RPL ACS Project Report Form 2019

1.5. Describe your role(s) and responsibilities in the project.

I was a Guidewire Claims Product Consultant in icare NSW for the AP Model – Authorised Provider Model Project. The Authorised Provider project extends existing Guidewire ClaimCenter applications so that third party providers (such as QBE, GIO and Allianz) can privately manage claims on the same platform, using icare’s operating model. This application is integrated with SalesForce, Onbase, Extreme, sitecore Portal, OKTA and SAP.

As part of this project, I was involved in user story elaboration sessions, estimating the user stories during sprint planning, solution design for the major features and user story development. In addition to this, I worked as a Technical Lead for the Guidewire ClaimCenter application and performed code reviews. I provided technical solutions to the offshore team, attended workshops to clearly understand the business requirements, document project discussions, and understandings in the confluence pages and JIRA tools.

I have been involved in analysing end to end integration flow for the proposed functionalities. I worked on solution design for the major features like claim allocation table, activity assignment rules, activity assignment rules, shared services, integrating ClaimCenter with Medipass for the invoice processing, document transfer. I have been involved in preparing the technical design documents and conducting code reviews for the user stories and triaging the defects in system integration testing and regression testing phases.

Based on my experience in the Insurance Industry and technical background, I have clearly understood the system architecture and the integration points. I was able to convert the Business requirements to use cases, provide POC (Proof of concept) upon the proposed requirements by designing, developing, and installing software solutions. I was involved in providing the estimates to the projects, factoring the cost and the efforts of resources involved in the project for each module.

The project team operated as an Onshore-Offshore model and I managed the team from Onshore and facilitated meetings regularly as a liaison to create a connection channel between the offshore team and the onshore team. I was responsible for planning and organizing sessions to meet system requirements, determine access groups of the application to enforce security constraints, and system designs and technical specification as per quality accepted standards. I was also responsible for writing, reviewing code and maintenance of software, end-user release documentation and relevant procedures.

I have created and maintained the business artefacts covering major features. I have developed Integration components of Applications with in-house and third-party systems through interfacing frameworks like web services, guidewire messaging and guidewire plugins. I was also involved in developing the solution for the submit invoice request and response, processing daily payment file from Medipass using Guidewire custom batch framework.

I prepared the Daily status summary report and published to the scrum master in daily stand-up meetings. I leveraged my insurance knowledge and Agile SCRUM experience in training the new joiners and helping them understand the Insurance domain and the Guidewire Claims System.

2. Business Opportunity or Problem

2.1. Describe the business opportunity or problem(s) this project addressed.

Historically, at icare for the Nominal Insurer Scheme had multiple Scheme Agents (Insurers), each agent managed claims on their own systems. icare has brought all of those claims (except legacy) onto a single claims platform, with a single Provider. This created lesser customer satisfaction as workers compensation claims processing time were increasing. In order to improve customer choice and satisfaction, the decision was taken to allow additional Authorised Providers to manage claims for some large employers. The Authorised Provider model project extends icare claims system and multiple Authorized providers can manage claims on the same icare claims platform, using icare’s operating model, while maintaining privacy and data security.

Another problem addressed in this project is Guidewire Claimcenter invoice handling, for the claim benefits/services were provided by service providers via through mail/email/FAX. These invoices will be processed manually that creates a sub-optimal experience for the service providers and increased administrative cost and effort on service providers and in claim handling process. A new payments capability called Digital Payments feature objective enables digital invoices coming from Medipass to icare ClaimCenter. Invoice payments could the be handled with real-time claim benefit adjudication using Straight Through Invoice Processing rules. This project reduces effort and costs associated with data entry and processing of invoices and enable staff to focus on more complex and higher value activities in the claim process.

3. Solution

3.1. Discuss your contribution to the solution, project or engagement.

As a Product Consultant – Technical Lead and a domain expert in Insurance (Property & Casualty), my contribution was present in all stages of the project.

Requirement Analysis: In requirement gathering and analysis, I Analysed User Stories, understood the business requirements and converted those into technical solutions. My contribution was towards researching, consulting, breaking the business requirements, evaluating system program needs, Impact Analysis and documenting them as Business use cases. I was also involved in identifying technical dependencies, and pointing out the technology limitations in the systems involved in the project.

Design, Development & Build Phase: As a technical lead, I was mainly responsible for planning, organizing the technical design sessions, preparing detail design documents, and data mapping between systems. I was involved in technical solution discussions, walkthroughs & reviews and provided inputs to arrive at design solution and documented the same for the project.

In AP Model project, I was involved in the solution design and development of the below components -

In addition to the above, I developed user stories by converting business requirement into technical solutions during development phase of the sprint. Furthermore, performing the code review and providing review comments to developers, i committed the code into the repository, monitored the Jenkins build and promoted the code to SIT/UAT environments.

Testing Phase: I was responsible for supporting Testing Team by unit testing, debugging, diagnosing the defects raised during shakedown/SIT/UAT/Regression testing phases. In addition to this, I corrected errors in the application using specified testing protocols, with appropriate guidelines and accompanying quality standards making sure that the application performs as per the specifications. This involved fixing Testing Environment technical issues due to Jenkins Builds, Data Modal Upgrade Issues and integration testing. Given walkthrough on the critical implemented functionalities and ensure them working as expected. I provided support to users while performing User acceptance testing in means of Data setup, Business scenario & workflow, Documentations etc. Participate in defect triage meetings and assist track defect closure with appropriate resolution and root cause.

Implementation & Support: I was involved in preparation of implantation plan for the Managing entity on boarded to icare claims system. I have supported production deployment activities along with Release Management team. Performed Technical Validation Testing (TVT) in Production Guidewire ClaimCenter application.

Correspondence & Training: I was involved in fixing the defects in training environment. I have prepared Business workflow documentation, prepared and maintained Application workflow documents and presentations, and presented to the team as part of training activities.

3.2. Describe any design or problem solving methods you used on this project.

I have been involved in the design and implementation and requisite multiple integrations in icare claims system.

Claim Allocation Framework – I was involved in the design and solution part of Claim Allocation framework. Claim Allocation is complex feature in icare claims system and for this problem I designed flexible solution to support complex business requirements. Solution was designed new page - claim allocation table in the desktop page of the ClaimCenter application. User hat to setup the data for a policy, update the allocation strategy and assignment type for each segment and managing entity should be updated. By doing this, claim allocation framework could be managed by respective authorised providers and flexible to change the allocation whenever required and monitored by icare team. Once claim was created in ClaimCenter, based on the allocation table, claim would be assigned to respective team and the right user. This framework supported future requirements of claim assignment when new scheme was onboarded to the icare Claims System.

Submit invoice request and response design – I was involved in the end-to-end solution design of this component. Invoice request comes from Medipass to GW ClaimCenter through Mulesoft, I designed custom WS-I web service to receive the request in GW ClaimCenter. After receiving the request, GWCC will parse the request XML and store the data into the database and send acknowledgement back to Medipass. For this invoice, system will invoke the workflow, using this workflow, straight through invoice processing (STIP) rules getting executed in sequence. After all the rules are passed, GWCC will create payment. If STIP rules fail then GWCC will create activity to process this manually. GWCC will be sending the invoice response status to Medipass using GW Messaging engine technique.

One of the Integration which drew significant attention was transferring and processing of inbound invoice payments file from external server location to GW ClaimCenter server location. I designed custom batch process to transfer the inbound payment file from AWS S3 bucket to ClaimCenter server location. After file transfer, I processed the file by reading and writing the records to database. After file processing, I archived the file into the archive folder in the server for the finance team audit purposes. I have implemented the technical solution for integrating Claims system and Medipass by leveraging distributed batch process framework design pattern. This implementation has optimized the file transfer mechanism from external system.

3.3. List the major deliverables of the project that you were responsible for or contributed to.

As explained in the previous section, I was part of complete phases in the software development life cycle(SDLC) for this project with deliverables in every phase of the project as described below:

In Requirement Analysis Phase, I

In Design Phase & Development, I

In Build & Testing Phase, I

In Production Implementation, I

In Correspondence, I

4. Results

4.1. Was your solution implemented? If so, describe the role, if any, you had in the implementation.

The solution was implemented successfully, and the Project went live. My knowledge on Insurance domain (Property & Casualty) and technical work experience facilitated me to work as Technical lead in the project. I was involved in Technical Solution designing the key features like Claim Assignment framework, Managing entity framework, Shared services framework, Document Transfer Module, submit invoice request and response and processing on inbound invoice payment file from Media. The solutions provided by me were implemented in the project as mentioned in section 3.2. In addition to lead responsibilities, I worked as developer and implemented few stories in the project.

Solution provided for Shared services team framework – As part of this project, icare team could view all claims managed by Authorised Providers. For this solution, I designed a new page in the administration tab and created one new managing entity named shared services. In this admin page, admin user could add security zone groups for all Authorised Providers and assign this managing entity to the care team members, so that these users can access all managing entity claims and support the claims processes to all providers. This screen was designed flexibly in such a way that new provider could be onboarded, or existing provider could be offboarded easily with minimal configuration changes in the system without any server downtime. For designing the solution, I received accolades from the architect and product owner.

This project also enriched my skills in deriving critical business scenarios and business cases. The framework which I developed during the project development using Gosu were utilized by other projects as well. This was highly appreciated by my leads and the client.

This project allows customers to select an authorised provider to manage their claims in a single, integrated platform adhere to icare’s operating model. Digital Payments Integration reduces the processing time of service provider invoice payments, reduces administration cost, increases operational effectiveness, improves & introduces new payment service experiences and increase transparency.

4.2. Assess the overall success or failure of the project.

The Project went live successfully, though we had to fix defects from existing claims application and requirements being added in the last phase of the project. The key objective of the project was to enable third party providers to manage claims on the icare claims platform using icare’s operating model. This project allows the managing entities to operate and provide a good customer experience. This project enables managing and adding authorised providers as simply like self-managed and configuration changes.

The successful implementation of the project was the result of a dedicated team with a focus on getting the job done in line with the project schedule. The project was implemented using Scaled Agile Framework (SAFe) methodology tailored to suit the needs of the organisation and deadlines were strictly followed. The initial solution architecture overview remained the directing document to the details of the development throughout the project. After the project Business Go-Live, no P1/critical defects been raised. Overall the project is successful and icare’s key objectives are achieved.

4.3. Lessons Learned

In retrospect, what you might have done differently on this project?

The major issues and lessons learnt for review and consideration are as follows: -

From Technical Perspective:

Undertaking Knowledge Transfer during project term, CCD and AP Model project development happened in parallel, resources shuffling between projects, working with reduced support from specialist development staff, Code Merge Issues – Running two code bases, KT for new team members were identified as impediments and corrective action were taken to resolve these issues. Automation should have some of the processes like code review, Recorded KT Sessions to increase productivity. This project helped me to understand the technical difficulties involved in COTS Product implementation, how to manage real-time issues under pressure, and work as team to implement the project successfully.

From Project Management Perspective:

During elaboration phase, some of the stories scope and complexity has been increased, due to that we had to perform re-estimation of stories. Daily stand-up meetings were held to make sure that there was no delay in the deliverables and remedial actions are taken to ensure the project is on schedule. Business SME was involved with major decisions about the project, product owner and release train engineer provided additional support wherever possible as requested.

Project 2: QBE BAU Application support and Maintenance

5. Project Summary

5.1. Identification

5.2. Duration

5.3. Resources