Sai Kotla

(Customers Kaiser Permanente, Risant Health)

Delivered time-critical multimillion-dollar programs to Healthcare customers.

• Drive platforms, including user management, administration, authentication, authorization, search, file systems, UX frameworks, data storage and encryption, public APIs, and developer tools in a B2B multi-tenant SaaS platform
• Develop Policies and Decision-making on Product vision and Road mapping implementations for AI/ML Digital Consumer Experience DCX team managing capabilities & shared services - Design System, Identity Access Management (Ada Health assessments, Dexcare - Patient engagement), Business Metrics Admin, Progressive Web Application. Squad mainly uses Data Analysis (predictive analytics, Pattern Recognition, Visualization), vision analysis (image & Video quality ), and speech recognition (voice assistants and transcription).
• Drive RFP winning Personalization & recommendation squad using AI/ML- LLM - NLP (text generation, Language translation, summarization, sentiment analysis, chatbots, and virtual assistants), Information retrieval (Answering questions, Knowledge based creation), Content personalization (Recommendations, Personalized Marketing) to serve experience products such as On-Demand-Urgent Care, Intelligent Triage, Outerdoor-Innnerdoor, Inbox management, Value Based Care Guidance, Clinical simplicity.
• Won contract that Integrates IoT devices like Philips IntelliVue and Medtronic Guardian Connect with EMR/EHR systems such as Epic and Cerner. Collaborated with Philips Healthcare and Fitbit for seamless, secure, and HIPAA-compliant integration using HL7 and FHIR standards. Also, implemented OneTouch Verio Flex Glucometer for At-Home and on-go blood glucose monitoring Enabled real-time data updates and continuous patient monitoring, significantly reducing hospital readmissions
• Delivered Clinical labs Supply chain Data Analytics and Executive reporting program with the charter increasing equipment utilization, reducing rental costs, Hospital Inventory management, improving recall processes, and better cost understanding. Squad used AI/ML for Decision support with IBM Watson expert system (Data integration, predictive analytics, recall) and simulation and Optimzation (Discrete Event Simulation, Agend-based modelling with Anylogic
• Won supplychain coordination project with 40+ diversified vendors providing clinical and non-clinical equipment for the three clinical lab regions, leading sourcing, procurement, logistics, and transportation, and maintenance - includes just-in-time business situations- ensuring regulation and compliance audits
• Won & Spearheaded delivery supply chain - workflows PMO initiatives in The Permanente Medical group on programs such as 4C profiling, implementing products ServiceNow, Sitecore, Tele-medicine Kiosks , Physician-Scheduler appointments, Digital-front-door, e-Consult (virtual visits), Digital companion.
• Won and Delievred LablinK portal project that enables Lab-decompression Program (clinical labs setup) to facilitate the network of 3000+ physicians and nurse practitioners- Histology, Cytology, Special Chem, Covid, Genetic, Microbiology, Diagnostics, etc.

• Spearheaded proprietary Healthcare Supply chain proprietary API-centric product platforms One stop Healthcare SCM & RPA Bot Scope (Automation Anywhere), and intelligent automation (IBM blue prism)- Product vision to Road mapping. The program concluded due to organizational-level M&A activities.

(Customer: Kaiser Permanente)

• Won NCAP RFP and Delivered cloud-based EPM (Enterprise Performance Management) product platform delivery to reduce costs, enable financial decision, evaluate financial asset & budgets performance, plan & track capital, capture healthcare Data Analytics, thus driving margins in National cost accounting system
• Implemented optimization of Medicare and Medicaid (Medi-Cal) programs to enhance service delivery and operational efficiency. Integrated advanced data analytics, member eligibility checks, enrollment processes, and benefits management. Managed vendors and cross-functional teams to ensure CMS and state compliance. Achieved significant reductions in claim processing time and errors, improved patient satisfaction scores, and realized cost savings through targeted interventions and process improvements
• Won & Delivered Technical migrations & Implementations such as Analytics 2.0 MS Azure Cloud implementations, National Cost Accounting, CDW-NPS (Claims dataware house to National Pricing Analytics, Teradata to Exadata, Abinitio-Informatica transition.
• Delivered migrations of Mainframe applications, data, and workloads from in-house systems to cloud infrastructure and services. SaaS migration moving applications from on-premise infrastructure to a cloud-based software-as-a-service (SaaS) model.
• Productized IDR (Integrated Data Repository) system integrating with ICD10 and Revenue Cycle management and processing high-volume data warehouse integrating Parts A, B, C, D claims, beneficiary and provider data sources, along with ancillary data such as contract information, risk scores to establish medical trend & utilization analysis, healthcare cost & Assessment, provider profiling & management, and keep the data available for claims-based program operational needs
• Track lead managing data wearhousing and analytics in assisting business teams reporting data to state DHCS and CHHS on Member eligibility, Claims, Services, Patient demographics, & Utilization information and Data Submission for Reimbursement to CMMIS via Healthcare bill format (HBF), Electronic Healthcare Claim (EHC), and Eligibility Verification (EV) transactions
• Delivered Decision Support tracks for KP Claimsconnect that implementing Epic Tapestry referrals, KP Healthconnect (EHR), & Member benefits for seamless referrals, tracks internal and external encounters, integrating claims processing with clinical, benefits , and referral information to report to California HPD (Healthcare Payment Database)
• Led Delivery of various initiatives implementing Teradata for data warehousing, Tableau & Power BI for data visualization and reporting, Apache Spark for big data processing and analytics involved in Group Health-KP Washington & Maui Health System mergers
• Won RFP & delivered the Cost Share Reduction program with buy decision implementing Acero claims double adjudication product platform.
• Won & Delivered on-time Affordable Care Act 3Rs initiaitives - Risk Adjustment, Risk Reinsurance, Risk Corridors. Implemented Datawearhousing, Data staging, Data refining, & Data analytics for Claims, Membership, & Pharmacy data to enable business & Actuaries to report to edge servers and CMS on-time.

Consultant & delivery collaborating with Pharma business teams to implement SAP ERP ECC 6.0 Supply Chain solutions, Siemens Opcenter, Oracle Demand Planner (Merck Pharmacy)

• Demand Forecasting & Production Planning
• Raw Material Procurement & Inventory Management (PMS) & SAP WMS
• Manufacturing Execution System (MES) for Batch Production & Quality Control
• Finished Goods Warehousing & Distribution to Wholesalers/Hospitals

Integrate SAP ECC.60 SCM with Windchill PLM (PTC), Ariba (SAP), Infor Nexus (Infor) for a Medical device manufacturing and distribution (GE Health)

• Coordinate with R&D and manufacturing teams for timely production ramp-up
• Manage regulatory submissions and approvals for new product launches
• Configured distribution channels and service support networks
• Balance inventory levels to meet demand fluctuations without excess stock by implementing demand forecasting models.

Headed CG’s strategic program for product partnerships and development with Cerner, Allscripts, SAP, and IBM in delivering solutions to various leading Healthcare customers. Portfolio P&L $5M (Bellflower Medical Center, LA county, Variety Health systems, Los Angeles Community Hospital)

• Revenue Cycle Management Systems
• Healthcare Analytics and Business Intelligence Solutions
• Patient Engagement and Experience Platforms
• Practice Management Software, Electronic Health Records (EHRs).

Managed PMO implementation and stabilization of various SAP SCM modules supporting the clinical trials using Interactive Response Technology(IRT) of Almac and Medidata (Johson & Johnson)

• Drug supply management by providing real-time visibility into inventory levels and ensuring efficient distribution to trial sites
• Timely and compliant transportation of clinical trial materials from production to trial sites, including temperature-sensitive shipments(SensorWorks)
• Aligning clinical trial material supply with forecasted demand, reducing the risk of stockouts or overstocking.
• Enable clinical team to ensure quality standards and regulatory requirements