Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Lakshmi Movva

Summary

Dynamic Software Engineer with extensive experience at HM Health Solutions, specializing in Pega development and integration. Proven track record in enhancing application efficiency and compliance, while mentoring junior developers. Proficient in PRPC and SQL, with strong analytical skills to drive innovative solutions and improve stakeholder engagement.

Overview

13
13
years of professional experience

Work History

Software Engineer

HM Health Solutions, HM
Pittsburgh
11.2019 - Current
  • Implemented claims process application to assess prior authorization requirements effectively.
  • Worked closely with business team to identify needs for prior auth determination tool.
  • Facilitated integration of Pega with external systems for improved data flow.
  • Conducted root cause analysis, collaborating with development teams on resolutions.
  • Mentored junior team members while evaluating their capabilities and progress.
  • Developed SLA rules and escalation procedures to meet compliance criteria.
  • Engaged stakeholders and SMEs in requirements gathering, ensuring compliance with CMS mandates.
  • Directed project teams, aligning software application development with business objectives.

Senior Analyst

Thryve Digital
, India
08.2019 - 10.2019
  • Coordinated daily with onsite teams to ensure alignment and efficiency.
  • Led a team to address roadblocks and enhance problem-solving capabilities.
  • Executed client enhancements to meet business expectations consistently.
  • Participated in stand-up calls to monitor issues across all project phases.
  • Engaged in daily calls with implementation partner leads to resolve challenges.
  • Contributed to deployment processes and conducted peer code reviews.
  • Supported defect fixes across all releases to maintain quality standards.
  • Involved in development tasks and unit testing to validate solutions.

Application Developer

HM Health Solutions
Pittsburgh
09.2016 - 05.2019
  • Developed and implemented Guardrails component to enforce adherence to Pega recommendations.
  • Coordinated daily with offshore teams, providing guidance and resolving technical challenges.
  • Performed root cause analysis for technical issues, ensuring future corrective measures.
  • Maintained compliance with Pega Guardrails while delivering defect fixes and enhancements.
  • Engaged with business team to propose effective designs for new functionalities.
  • Participated in DCO sessions, aligning technical capabilities with business needs.
  • Interacted with clients to ensure accurate implementation of new requirements.
  • Oversaw deployment activities, including thorough code reviews of offshore work.

Application Developer

G3Infotek
Pittsburgh
03.2016 - 09.2016
  • HM Care Management Solution organizes all sets of Activities Designed to manage and improve the Health & Quality of Life of a Member
  • Main objectives are to improve health outcomes, reduce the cost of a member’s treatment, increase member satisfaction, and comply with requirements.
  • The main business objective is to produce the ability to manage admission cases with concurrent medical review and discharge planning, manage admission notification, design and deliver accelerators to set up program and care plan components, design and deliver accelerators to set up assessment questionnaires and components, and conduct interactive post-discharge care planning.
  • Responsibilities:
  • Coordinating with offshore daily and working with them.
  • Involved in design discussions.
  • Mostly involved in development work, and defect fixes.
  • Working with offshore teams if they have any issues, and helping them to resolve those.
  • Participating in stand-up calls and knowing the issues in each phase.
  • Involved in deployment and conducting code reviews for the code from offshore.
  • Participating in daily calls with implementation partner leads, managing resources, and handling the issues.
  • Monitoring offshore teams by giving inputs from clients and getting them to work.

Pega Developer

G3Infotek, Cahaba GBA
Birmingham
05.2015 - 01.2016
  • Cahaba GBA provides innovative and cost-efficient administrative services as the Jurisdiction J Medicare Administrative Contractor (MAC) to the Centres for Medicare and Medicaid Services (CMS)
  • In this capacity, Cahaba processes Part A and Part B Medicare claims for providers in Alabama, Georgia, and Tennessee
  • With a long history as a Medicare contractor, Cahaba continues to provide exemplary service to ensure that beneficiaries receive the care they need, that the providers who serve them have their claims adjudicated accurately and timely, and that funds from the Medicare Trust Fund are used appropriately
  • Cahaba is a wholly owned subsidiary of Healthcare Business Solutions, LLC (HBS)
  • Responsibilities:
  • Part of up-gradation team to upgrade 13 applications from PRPC 5.4 to Pega 7.1.6
  • Actively involved in converted deprecated controls to latest controls
  • Converted all non html5 code to html5 complaint code
  • As previous version projects were mainly custom coded using pega declaratives, JavaScript and html, converted all custom sections into automated ones
  • Converted all harnesses, previous portals into composite portals
  • Used all the latest Pega 7 features to make an application and UI responsiveness to access the same across different devices
  • Converted all list views into Report definition rules with better charts
  • After basic up gradation, part of the team to test the application in CIT environment
  • After successful implementation in SIT, part of core team to take application to live for end business users
  • Worked on circumstance rules to parameterize the common rules among different workflows
  • For enhancements, created activities, when rules, declarative and decision rules
  • Performed Web Service integration of the application with Legacy Systems using Connect- Soap and Connect – SQL
  • Creating New Rule Set Versions and applications
  • Good at using SMA for monitoring PEGA logs, errors and other alerts types
  • Formulated process and business rules and generated ad-hoc and scheduled reports by customizing the framework
  • Debugged issues logged in Spira Team Application (Bug Tool) and fixed performance issues using PRPC tools such as Tracer, PAL, SMA, and Clipboard in troubleshooting applications and for memory usage
  • Environment: Pega PRPC V5.4, 7.1, IBM DB2, Web sphere, HTML, JavaScript
  • G3Infotek

PEGA Developer

Ameri Group
02.2015 - 05.2015
  • Next Gen Appeals or Medicaid is an internal application in Anthem Group where we have two more applications like Medicare and California Medicaid for health insurance
  • In all applications we must use the intake tool to take the data from user and we have to see what plans are applicable to the user
  • Medicaid is available in all states except California so now we are developing California Medicaid
  • FACETS are internal storage where we have member, provider, claim and auth details for all states except California
  • So, for California we have to take information from other sources or by pulling existing systems (not facets) we can migrate Medicaid data to California
  • Based on type of data we have different work types like grievance, appeal, Inquiry
  • By collecting all data from the user and after entering it in intake tool we can know whether the appeal type HP appeal or claim appeal
  • Appeal will be created based on the information user gave in the intake tool
  • Responsibilities:
  • Client interaction to implement the new requirements/enhancements
  • Involved in GO-LIVE phases
  • Interacted with the business team to understand the requirements and developed according to the requirements
  • Involved in Bug Fixing Activities with Lead and System Architects for Harness, Declare Expressions and When Rules
  • Involved in fixing the defects and writing the test cases
  • Participating in stand-up calls and knowing the issues in each phase
  • We need to have valid id to populate member’s general information along with their Eligibility records
  • Appeal type can be Health plan or claim type, so we must be very careful while taking data
  • In appeal type we have letter selection based on user decision, for that letters we must develop the acknowledgment letters or member letters or claim letters using paragraph rules
  • Involved in developing the letters using paragraph rules based on application and rule set versions
  • Used decision table to map the paragraph rules based on languages
  • Involved in developing the functionality for facets in all applications
  • Handling, assigning, delivering defects
  • Created User Interface, Activities, Attended daily scrum calls
  • Building flows, UI, and basic design based on the requirements captured in DCO
  • Developing sections, flow actions and Harness Rules
  • Played a major role in writing activities as per the business logic
  • Supporting to the defect fixes in all the releases
  • Involved in Development and Unit testing.

Associate Software Engineer

Igrid technologies
Hyderabad, India
06.2012 - 07.2013
  • There are seven different types of transmitters the company manufactures, and each of them is again categorized as 'A'-series or 'C'-series.
  • Each transmitter has a set of 15 specifications, and each specification can assume any value from a set of properties.
  • The combination of these specification codes defines a transmitter.
  • Once the code for the transmitter is generated, a quotation form and an order form are generated.
  • There are seven different types of transmitters the company manufactures, and each of them is again categorized as 'A'-series or 'C'-series.
  • Each transmitter has a set of 15 specifications, and each specification can assume any value from a set of properties.
  • The combination of these specification codes defines a transmitter.
  • Once the code for the transmitter is generated, a quotation form and an order form are generated.
  • Responsibilities:
  • Designed and developed Java programs using JDK 1.1.
  • Designed web pages using HTML, DHTML, and JavaScript for validations.
  • I wrote Java classes, which help in generating the necessary flat files.
  • Created the required web images using Microsoft Animator, Microsoft Image Composer, and Paint Shop Pro.
  • Involved in interacting with the user, and designing the module.
  • Involved in converting the static wireframes to JSP and Servlets.
  • Database-level interactions are developed using JDBC.
  • Involved in tracking, reviewing, and analyzing bugs by using defect tracking.
  • Distributed Java programming is developed using RMI (for calling remote objects).
  • Front-end user interface design prototype is developed using JSP and UML.
  • Created the required web images and developed prototypes.
  • Trained on the Pega tool.
  • Debugged issues logged in the CleraQuest application and fixed performance issues using PRPC tools such as Tracer, PAL, SMA, and Clipboard in troubleshooting applications.
  • Worked on activities when rules, declarative, and decision rules.
  • I completed unit testing after fixing the defects.
  • I attended daily team calls for a better understanding.
  • Worked on developing sections, flow actions, and harness rules as per business.

Education

Master of Science - computer engineering Computer Engineering

University of Houston Clear Lake
Houston, TX
01.2014

Bachelor of Technology - Electronics and communications

Koneru Lakshmaiah College/Nagarjuna University
01.2012

<ul><li>PRPC Certified System Architect</li><li>PRPC Certified Senior System Architect</li></ul> -

Skills

  • Technical skills
  • BPM tool
  • PRPC 54, 62 sp2, 63 sp1, 71, 8x
  • Design tools
  • XML, HTML, CSS
  • Other tools
  • Toad, SQL Developer

Additional Information

  • Proficient in Pega Implementation life cycle. The Implementation cycle includes modeling of business process, PRPC tool installation, development, testing, and deployment. Developed Activities, Data Transforms, Decision Rules, Declarative Rules, When Condition, Process Flow and User Interfaces like Harness & Section. Experience in troubleshooting & performance tuning of PRPC applications using Clipboard, Tracer, PAL and DB Trace. Proactively monitor systems in PDC and Dynatrace to address potential outages and perform post-release checkouts to ensure uninterrupted business operations Strong expertise in UI, Process flows, Caching, Rule resolution, Activities. Experience in end-to-end software development lifecycle (SDLC) including Analysis, Design, Development, Testing, Implementation, Maintenance and Support. Experience in Design of the Data Model of applications. Experience in defining class structure and hierarchy, based on PEGA best practices and guardrails, configuring agents, connectors, data model, process flows, business logic definition, SLA, user interface Design, QA, Case Management, Dynamic Class Reference (DCR), Pega Pulse and Performance Tools. Extensively used Connectors and SOAP Services in Pega PRPC to integrate with external systems. Develop a deep understanding of the end-to-end architecture of supported applications, and contribute to the improvement of development processes, tooling, and software architecture. Design and development of SOAP connectors for interacting with external web services. Implementing application using Pega Case Management/Workflow

Timeline

Software Engineer

HM Health Solutions, HM
11.2019 - Current

Senior Analyst

Thryve Digital
08.2019 - 10.2019

Application Developer

HM Health Solutions
09.2016 - 05.2019

Application Developer

G3Infotek
03.2016 - 09.2016

Pega Developer

G3Infotek, Cahaba GBA
05.2015 - 01.2016

PEGA Developer

Ameri Group
02.2015 - 05.2015

Associate Software Engineer

Igrid technologies
06.2012 - 07.2013

Master of Science - computer engineering Computer Engineering

University of Houston Clear Lake

Bachelor of Technology - Electronics and communications

Koneru Lakshmaiah College/Nagarjuna University

<ul><li>PRPC Certified System Architect</li><li>PRPC Certified Senior System Architect</li></ul> -

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