Sumit N.
Mainframe Tech Lead Medicare Eligibility & Enrollment Analyst @Highmark Health
Signup · Get unlimited contacts
WORK HISTORY
Mainframe Tech Lead Medicare Eligibility & Enrollment Analyst @Highmark Health
Working as a Mainframe Tech Lead/Programmer Analyst to maintain the Medicare enrollment platform M360.• Implementing CMS releases to enhance and customize the product based on Medicare guidelines and customer needs. • Manage membership for the existing Medicare Advantage plans for the Highmark, IBC, BCBS/MN.• Supporting the system/batch processing of enrollment/disenrollment application (COBOL/DB2/JCL/SQL/Stored Procedure/Java/Rest API) E2E that includes modules – Eligibility/Election period verification, Late-Enrollment and Low-Income subsidy derivation, Application RFI process, CMS correspondence letter generation and TRR run etc.• Worked on development and customization of the M360 product for new Customer – HealthNow New York/HMK New York.
EDUCATION
West Bengal University of Technology, Kolkata
Bachelor of Technology (B.Tech.)
ABOUT SUMIT N.
IT experiences of 15+ years as a Mainframe/COBOL Developer and 8+ years as Medicare Analyst (US Healthcare)- Currently working as a Tech Lead and Medicare Eligibility/ Enrollment / Membership Analyst in Jefferson City, MO with Wipro Infocrossing for BCBS/MN, IBC, Highmark Health (M360)- Currently employed as a Mainframe Developer/Software Engineer at MSR Technology Group- Worked extensively on eligibility verification, enrollment and membership management for CMS/Medicare Advantage plans (MA, MAPD, PDP, CO, COPD) for Highmark Health, IBC and BCBS/MN- Previously Worked as a Senior Mainframe Developer for Federal Office of Child Support Enforcement- HIPAA (Health Insurance Portability & Accountability Act), ‘CMS – Fraud Waste and Abuse’ (FWA) and ‘CMS – General Compliance’ trained and certified- Worked for UK-Retail HRG at Milton Keynes, United Kingdom as a L2 Technical Support/SME, and developed Stock Auditing system designing/and coding COBOL/DB2 Stored procedure independently- Worked for US-Retail Levi Strauss, supporting DWH/ ETL batch application developed by SAS on Mainframe platform- Have extensive experience developing applications using COBOL, JCL, DB2, SQL, DB2 Stored procedure, VSAM, SAS, APS-COBOL, APS/CICS, Java, Rest APIs- Worked on mainframe system/batch performance improvement and have good knowledge on DB2 DBA maintenance activities (RUNSTATS, REORG, REBUILD, LOAD/UNLOAD etc.)- And have basic knowledge/working experience in IMS/DB, C++, Java, Data Warehouse Basics (DWH) & ETL Studio- Awarded “Feather-In-My-Cap” and “Gyan-Guru” for dedication and commitment to meet flawless delivery- Have interests in blogging, playing Guitar/performing at Open Mic and investing in equity.
This profile is compiled from publicly available professional sources. Unifers is not affiliated with or endorsed by LinkedIn. Request removal of this profile.