Praveen Kumar K

• Responsible for analyzing business processes with Business SME’s, identify automation opportunities, define RPA value proposition, reengineer process to improve automation potential and recommend RPA approach/strategy across different applications like payroll, customer service and accounting.
• Identifying opportunities for RPA using Opportunity Assessment tool across different service lines of Financial Service Center.
• Documenting As Is and To Be artifacts for the RPA and Pega.
• Designing automation case flow for use case as a part of COE for the business processes identified for RPA.
• Working with business stakeholders to understand the productivity impact of the automation and business priority for RPA process with process Assessment, ROI Assessment, feasibility, and complexity analysis.
• Support proof-of-concept automation solutions to demonstrate the viability of automation in client environments.
• Document the automation flow process in functional specification document and elaborate to epics, features, and user stories.
• Support Cloud team to capture the requirements with technical specifications to migrate the On Prem projects to Pega PaaS.
• Responsible for facilitating business design work sessions, documenting gaps in different business processes, and designing a new business process.

● Responsible in gathering requirements and documentation using use case specifications for a government-contracted healthcare program – Risk Adjustment Data Validation (RAD-V) and Online Submission (OLS).
● Conducting DCO sessions, Focus Group Interviews and Discovery Workshops with Product Owners for Requirements Elaborations and documentation in the form of User Stories, Business Rules, Data specification, Workflows and Screen mockups leveraging Pega OOTB features. Educate Product Owners on Pega OOTB features and ensuring requirements efficiently leverage the Pega OOTB features.

● Hands on experience using the OOTB features such as User Admin, In-bound correspondence.

● Created work type process workflows and local action workflows in PRPC.

● Created and edited case flows and build mock up screens using Process modeler
● Responsible for documentation of ‘As Is’, ‘To Be’ and articulate them to the impacted users and delivery teams.

● Used Contour for writing Epic, user stories with use cases and uploaded them to SharePoint.
● Responsible for conducting JAD sessions with business users, SME’s and System Architect and capture the backlogs in Agile system.

● Participated in weekly status meetings, walkthrough and documented the proceedings through Excel and upload it to SharePoint and Contour.

● Responsible for conducting Client, Product owners’ meetings for anticipation of possible issues and communicating back to the team.

● Created and managed project templates use case project templates, requirement types and traceability relationships in Contour.
● Used Postman and REST service testing for the payload on OLS project from DocuSign. Responsible for Database Testing and Data retrieval by writing SQL queries.
● Hands on experience with documentation of production implementation plan.

• Stake holder interaction: Business need analysis and Scope Definition for Clinical and support service departments.
• Requirement elicitation: Collaborate with Clinical and ancillary Users for Identification of use cases.
• Requirement rationalization: Communicate the expectations gathered from the business from the system to the development team, in form of systems requirement.
• Prioritize & Trace Requirements: Prioritize the functionalities to be implemented based on the complexity rating & relevance.
• Manage Functional Changes: Configuring the system as described in the business requirements.
• QA & Test strategy: Testing Strategy -in collaboration with project stake holders, confirming if the system is fulfilling the requirements.
• Training Application Users: Provide training to users of different modules . Help in building the paper based and electronic training material for clinical and support modules of the information system.

• Analyze health insurance data (costs, utilization, fraud) and generate reports.
• Identify areas to improve efficiency and reduce costs in healthcare processes.
• Recommend changes to plans, networks, or reimbursement policies.
• Gather business requirements for new systems or process improvements.
• Collaborate with various departments and communicate findings to both technical and non-technical audiences.
• Stay updated on healthcare regulations and industry trends.
• Utilize data analysis tools and potentially have knowledge of healthcare coding systems.

• Functions as a liaison between Production Technology, Account Management teams and business clients in gathering, defining and understanding client’s needs.
• Collaborate with Supervisor, Subject Matter Experts, Product Managers to find the best approaches to address the client’s requirements.
• Development of business process and technology to support Medicare Claims, Care Management and Medicare Risk Adjustment.
• Experience in developing requirements and performing system analysis.
• Experience with managing and or implementing Claims systems and technology.