Sanjay Pathak Email & Phone Number

Bengaluru, KA, IN

Bengaluru, Karnataka, India

• In my current role, I lead strategic initiatives and drive operational excellence within the healthcare division. This includes a deep understanding of the industry landscape, including market trends, regulatory.
• Developing IT Strategy: Formulated an IT strategy to promote innovation and create tailored solutions for Healthcare and Life Sciences sectors, including Payers, Providers, Pharmaceutical/CROs, and Medical Devices.
• Business Growth and Market Expansion: Contributed to the growth of business unit.
• Digital Transformation and Cost Reduction: Led digital transformation initiatives and IT cost reduction based large deals, enhancing digital health, patient experience, remote virtual care, and value-based care (VBC).
• High-Level Solution Design: Crafted solutions and articulated perspectives, offerings, and capabilities, presenting high-level pitches to executives to address client needs effectively.
• Subject Matter Expertise: Acted as a Subject Matter Expert (SME) to support sales and delivery teams in the successful execution of projects.

Bengaluru Area, India

• During my tenure at this organization, I led the development and execution of healthcare and insurance solutions tailored to the industry. I worked with diverse teams to enhance our service & solutions offerings.
• Revenue Impact: Managed the Healthcare and Insurance practice, generating over $15 million in revenue.
• Corporate Strategy: Directed the corporate strategy for the services division with a focus on geographic expansion and growth initiatives.
• Market Expansion: Developed and implemented strategies for entering new markets, including the integration of innovative technologies such as conversational AI, robotic process automation (RPA), and blockchain.
• Blockchain Practice: Established a Blockchain practice from scratch, leading to the acquisition of new clients and the execution of targeted marketing plans for the services division.

Bengaluru Area, India

• As a Practice Head, I am responsible for driving the strategic development, execution, and oversight of innovative healthcare and insurance solutions that enhance patient care, improve operational efficiency, and boost.
• Market Entry Strategy: Developed and executed a market entry strategy, establishing and managing a Centre of Excellence (CoE) focused on Healthcare, Insurance.
• CoE for Core platforms: like HealthRules (HealthEdge) and Facets
• Subject Matter Expertise: Served as the Subject Matter Expert (SME) for presales activities and project delivery, creating proof of concepts, solutions, and frameworks in areas including core administrative services.
• Sales and Market Strategy: Partnered with sales teams across various regions to refine solution and service offerings and effectively implement market strategies.
• Client Engagement: Conducted due diligence processes, workshops, and consulting projects to support clients and address their needs.

Austin, Texas Area

• As a Management Consultant, I utilize specialized knowledge to deliver strategic advice and innovative solutions for Core Administrative Processing Systems (CAPS) such as HealthRules, to help Payers enhance operational.
• Project Management: Led projects from start to finish, defining scope, estimating resources, drafting Statements of Work (SOW), identifying risks, and coordinating with leadership.
• Strategic Advisory: Offered strategic guidance on business and project implementation, managing both onsite and offshore teams for effective project development and setup.
• Client and Development Team Liaison: Served as the main link between clients and development teams during product creation, ensuring that client requirements were met.
• Product Configuration and Deployment: Directed the configuration and deployment of products like HealthRules and acted as a Subject Matter Expert (SME) in requirement gathering, configuration, and testing.

Dallas/Fort Worth Area

• Commercial Payer & MEDICAID Enterprise: Medicaid is state program based on title XIX of Social security act (1965) which is the largest source of funding for medical and health-related services for America’s poor.
• Lead Project Teams as Lead Business Analyst/SME for integrated Payer solution for government and commercial health insurers.
• Initiated process automation and customization using BPM and BRE.
• Developed Business Architecture for Health Care Payer System and Health Care Portal System
• Collaborated JAD sessions to Analyze as-is business processes and to-be process (gap analysis) leveraging Visio (BPMN2.0) and process modeling techniques
• Established business documentation process & procedure for the company’s new strategy.

• E-Medical Bill ManagementBill Management work for e-Medical includes sending the medical bills from e-medical locations to a Data capture vendor, mapping the Key from Image results, associating the bill to the correct.
• Lead a team of 10 members as medical Bill type lead.
• Redesigned & developed requirements for Medical Provider Matching & association to include the new National Provider Identifier (NPI).
• Worked as a SME for the CMS 1500 (HCFA), UB92/04 (Institutional) & dental medical forms and bill review process.
• Developed functional requirements, Use cases & UI mock-ups as per customer's business needs. Developed context diagrams & process maps for the business flow.
• Prepared detailed instruction for a data capture vendor to capture data from paper bill.

New Delhi Area, India

• Performed Research & Development for various organizations like LG, DRDO, and Anergy Instruments on DSP, Micro controllers, C, ORCAD, Assembler platforms.Responsibilities:
• Analyzed the feasibility of the project, Implementation of designs and testing.
• Implemented designs for Microprocessor subroutines in C, assembly and testing.
• Involved in selection of electronic hardware and design of control circuits.
• Designed and developed complete microcontroller circuit and its control.

M Tech, Instrument Design & Development

Be, Electrical

Education record