Pramod

E-mail : pramodpega2244@gmail.com
Mobile No: +919515653144

PROFESSIONAL SUMMARY

 5+years of IT experience, including 3+ years of experience in Design and development

of Business Process Management (BPM) and Business Rules Engines
(BRE) applications using Pega Rules Process Commander (PRPC)with good exposure in
Health Care,Manufacturing,Banking domains.
 2 years of Java/J2EE and Internet/Intranet based experience as onsite/offshore Technical,
Software Engineer in Java/J2EE projects.
 Excellent hands on experience on PEGA PRPC 6.x versions.
 Experience in pega 7.x Version.
 Implementing the Business Requirement by following the Pega best practices
 Implementation on Flows and Activities
 Implemented business rules using Decision Tree, Decision Table and When rules.
 Designed and implemented user interfaces using Sections, Harness and Flow Actions rules
 Used declarative rules like Declare Expressions and Declare Onchange.
 Worked on Integration Services File Listener and Email Listener Rules.
 Extensive debugging Skills in PRPC using with TRACER, Clipboard, and Rules Inspector.
 Worked on integrating External applications through SOAP connector.
 Experience in case management.
 Strong analytical skills, Capability to deal with ambiguity and Patience and strong
determination are some of his strengths. A good team-player with excellent team building
skill.
Professional Experience

 Working with Accenture from June 2015 to Till Date.

 Worked as a Software Engineer for UnitedHealth Group Information Services Pvt. Ltd, from Aug
2012 to June 2015.

Educational qualification

 B.Tech computer science engineering with 75%.

Certifications:

 Certified System Architect in PRPCV6.2 SP2 from Pega Systems, USA.

 Certified Senior System Architect in PRPCV6.2 SP2 from Pega Systems, USA.
Technical Expertise

BPM Tools: Pega PRPC V7.x/6.2

Operating Systems Windows 95 / 98 / NT / 2000/XP,UNIX

Java Technologies Java,J2EE,JDBC,Servlets,JSP

Languages: C, C++, XML, SQL, PL/SQL

Design Tools: MS Visio, UML

Web Technologies: HTML, JavaScript, CSS

Databases: Oracle 10g/9i, SQL Server.

App/Web Servers Tomcat, IBM Websphere

Project #1

ProjectTitle ELDT(Enterprise Learning Development Tool)

Client Bank of America(BOA)

Environment PRPC 7.3, IBM Web Sphere, ORACLE

The ELDT is the end-to-end system to trace potential learning needs from inception to
delivery. The new ELD Transformation tool allows for my learning plans to be managed
through an automated process flow from creation to Approval.Previously,my learning plans
for each employee or group of employees were governed, created and approved manually,
through spreadsheets then loaded into the my learning portal for employees to complete.

Responsibilities:

 Understanding the business requirements and involved in the estimations of the

task.
 Implemented Activities, User interfaces, Workflows, Decisions, Declarative rules,
reports in various projects.
 Involved in Creation of validation rules to implement business logic validation and
expressions using expression builder
 Worked on various enhancements.
 Worked on process improvements for the project. Involved in AUTCG tool configuring
and issues fixing .
 Good skills in Relational database application development using SQL server and
Oracle.
 Worked with Clipboard and Tracer for troubleshooting the issues.
Project #2

ProjectTitle Cisco Systems, Inc. USA

Client Test and Report Generation Application

(TARGA)
Environment PRPC 7.1, IBM Web Sphere, ORACLE

The TARGA application is used to test the Equipements developed by Cisco to meet the
global and regional quality and compliance standards. This requires a complex workflow
model so That various teams can do individual testing that can later be collated and
presented as a Compliance Report .

Responsibilities:

 Understanding the business requirements and estimating the User Stories

 Developed web based User Interface using Sections, Harness and flow action rules
 Good experience in writing Activities, Data Transforms ,Validate rules
 Created Skins for better look of User Interface
 Fixed issues raised or identified in Remedy tool
 Worked on the CR’s and Requirements
 Involved in the agent monitoring Activities
 Involved in Production Health checks activity.
 Experience in code migration activities.

Project #3

ProjectTitle Coverage Review and Determination(CRD)

360
Client Express Scripts

Environment PRPC 6.1 SP2, IBM Web Sphere, ORACLE 10g

Description:

Express Scripts Holding Company is the largest pharmacy benefit management

(PBM) organization in the United States.
Express Scripts provides integrated pharmacy benefit management services including
network-pharmacy claims processing, home delivery pharmacy services, specialty pharmacy
benefit management, drug-utilization review, formulary management, and medical and drug
data analysis services to manage drug plans for health plans, self-insured employers and
government agencies (both as administrator of employee benefits and public assistance
programs).
Coverage 360 is an application that determines whether a certain medication or dosage will
be approved or denied for patient depending on the coverage program (insurance plan) he
is in.
 Since some medications are expensive or not safe and it needs approval from
provider. Priorauthorization(PA) is needed inorder to check whether this drug or medication
is fall under this period of time, with this quantity, or is it within the coverage program. This
will impact the distribution of claims, thus less spending on drugs that are really not needed
by the patient, nor is covered by the insurance plan he/she is under.

Responsibilities:
 Analyzed the requirments.
 Fixed issues raised or identified in Remedy tool.
 Modified the Logic As per the fix.
 Involved in the CR’s and Requirements.
 Involved in the agent monitoring Activities.
 Sent RCA and Impact analysis of the issues.
 Analysis on Production logs daily basis
 Issues solving with the help of TRACER, Clipboard, and Rules Inspector.
 Involved in code migration from Development –UAT- Production.

Project #4

Project Title Cosmos Review Service.

Client United Health Group

Environment PRPC 6.2 SP2,ORACLE

Role Developer

Description:
Cosmos is the legacy system in UHG which handles Medicare & Medicaid claims.
These claims are tagged with certain Reviews (like 2043, 2086, 415, 603, 655, 657, 019,
75) which stop the claim from getting auto adjudicated at COSMOS. All such claims which
generate reviews will be pushed to the manual processing for adjudication.
All the claims which are pushed to the manual processing will be handled by the CRS
developed in PRPC and if the claim meets certain set of conditions, the CRS will clear the
reviews on the claim. Resulting in reduced human intervention, increased auto adjudication
rate and increase in quality of the service. During the review clear process, CRS will interact
with external systems to enrich claim data, validate authorizations of member and provider
information. On fetching required information CRS applies the configured business rules to
the clear the reviews on claim.
Roles and Responsibilities:
 Analyze the requirments.
 Modified the existing flow to meet the requirements.
 Developed Harness, Sections, Portals, Decision rules, Declarative rules, Connect-
SQL, Activities, Agents, Reports in application.
 Implemented the Integrations module that involved interaction with external systems
using integration connectors.
 Worked on Integrations.(Connect SOAP )
 Worked on Agents
 Issues solving with the help of TRACER, Clipboard, and Rules Inspector.
 Involved in code migration from Development –UAT- Production.
 Implemented Change Requests.
 Validating claims in production post deployment.

Project #5

Project Title
Provider management system
Environment Java (JDK 1.6), HTML,CSS, JSP, Servlets, JavaScript, Struts,
Hibernate, Windows XP, Oracle 10g database,
Oracle Web logic 10.3.

Streamline interactions and eliminate complexity in order to reduce administrative expenses,

establish trust and become the payer of choice. Deliver a centralized security for management
of Provider applications. Combine existing functionality for authorizing currently active admins
from UHC Online and build a new User Interface unique for Provider Touchpoint program .

Roles and Responsibilities:

 Requirement Analysis, Validation and writing of Software Design Document.

 Involved in developing new UI and learning new technologies to fulfill the requirements.
 Developed Action classes and Form Bean classes using Struts.
 involved in writing code for CRUD operations with database using hibernate Framework
 Involved in developing new UI and learning new technologies to fulfill the requirements.
 Preparation of unit test scenarios and running unit test cases and fixing the issues.
 Contributed to the Innovation momentum with new ideas and took ownership of features.