Summary
Overview
Work History
Education
Skills
Timeline
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Sowjanya Athmakuri

Sanford,FL

Summary

Www.linkedin.com/in/sathmakuri


The Top 5:

ASQ Certified Six Sigma black belt operations excellence leader with over 17 years of extensive IT experience.


Over Fifteen years of Pharmacy Benefits Management Healthcare experience specializing in Medicare Part D supporting clients CVS, AETNA, HealthNet, Universal American Corp, Member Health LLC.


Extensive experience in Medicare Enrollment applications such as Facets, FAZAL, Market Prominence.


In-depth expertise in Eligibility, Fulfillment, Subscriber, Billing healthcare modules.


Distinguished Toastmaster with excellent interpersonal, communication skills.

Overview

20
20
years of professional experience

Work History

Head of Operations

CVScaremark
05.2014 - Current
  • Over 15 years of Pharmacy Benefits Management experience specializing in Medicare Part D enrollment operations
  • Within CVS Health Medicare Part D project, responsibilities involve running 24/7 cross functional team that manages and executes production schedules with over 200 jobs per day
  • I am responsible to meet and exceed CMS (Center for Medicare and Medicaid Services) Service Level Agreements for Med D project. I ensure projects adhere to Compliance regulations while catering to CMS memos and software deliverables.
  • Within this role, I have delivered several multi-million-dollar projects for Annual Enrollment Period (AEP) to our business partners and contributed to the growth of CVS Medicare business
  • I oversee the Configuration and Enrollment batch IT operations project delivery, workflow development & execution, service assurance, and operational support
  • CVS Caremark has over 5 million active Medicare Part D members hosted on vendor application. I run enrollment, eligibility, billing, correspondence, and several other critical member information services within Facets

Consultant

Computer Science Corporation, Infosys
07.2003 - 05.2014
  • Analyzed problematic areas to provide recommendations and solutions.
  • Delivered outstanding service to clients to maintain and extend relationship for future business opportunities.
  • Managed multiple deadlines across several businesses to meet dynamic needs of multiple clients.
  • Created and developed detailed work plans to meet business priorities and deadlines.
  • Led the technical team for Conversion project in which 1.2 Million PrescribaRx members and related membership data has been converted from legacy Facets 4.21 (SQL Server database) to Facets 4.31 (Oracle 10g database)
  • Designed and programmed the billing extract project which spits out invoices that are to be mailed to members every month.
  • Gathered requirements, designed and developed a complete automated program to process the monthly LICS file obtained from CMS into Facets database.
  • Involved in enhancing TRR engine (Transaction Reply Report) which processes all changes to member eligibility in the database.
  • Serving as a senior analyst and technical architect, led the “SLA project”, one of the key projects in the program. The project aims at measuring critical and non critical SLAs of various member attributes.

Education

Bachelor of Science - Computer Science And Engineering

Kakatiya University
Warangal, India
06.2003

Skills

  • Pharmacy Benefit Management
  • Medicare operations Management
  • Regulatory Compliance Management
  • Enrollment Operations
  • Schedule Management
  • Business Forecasting
  • Performance Improvement
  • Customer Service Management

Timeline

Head of Operations

CVScaremark
05.2014 - Current

Consultant

Computer Science Corporation, Infosys
07.2003 - 05.2014

Bachelor of Science - Computer Science And Engineering

Kakatiya University

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Sowjanya Athmakuri