Ramanakar Reddy Danda is an internationally recognized expert in Artificial Intelligence (AI) and Machine Learning (ML). He specializes in the Healthcare sector and contributes significantly to the field of Agricultural Machinery. Celebrated for his exceptional technical skills, creative problem-solving, and forward-thinking leadership, he has played a pivotal role in driving progress in these domains. His strategic vision empowers organizations to excel in the dynamic and ever-changing technological landscape.
Vice President
Integration Architect
Integration Technical Lead
Senior Consultant
Application Developer
Developer
Software Developer
Vice President
Integration Architect
Technical Lead Integration
Experience Health:
Experience Health Integration (EH) is being established by Blue Cross Blue Shield of North Carolina (BCBSNC) in Partnership with Duke Health with the goal of providing a Health Maintenance Organization (HMO) for the Medicare Advantage Programs of CMS in the
state of North Carolina. Population Health Management (PHM) is a systematic approach aimed at improving the health outcomes of a specific population by monitoring and addressing the medical, social, and behavioral needs of individuals within that population.
Facets Migration (NCTIO).
BCBSNC is moving all their membership from Mainframes to Facets to serve the customers better. I was responsible for the design, and delivery of the 837 Professional, Institutional, and Dental Claims migration from the Legacy backend systems to Facets in Java Caps 5.1.3. Received a special award for Best Code Quality and led a smooth migration of all the lines of business (Small Groups, Large Groups, Medicare, Medicaid, Blue E Claims) migration to the Facets system.
Blue Connect (Micro Servicesin Member Portal)
We redesigned the member portal to provide total 360-degree member information using Micro Services architecture was responsible for Architecture, design, and Data Modelling for the member Portal of Blue Cross Blue Shield of North Carolina. The key goal of the project was to enable the member to get a 360-degree overview of his eligibility information, benefits information, Claim Status Information, Explanation of Benefits and Primary Care Provider Information. Appreciated with a Spot Bonus Award for Delivery Excellence.
Enterprise Services Team Architecture Rewrite
The Enterprise Services Team was tasked with rebuilding and rewriting the entire architecture of Blue Cross Blue Shield of North Carolina as the Organization. The key objective of this project was to modernize and ensure that the current system which was slow to respond to change
Pharmacy Accumulators
The Pharmacy Benefit Managers for various Pharmacies require the Membership/ Eligibility information for the various members of BCBSNC to validate their Insurance eligibility and process the pharmacy claims. I was responsible for designing and developing the Pharmacy Rx Accumulator which calculated the balance amounts to be paid by the members of BCBSNC to the pharmacy. This involved validating the enrollment, eligibility and benefits of the members and exchanging the information with the pharmacies for the final calculations of the accumulator amounts
Pharmacy Integration (CAFÉ)
Responsible for the design and development of the Implementation of Pharmacy Benefits across all non-X12 Transactions. In this project, we integrated various Pharmacy systems (Express Scripts, Prime, CVS, Avail Pharma, Catamaran, etc.) across North Carolina
with the Blue Cross Blue Shield of North Carolina Accumulators & Member Benefits system. The key goal of this project was to exchange the member information (PHI & Non-PHI) and the member accumulator benefits to all the Pharmacies.
BCBSNC Infrastructure Migration Project
BCBSNC is migrating all its current on-premise infrastructure to AWS. I was involved in defining the Architecture best practices for the migration of the infrastructure for the EDI Team during the migration. Executed various Proof of Concepts (Rest Services, DB connection, and MQ) to migrate business services to MuleSoft 3.0
HIPAA 4010 to 5010 Migration of All EDI Transactions
I was involved in the migration of the HIPAA 4010 version to the HIPAA 5010 Version for all the EDI Transactions as mandated by CMS.
ICD 9 to ICD 10 Conversion
I was involved in the implementation of ICD 10 – updated from ICD 9.
Senior Consultant
Application Developer
Kraft Foods Star Integration
Kraft is the world’s second-largest food and Beverage Company with 2010 net revenues of more than $34 billion, and more than 140,000 employees. The Kraft brand portfolio is one of the strongest in the space of any packaged goods company. The Kraft Foods Star Integration Project involved integrating the data across various countries in the US, Australia, Africa, and EU for Kraft Foods to ensure smooth supply and distribution of the food products. This involved the complete set of EDI X12 transactions in the logistics distribution across warehouses to Air, Sea, and Land shipments.
Developer
There are 100+ EAI interfaces categorized into three functional areas and each interface is routed to different facilities. This implementation uses Java business logic to parse and manipulate data for GFSS Applications. EDDIE for [European Demographic Data Information Exchange] for Pfizer EDDIE was developed to extract relevant employee data and create an XML file for each 1000 records. Later all created files were read and processed by destination different downstream systems like Ariba, GCE, and Oracle. Blue Cross Blue Shield, Rhode Island Campaign Management System is a web-based application of CRM. This application is primarily used to manage campaigns to enroll patients in self-help groups and campaign for better health care practices. These patients are enrolled into these groups based on their diagnosis and encouraged to participate in various self-help discussions and activities and monitored for changes to lifestyle and health care indicators. This application has multiple modules:
1) ‘Groups’ identify a patient based on specific criteria and place them into a particular group.
2) ‘Churn’ analysesthe behavior of the patients who drop out and matches them with other groups that align more closely with their
interests.
3) ‘Campaign’ selectsthe group of patients and evaluatesthe performance of the patient in the self-help groups.
4) Some ofthe self-help groups are – Alzheimer’s, Cancer Survivors, Tobacco Cessation, Alcohol Cessation, Drug Cessation, Depression,
etc.
Software Developer
Pfizer–Global Operations (GO)
Project GO (Global Operations) is an integration project to automate work order flow between different systems like assets, medical distribution details, etc. The main goal of this project isto automate all the processes involved in Global Operations for Pfizer like supply chain distribution and handling of medicines globally. This project involves real-time updates as well as batch updates through various interfaces in Seebyond eGate.
NHS, Health Care UK
The main objective of this project is to ensure that the patient clinical information registered at his local service provider can be shared across the UK with other service providers. When a patient moves out of his/her region, different service providers use different types of applications. The new National Clinical Record Systems is used to provide two levels of integration – one with the Local service provider and, second level integration with NHS.
I’m currently avaliable to take on new projects, so feel free to send me a message about anything that you want to run past me. You can contact anytime at 24/7