Clients

Industry:  State Government – Dept. of Human Services

The Department of Human Services provides essential services to the state’s most vulnerable residents. Working with many others, including counties, tribes and nonprofits, the department helps ensure that the state’s seniors, people with disabilities, children and others meet their basic needs and have the opportunity to reach their full potential. The department was looking to build an auditing platform on BPM technology.

Role: Design and implement IBM Business Process Manager Advanced platform infrastructure and IBM Business Monitor infrastructure.

Technical Environment: IBM Business Process Manager Advanced 8.5.6, IBM Business Monitor 8.5.6, Redhat Linux

Industry:  Health Care and Life Sciences

With over $32B in revenue, the client is a large in health care services corporation.

In order to reduce overhead expenses, increase productivity and efficiency, and improve speed to market with new products, the client was looking to streamline and automate claim adjudication business processes, including areas of eligibility & enrollment all the way through post payment processes. The client also wished to have real time updates on their processes through the use of business activity monitoring.

Role: Design and implement IBM Business Process Manager Advanced platform for use with claim applications.

Technical Environment: IBM Business Process Manager Advanced 8.0.1.2 & 8.5.0.1, IBM WebSphere Service Registry & Repository, IBM WebSphere Enterprise Service Bus, IBM WebSphere Application Server, IBM Business Monitor 8.0.1.2, Redhat Linux

Industry:  Business Services

The client offers solutions for direct mail, transactional mail, customer engagement management and analytics and e-commerce parcel management, along with digital channel messaging for the Web, email and mobile applications

Role: Design and implement IBM Business Process Manager Advanced platform.

Technical Environment: IBM Business Process Manager Advanced 8.0.1, IBM WebSphere Application Server, Windows

Industry:  Health Care and Life Sciences

With over $8B in revenue, the client is a large in health care services corporation.

In order to reduce overhead expenses and increase productivity and efficiency, the client was looking to streamline and automate claim auditing business processes.

Role: Design and implement IBM Business Process Manager Advanced platform for use with claim auditing applications.

Technical Environment: IBM Business Process Manager Advanced 7.5.1, IBM WebSphere Service Registry & Repository, IBM JRules ILOG, IBM WebSphere Enterprise Service Bus, IBM WebSphere Application Server, Microsoft IIS, AIX

Industry:  Health Care and Life Sciences

With over $34B in revenue, the client is one of the nation’s leaders in health care, dental, pharmacy, group life, and disability insurance, and employee benefits.

With the dozen plus lines of businesses and the sheer size of their book of business, ICD-10 compliance in itself presents a unique challenge to the client. Integrating 150+ impacted systems spanning a majority of their core admin domains into a multi-year cohesive roadmap poses one of the significant planning challenges to the client in recent years.

Role: Provide advisory support and industry perspective for a $200M regulation program on a variety of program level issues.

Technical Environment: Claim adjudication platforms, benefit systems, custom developed applications related to member enrollment and claim processing

Industry:  Financial Services

Major Financial Services company with $24.5 billion in annual revenue.

The client wanted to design a technology architecture that would allow them to streamline business operations and allow for cross-channel, market, and business unit interactions.

Role: As the middleware architect on the project, documented the current state technical landscape and then worked with the client to create a future state architecture.

Technical Environment: Enterprise Service Buses, Middleware, Services

Industry:  Insurance

The client is the nation’s largest publicly held personal lines insurer. A Fortune 100 company, with $133 billion in total assets, and sells 13 major lines of insurance, including auto, property, life and commercial.

Assisted the client with an application rationalization exercise.  As the client has acquired other firms throughout the years, there were many applications across the organization that performed the same functions.  To streamline processes and remove duplicate applications, we assisted the client with creating a current state application inventory, identifying which applications could be removed, and a plan to begin the rationalization.

Role: Created current state inventory and identified duplicate applications that could be safely rationalized.

Technical Environment: Multiple legacy platforms

Industry:  Health Care and Life Sciences

Major health insurance company with over $18 billion annual revenue.

Lead a technical development team of seven within the Enterprise Application and Data Integration group and was responsible for software delivery upon technical platforms such as Websphere Process Server (WPS), Data Integration tools, and Rules Engines. Responsible for providing technical design and development leadership while focusing on enabling business capabilities. Designed, architected, and integrated business applications on IBM Websphere Application Server, IBM WebSphere Process Server, IBM MQ, IBM Message Broker and SOA infrastructure solutions using various technologies.  Experience with workflow based enrollment/claim system, which uses cutting edge technology to provide an automated system to support the needs of the health plan’s members and provide them with faster turnaround of their enrollment and claim submissions, reducing costs to the business by removing manual processes.

Role: Manager and technical subject matter expert

Technical Environment: IBM WebSphere Application Server (ND), IBM WebSphere Enterprise Service Bus, IBM WebSphere Integration Developer, Web Services, IBM MQ, Blaze Rules Engine

Industry:  Health Care and Life Sciences

Major health insurance company with over $18 billion annual revenue.

Managed the web / SOA administration team across all platforms and lines of business. Oversaw a team of 10 direct reports regarding web code deployments, web engineering tasks, and production support. Facilitated effective operation of human resource management processes including hiring, training, mentoring, performance appraisals, and career development. Designed, architected, and integrated business applications on IBM Websphere, Oracle Web Logic, IPlanet, IIS servers, and IBM HTTP servers and SOA infrastructure solutions using various technologies.  Successfully managed the team’s responsibilities to ensure the implementation and support of several hundred web-based applications, which contributed to the health plan members’ exceptional service and experience.

Role: Manager and technical subject matter expert

Technical Environment: IBM WebSphere Application Server (ND), IBM WebSphere Enterprise Service Bus, Web Services, IBM HTTP Server, SSL Certificates, Oracle WebLogic, Amberpoint, Microsoft IIS

Industry:  Health Care and Life Sciences

Major health insurance company with over $18 billion annual revenue.

For the same healthcare insurance company, provided technical support for the entire web-based application across all lines of business and across all platforms.  Provided 24×7 support for business critical web hosted applications and sought out root cause analysis to further stabilize the environments.

Role: Manager and technical subject matter expert

Technical Environment: IBM WebSphere Application Server (ND), IBM HTTP Server, SSL Certificates, Oracle WebLogic, Amberpoint, Microsoft IIS

Industry:  Health Care and Life Sciences

Major health insurance company with over $18 billion annual revenue.

For the same healthcare insurance company, gathered and documented requirements using the health plan’s methodology for a major claim engine on a project to improve claim adjudication and accuracy.  Developed use cases, test scenarios, and executed testing scripts.  Led meetings to drive resolution on any known issues.

Role: Manager and technical subject matter expert

Technical Environment: MS Office suite, MS Project