Select Page

Case Study

Integrated the health plan data as per the business need of a diversified, multi-national FORTUNE® 50 major health insurance provider in US

Client Background

The client is a diversified, multi-national FORTUNE® 50 major health insurance provider in US, providing various health insurance plans under Medicaid, Medicare and commercial line of business

Client Need

  • Integration of Claim, Member, Provider, and Clinical data from each health plan to the corporate RTR structure
  • The CMS Interoperability Mandate is a significant requirement on the RTR program, which got initiated on 07/01/2021
  • The process needed to be appropriately designed and implemented without affecting other health plan timelines and had to meet the CMS mandate deadline
  • Coordination was required among the individual teams to push the data to RTR in the specified format

Our Solution

  • Developed multiple stored procedures to map the logic with the JSON fields and generated the JSON using .NET application
  • Optimized the process to push JSON messages to downstream within the run window and implemented the logging mechanism for effective monitoring
  • Designed Automic workflows to source the data every 15 minutes and push it to RTR via API/Kafka Topic
  • Created an automated process to report JSON schema errors and to notify business teams via email

Tools & Technologies

Sybase, Greenplum, Oracle, Microsoft .NET, IBM Datastage, Kafka, Atomic

Key Benefits

  • Successfully integrated the health plan data as per the business need and timeline
  • Created reusable components to be reused across the streams (Claim, Member, Provider, and Clinical) and achieved the optimal performance in all the streams
  • Implemented error reports for reconciliation and to notify the business immediately
  • Built robust process for initial and synchronous hydration handling up to 200 million records optimally
  • Data is available for downstream applications to fetch member and provider details via APIs and useful for functional migration and channel applications
Case Study KeyPoints


Digital Product Engineering

Cloud Services

Data & Analytics

Intelligent Automation

Cyber Security

Build Operate Transfer

Talent Solutions


Communications & Media

Government Solutions

Healthcare, Life Sciences,
and Insurance

Banking & Financial Services

Energy, Oil & Gas and Utilities


Retail & CPG
Manufacturing & Automotive

Travel & Transportation and Hospitality



Automation Anywhere









Innovation @ Work

Blogs and Insights

Research and Whitepapers

Case Studies


Webinars & Tech Talks
US Employment Reports


About Us

Leadership Team

Strategic Partnerships

Office Locations

News and Events


The Innova Foundation


Explore Open Positions

Life @ Innova Solutions

Candidate Resource Library

Let's Connect