Pradeep Athmakuri

About Pradeep Athmakuri

A seasoned IT Leader with over 20 yrs of experience, focused primarily in the Healthcare space the last 15+ yrs. Supported multiple health plans (Major Blues and non-Blues) across the country in various capacities as a Technical delivery lead, Solutions Architect, Application Architect, Advisory Consultant. Experienced with Commercial, Federal and State Healthcare programs, ability to interpret, translate and simplify regulations.Specialties/Skill-set: Health Insurance, HIPAA regulations, Health care reform, Interoperability, Transparency, Payment Integrity, Clinical Editing, Value-based benefits & reimbursements, Analytics and Insights. Holds a 360 view of expertise in application, infrastructure and governance over the years. Led multi-year application migrations, system consolidations, rearchitect systems, data center migration, consolidations- On-Prem, CoLo, Cloud, Hybrid deployments ( MRC, Stretch clusters), DR test strategy and execution. Partnered with multiple vendors and integrated/implemented their product offerings in specialized areas like clinical evaluation, payment integrity, fraud, waste and abuse. TriZetto product stack: Facets Architecture, FXI, Blue ITS Processing ( Host - Home), HIPAA Gateway, Data Publishing, Insights Blues Integration: Blue Exchange, BlueSquared, Claims AdminTools / Frameworks:*Business capability model, Value stream, Use-case - UML, BIZBOK principles. Frameworks - Zachmann, TOGAF ADM Tools - Archimate, Casewise*AWS Solutions Architect Certified Professional*Confluent Kafka - Enterprise implementation (Salesforce integration, Data Streaming, Event Streaming)* Perl, PShell, Python, Scikit, Tensorflow, Docker, K8s, rpi* Love to learn, read, and work on large scale systems, distributed computing, parallel processing* Experimentation and building gadgets as a hobby. rpi cluster, k8s on rpi, HAT modules, google voice integrations - live sentiment analyzer, Alexa skill builder, etc.

Experience

1. Sr Technology Consultant

   Blue Cross NC

   Aug 2023 — Present

   Strategy, Governance, Transformation and Technological Advancements of Core systems.

Education

• University of Madras

  B.E, Computer Science and Engg

  1999 — 2003

• DeepLearning.AI

  AI Coursework, Deep Learning: Vector DBs, Search, Retrievers, LLM

• University of Louisiana at Lafayette

  MS, Computer Science

  2004 — 2006

Skills

• Data Warehousing
• Customer Relationship Management (Crm)
• Integration
• Process Improvement
• Requirements Analysis
• Business Intelligence
• Healthcare Information Technology
• Business Process Improvement
• Software Project Management
• Crm
• Software Development
• Data Modeling
• Sql
• Visio
• Asp.net
• Service-Oriented Architecture (Soa)
• Sdlc
• Solution Architecture
• Etl
• Software Development Life Cycle (Sdlc)
• Trizetto Facets
• Microsoft Sql Server
• Agile Methodologies
• Requirements Gathering
• Business Analysis