery Manager, Product Development
Independence Blue Cross (IBC)
03.2002 - 10.2004
- Consulted on Enterprise Data Interchange (EDI) initiatives, optimizing provider claims integration
- Led implementation of federally mandated HIPAA 4010 for Institutional and Professional claim transactions
Oxford Health Plans
Connecticut, USA
01.2001 - 01.2002
Pacific Internet
Singapore, Singapore
01.1999 - 01.2000
System Access Pte. Ltd
Singapore, Singapore
01.1998 - 01.1999
NewMark Technologies
Bangalore, India
01.1997 - 01.1998
Education
Bachelor of Science - Mechanical Engineering
Bangalore University
BangalorePost-Graduation in Diploma - Computer Applications
Software Solutions Integrated
Skills
- Product Management
- Health care Industry Standards (X12, FHIR, HL7)
- Consumer Cost Transparency tools
- Value Based Care products
- Business Analysis and Process design
- Product Lifecycle development (Waterfall and Agile Delivery)
- Financial Stewardship
- Leadership
- People management
- Mentoring
- Coaching
- Customer Relationships (BCBS Plans and Vendor Collaboration)
- Vendor management (RFP, Vendor Selection, Contract negotiation and Statement of Work creation)
- Technical Expertise
- AWS serverless technologies
- API Management
- IT Operations
Certification
- Certified (Coursera) GenAI Program Manager
- Certified HL7/FHIR Professional
- Certified AWS Cloud Practitioner
- AWS Well-Architected Best Practices Certified
- Certification Innovation Activator Professional
- Certified Consumer Experience (CX) Professional
- Certified Agile Product Management and Business Product Lifecycle Management Professional
Recognitions
- BCBSA Presidents Team Award Winner, 2017
- BCBSA Presidents Team Award Winner, 2019
- BCBSA Presidents Award Winner, 2013
Timeline
Manager, IT Operations (BlueCard Modernization, Operations)
Blue Cross Blue Shield Association
01.2024 - Current
Technical Lead (BlueCard Modernization, Clinical Data Exchange)
Blue Cross Blue Shield Association
01.2021 - 12.2023
Business Design Manager, Value Based Care & Consumer Transparency
Blue Cross Blue Shield Association
03.2013 - 12.2020
Business Solutions Lead
Blue Cross Blue Shield Association
10.2004 - 03.2013
Delivery Manager, Product Development
Independence Blue Cross (IBC)
03.2002 - 10.2004
Oxford Health Plans
01.2001 - 01.2002
Pacific Internet
01.1999 - 01.2000
System Access Pte. Ltd
01.1998 - 01.1999
NewMark Technologies
01.1997 - 01.1998
Bachelor of Science - Mechanical Engineering
Bangalore University
Post-Graduation in Diploma - Computer Applications
Software Solutions Integrated
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