SUMMARY:

• Project Manager with 10+ years’ experience in Healthcare Project Management with strong understanding of the Software Development Lifecycle (SDLC), including managing complex projects and teams of up to 32 people.
• Experience coordinating various healthcare systems implementations by interfacing closely with vendors, technical teams (Server Operations, Systems & Desktop) and clinical users (VPs, Directors, Physicians, Pharmacists, RNs, MAs, Technologists)
• Dynamic Master of Business Administration with experience managing various systems - based projects in a health-care setting including healthcare risk adjustments.
• Strong experience & understanding of health care industry, Knowledgeable in CMS (Medicare, Medicaid) and Health Insurance Exchanges related models.
• Strong understanding of US Healthcare system including Office, professional, FIDA, MLTC, Home healthcare, Ambulatory service,
• Very good understanding of Health Care Reform, ICD-10 initiatives, Medicare, Medicaid
• Experience in implementing systems based on HIPAA policies and privacy regulations
• Experience in testing, modification and implementing system interfaces in compliance with the HL7 v2.3 standards for exchange, integration and sharing of Electronic Patient Health Information (EPHI)
• Experience with X12 based EDI standards such as 834 and 837 standards
• Good knowledge of Project Management, IT Governance, and project portfolio management
• Knowledge of more than ten EMR system: MISYS TIGER, EClinicalWorks, SurgiSource, Medaaxis, Elligence, Medical office management, e-MDs, MedLook, NextGen, MetaFrame, Medisoft, Amazon, Recunet & Dentrix, CareNSync, EPIC
• Proficient in utilizing Project Management tools to develop SOWs, RFPs, RFQs, project plans, project schedules, resource planning and management, cost-benefit analysis, budgeting, project kickoff meetings, status meetings, and timeline management
• Proficient in resource leveling & resource smoothing, defining communication channel’s, Project network diagram’s, critical path, BAC, PV, NPV calculations using PMBOK guidelines
• Experience in mapping UML diagrams for data flows, system diagrams, data warehouse diagraming, process flow diagrams, Activity diagrams, Sequence diagrams using Microsoft Visio
• Experience in facilitating Technical Specification discussions, conducting JAD sessions with user groups, stakeholders, SME’s and end-user clients
• Highly organized, results driven; adept at recognizing inefficiencies and developing innovative cost-effective solutions.
• Excellent communication, documentation and interpersonal skills

TECHNICAL SKILLS:

Program/Project Management: Project planning; Process improvement; Mapping and managing budget, Project network diagrams, communication channel calculation, resources leveling, resource smoothing, BAC, PV, NPV, risk score calculations, ; PMBOK Methodology

Methodologies: SDLC (Agile, waterfall) and Six sigma

Tools: MS Visual Studio, MS Visio, SharePoint, MS Project, MS Access, and other MS Office tools

PROFESSIONAL EXPERIENCE:

Confidential

Project Manager

Responsibilities:

• Develop roll-out and/or go-live schedules and manage overall implementation
• Collaborate with the Application Specialist and members of the Business and/or Clinical teams to develop end-user programs and/or guides
• Documented the Project Charter and received approval from the Project Sponsor and other Stakeholders
• Managing project meetings and record keeping with Project meeting minutes and action items.
• Developed a work breakdown structure and created a clear project plan
• Developed a detailed project plan and updated as necessary
• Managed project Change Control
• Managed the project SharePoint site and adhered to the HIE standards
• Establishing and implementing project management processes and methodologies for the Healthcare and Technology community to ensure projects are delivered on time, within budget, adhere to high quality standards and meet customer expectations.
• Ensured clear communication via Activity Diagrams, Workflows, Use case Diagrams, Swim lanes
• Identified the Gaps and conducted GAP analysis
• Documented Projects Risks and developed Risk Mitigation plan
• Identifying the right SME’s and persuading them to participate in the project
• Ensured that the Project SharePoint site is up-to-date and versioning of the documents are clearly maintained
• Closely Supported QA team to ensure that requirements were clearly translated to Test Cases/Test Scenarios
• Identified the scope and vision of the SSP project
• Managed HealthCare Information Exchange (HIE) and Clinical affairs projects in coordination with Government rules and regulations.
• Responsible for assembling project plans and teamwork assignments, directing and monitoring work efforts on a daily basis, identifying resource needs, performing quality review; and escalating functional, quality, timeline issues appropriately.
• Responsible for tracking key project milestones and adjusting project plans and/or resources to meet the needs of customers.
• Maintained collaborative team relationships with peers and colleagues in order to effectively contribute to the working group’s of goals, and to help foster a positive work environment
• Coordinating communication with all areas of the enterprise that impacts the scope, budget, risk and resources of the work effort being managed.
• Partnering with senior management of the business and healthcare community to identify and prioritize opportunities for utilizing IT to achieve the goals of the enterprise.
• Identified stakeholders of the project; prepared interview questionnaire for requirement elicitation on Benefits, PA submission, and Referral areas; and interviewed SMEs and documented requirements
• Managing multiple cross-functional projects of medium to high complexity.
• Independently designing technical solutions for modules of a project, or to resolve most problems
• Marshaling both Hospital and vendor project resources to ensure successful completion of project goals and objectives.
• Monitoring project variables (cost, effort, scope) against the project plan and project schedule.

  Identifying any necessary corrective actions to address project issues or risks.

  Preparing timely project status updates for presentation at bi-weekly Operations and other Steering Committee meetings.

• Working with Finance Department resource to ensure appropriate monitoring and reporting of all project costs and budget.

Confidential, Long Beach, CA

Project Manager

Responsibilities:

• Established project objectives and detailed delivery plans for ICD-10 conversion Incorporating the results of Gap Analysis, including strategies for staff, process improvement, application software remediation, and contract management agreement changes
• Documented the Project Charter and received approval from the Project Sponsor and other Stakeholders
• Managing project meetings and record keeping with Project meeting minutes and action items.
• Developed a work breakdown structure and created a clear project plan
• Developed a detailed project plan and updated as necessary
• Managed project Change Control
• Developed graphical presentations for senior office & Hospital management to garner support for project as staff navigated through a sea of changing priorities
• Communicated data / reports to the department leadership
• Coordinated and facilitated the ICD-10 implementation throughout the health system using the accepted project management methodology.
• Ensured clear communication via Activity Diagrams, Workflows, Use case Diagrams, Swim lanes
• Identified the Gaps and conducted GAP analysis
• Documented Projects Risks and developed Risk Mitigation plan
• Functioned as a liaison in coordinating the system implementation, maintenance, and support as well as resolves functional, process and technical issues throughout the health system.
• Managed SDLC projects to enable electronic document processing of claims and remittance advices for modulated EMR software
• Identifying the right SME’s and persuading them to participate in the project
• Ensured that the Project SharePoint site is up-to-date and versioning of the documents are clearly maintained
• Closely Supported QA team to ensure that requirements were clearly translated to Test Cases/Test Scenarios
• Identified the scope and vision of the SSP project
• Developed and modified policies and procedures impacted by the ICD -10 transition.
• Developed detailed project schedules using MS Project, Also, drafted communication plans, risk management and contingency plans, for this HIPAA 5010 conversion
• Ensured the timely communication of project status and identified application, process and quality improvement opportunities.
• Promoted and adhered to departmental and organizational information systems security policies, standards and procedures.
• Provided effective and timely communication of project information to pertinent staff across the organization.
• Functioned with a high level of independence in the performance of the role.
• Participated in high level ICD 10 update assessment session and documented the meeting outcome
• Created high level ICD 10 update related implementation plan, and presented to the manager
• Worked as an Interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes.
• Participated in 1CD 9 to ICD 10 codes conversion requirement gathering sessions and created high level business requirement document.
• Collaborated with configuration team in analyzing configuration change requirements for ICD 9 to ICD 10-CM and ICD10-PCS codes conversion and forward and reverse mapping between the codes sets.
• Participated in all project management tasks and deliverables as identified in the attached ICD-10 program schedule and resource projection spreadsheet
• Mentored business analysts in methodology for defining ICD-10 mapping processes, using GEMs and documenting business requirements
• Worked with E&Y advisory team on various projects towards the implementation of ICD 10 Program
• Verified test scenarios written for ICD 9 extreme testing for ensuring system compliance with ICD 9 code set rules and participated in testing.
• Oversee Requirements and Gap review for ICD-10
• Reviewed Project Progresses of Project Managers working around the ICD-10 project
• Responsible for auditing off-shore team selection
• Built job descriptions, financials, and ramp-up/ramp-down models for multi-million dollar ICD-10 project
• Work with Integration Teams on related projects such as EHR and HIPAA 5010 projects
• Review Testing Approach for ICD-9 to ICD-10, including mapping rules and issues

Confidential, Albany, NY

Project Manager

Responsibilities:

• Documented the Project Charter and received approval from the Project Sponsor and other Stakeholders
• Facilitated JAD sessions to collect requirements from system users and prepared business requirement that provided appropriate scope of work for technical team to develop prototype and overall system.
• Involved in gathering, documenting and verifying business requirements.
• Involved in requirement gathering phase (Provider, Claim components and HIPAA)
• Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures
• Developed detailed project schedules using MS Project, Also, drafted communication plans, risk management and contingency plans, for this HIPAA 5010 conversion.
• Met with report users and stakeholders to understand the problem domain, gathered customer requirements through surveys, interviews (group and one-on-one) along with JAD sessions.
• Involved in understanding the current business process, defining scope of the project along with position statement.
• Managed gathering of claims requirements to match new HIPAA 5010 transactions while coordinating with agency department heads
• Managed migration of HIPAA (conversion analysis).
• Made sure that the systems complied with the rules of HIPAA
• Collaborated with project architects for clearing house to remediate the existing MMIS to comply with new HIPAA standards
• Ensured continuity of on-going operations while developing new HIPAA transactions. Brought legacy electronic transactions like provider claims and remittance advices to comply with new HIPAA standards.
• Worked with software vendor’s to resolve HIPAA compliance issues
• Established strategic objectives, vision, and project scope. Included full lifecycle deliverables and execution.
• Had team perform SQL queries to test various reports and ETL load jobs in development, QA and production environment
• Worked extensively on X12 files (837, 835, 270, 271, 276, 277, and 278) transactions and analyzed response files such as TA1, 997, and BRR for HIPPA validation.
• Provided and support for the team members in understanding Medicaid business processes and developing low level test scripts
• Created detailed level test scenarios on HIPPA compliance testing.
• Gathered business requirements from business users such as Insurance Policy Managers, credit card Managers and drafted business requirement specification (BRS).
• Co-authored Business Requirements Specification (BRS), Use Case Specifications, Systems Requirement Specification (SRS) and Change Request along with the Business Group and the IT project group members.
• Understood the Business Logic, User Requirements and test-objectives to develop Test plans, Test cases, Use Case Scenarios.
• Used Quality Center to write and execute test cases and reporting defects.
• Analyzing tests using Quality Center pertaining to the test scenarios on the transaction based tests and the environments.

Confidential

Project Manager

Responsibilities:

• Identified business functions within business and system processes - existing and new - that can be developed as enterprise services
• Provided Initial Assessment(s) - estimate of work required to fulfill the requirements - and successfully identified lists of candidate services
• Formulated and defined system’s scope and objectives based on both user needs and a good understanding of applicable business systems and industry requirements/ regulations
• Decomposed business components to facilitate a logical understanding of business design that can be leveraged to provide finer levels of detailed analysis on how the process operates
• Produced service functional specifications for services and service operation(s) that serve not just the requesting business unit, but the entire corporation.
• Bridged the gaps (if any found) between analysis and design
• Created EDI documents for EDI maps to generate requirement documents and Project Charter, and logical design documents for EDI transactions and code sets.
• Created and updated data mapping document(s) with to the source for 270/271, 276/277 and 837.
• Drafted business scenarios that define all possible business outcomes for the functions which could be incorporated into the more detailed test scripts.
• Identified testing and data requirements; reviewed functional test cases with respect to the expected behaviors and proposed changes to the scenarios (where necessary) for testing purposes.
• Used SQL to validate Data Warehouse reports and data marts
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
• Ensured that developed services are in compliance with HIPAA Standards.
• Accounted for and anticipated impacts to enterprise services with respect to the transition from . More specifically, impacts related to the support of the following HIPAA Transactions: 837, 835, 270/271 and 276/277.
• Utilized EDIFECS Spec Builder to create data map, short companion guides, long companion guides, test data creation X12 data conversion etc.
• Played an active role in non-project activities, such as task and flow decompositions and creation of templates for artifacts produced by the SA.
• Constantly worked as a member of CoP for establishment of best practices for BSD.
• For UI Projects: Analyzed and translated High Level Functional Requirements into more detailed functional requirements; created new and made updates to the existing Use Cases. Worked along with UI Designer to draft screen mock-ups. Created wire frames and demo prototypes.
• Received of Appreciation for contribution to the success of one of the core projects.

Confidential

Project Manager

Responsibilities:

• Established the policies, procedures, and business processes regarding new products
• Documented the Project Charter and received approval from the Project Sponsor and other Stakeholders
• Facilitated JAD sessions to collect requirements from system users and prepared business requirement that provided appropriate scope of work for technical team to develop prototype and overall system
• Managed and monitored the Client Implementation EngagementLifecycle delivery and support phases following the PMBOC process
• Calculated & established communication channels, mode of communication for effective coordination
• Developed Product Development Strategies and Planning based on Roadmap.
• Implemented continuous improvement strategies using PMBOC methodologies
• Involved in gathering, documenting and verifying business requirements.
• Involved in requirement gathering phases
• Developed high-level project planning for deliverables, tasks, timeline, milestones, etc.
• Lead the User Acceptance Activities providing sign-off acting as a Subject Matter Expert in the team.
• Analyzed and updated the current systems with the annual announcements regarding the Policy updates.
• Created Business Requirement Document (BRD) and Functional Requirement Specifications (FRS).
• Performed risk adjustment I domain related models
• Negotiated priorities and resolved conflicts among teams and stakeholders
• Achieved results through repeatable and scalable processes
• Coordinated with other departments those played role in the Client Implementation Engagement Lifecycle such as product development, client services, huntsman resource, legal, managed services,, and finance.
• Built key business relationships vital to project success by working closely with other business areas to ensure successful QA,, Documentation, and Implementation of project.
• Prepared demand resource forecast following PMBOC guidelines
• Prepared project network diagrams, calculated BAP, PV, NVP
• Estimate resources and participants needed to achieve project commitments; where required, negotiate with other department managers for the acquisition of needed personnel.
• Coach, mentor, motivate, and resolve conflicts within project teams.
• Provide performance metrics to General Manager and Management Team.
• Managing delivery of project

Confidential

Business Analyst / Project Coordinator

Responsibilities:

• Business Analysis of Client needs, gathering and analyzing business requirements, managing all requirements using Rational Requisite Pro.
• Maintained Requirements Traceability Matrix (RTM) across the deliverables of the project.
• Performed Gap Analysis for new functionality requirements, as well as prioritized them based on actual business needs so as to align them with the product release roadmap.
• Documented workflows and results of business analysis and obtaining sign-off from client on specification.
• Implemented Rational Unified Process (RUP) in terms of disciplines and phases, each consisting of one or more iterations.
• Developed Use Cases using UML for new product functionality after conducting requirements elaboration sessions with client teams. Worked with internal product management teams to include this functionality in the product release cycle. Ensure that the product and the client were in agreement with the requirements.
• Developed Business flow diagrams, Activity diagrams and Sequence diagrams so that the development team and the stake holders can understand the business process.
• Assisted with user testing of systems, developing and maintaining quality procedures, and ensuring that appropriate documentation was in place.
• Participates in project definition and analysis phases of project to ensure that business needs and requirements are captured effectively, and work with tech lead to identify Assumptions/Risks Identified for the project
• Convert those HLBN (High Level Business needs) into appropriate Requirements.
• Interacted with clients for gathering, analyzing and documenting business requirements.
• Served as liaison between business team and various other project groups.
• Followed an iterative approach to organize requirements into logical groups of business processes, business rules and information needs and ensured that critical requirements are focused upon
• Involved in gathering Business Requirements and interacted with the users, analysts, developers, project manager and SME’s to get a better view of the Business Processes.
• Conducted meetings with business experts and carefully refined the requirements for both business and technical teams.
• Created swim lanes, Activity Diagrams and Sequence Diagrams using Rational Rose and also involved in creating the Business Process Model.
• Organized JAD sessions periodically with various stakeholders during different phases of the Software Development Life Cycle (SDLC) to discuss open issues and resolve them.
• Assists in the analysis of underlying issues arising from investigations into requirements.
• Perform analysis and reporting for management as required
• Oversee entire process to maintain quality
• Create special reports as requested from other business units, as assigned by the Manager.
• Enforce and monitor audit control change functions and processes
• Maintain current knowledge and consistent compliance with regulations and bank policies and procedures related to the position
• Interact with others (co-workers, management, clients, and vendors) in a professional and tactful manner including treating them with respect and consideration regardless of their status or position
• Collects and analyzes complex data for reporting and/or performance (trend) analysis

Confidential

Lecturer

Responsibilities:

• Develop and implement innovative instructional methods
• Develop professional logistics to improvise student performance
• Guide, lead and mentor students in research projects.
• Evaluate, monitor and mentor student academic progress
• Create, innovate and implement career-enhancement programs and activities
• Supervise and support teaching assistants
• Participate in departmental and college activities
• Serve and support functional activities of departmental committees
• Assess, review and evaluate student activities and progress
• Assist and support senior professors in their day-to-day tasks and functions