SUMMARY:

• Confidential has delivered multiple large - scale, mission critical initiatives in the area of healthcare, finance and telecom industry.
• He has been responsible for conceptualizing the projects from the beginning, assessing problem and creating objectivity and value generation resulting into desired outcome. Other responsibilities include Cost management, Resource management, driving design and architecture discussions, directing team or folks for desired results, solution conceptualization, requirement presentation, risk assessment, change management, delegation, and budgeting, managing offshore/onsite team.
• He possesses strong management, business and technical skills and ability to define and improve business process workflow at the enterprise level.
• Experience with enterprise wide applications development, infrastructure s/w upgrades, system integration, business analysis, data analysis & reporting development, mapping activities, managing COTS implementation, meeting federal compliance and regulation, corporate security needs, defining Confidential reflecting comprehensive ability in understanding client’s requirement and providing scalable IT/business infrastructure.
• He has knowledge and strength in devising strategy for the projects and providing leadership in the Project Management, Architecture, Cost-Management, IT, Business, Methodology, Regulation, Emerging technology & System/Enterprise Integration, business agility and meeting future challenges.

CORE COMPETENCY:

Project/Product Management, Project Planning, Critical Path Development, Project Budgeting, Estimation, Forecasting, Earned Value Management, Vendor Management, Technology Management, Architecture, Business Understanding, Scope, Resource Management, Cross Functional Team, Vendor Release management, Cost & Estimation, Risk Assessment, Product Development, Project Reporting, PMO requirements, Forecasting, cost-engineering, cost management, SH Management, Communication Planning, Client/Vendor Dealings, Conduct ROI, RAID, RACI, Resource Calendar, Budgeting and Tracking, JAD sessions, Managing Risk, Negotiation, Rolling Wave Planning, Management Matrix, Prioritization Matrix, Project Status Reporting, Project Templates, Setting up Project Agenda items, Tracking and Reporting Project Updates at all level, Project Methodology, working in the team environment, User Training, Regulatory and Compliance Projects. MS Excel (charts, pivot, analytics), MS Project, MS Word, Pivot, HIPAA-SME (837, 835, 278, 271/272, 276/277, 834), Encounter Reporting, MMIS Implementations, BI Reports, EDI X12, Remittances, THIN, MARS, MAX Reporting, SQL, Strong Analysis.

PROFESSIONAL EXPERIENCE:

Confidential, Basking Ridge, NJ

Project/Program Manager

Environment: COTS-EMC Content Management, Archival, ETL, EDW, PAAS, XML, XDB Screens & Reports, ITSM, Clarity, Ariba, Oasis, ITG, HPSM, cloud/hadoop strategy.

Responsibilities:-

• Serve as Lead for the program scope development leading to dealing with project teams to meet multiple project related requirements and comprehensive business & IT process improvement. This includes: working with SHs members to understand and prioritize their workload, facilitate technical discussions, create action plans to move projects forward, provide technical guidance and recommendations, negotiating and coordination with vendors.
• Conduct status meeting, technical review, assess changes, provide action items, assist in providing guidance to the team for compliance with the SHs requirement, security & auditing needs, performance requirements, H/W & S/W requirements, Risk assessment, and resource requirements. Review impact to the infrastructure, operations, lifecycle costing and risk involved.
• Gather and provide regular updates of the progress and status of multiple projects; participating in PMO meetings, gate reviews and go-live decisions. Contributes to ensuring adherence to project management standards in a manner consistent with needs for continual improvement.
• Define project objectives thru collecting requirements; develop detailed functional reqs, conduct design session, coordinate efforts to scope, schedule, and cost. Conduct deployment of new features sets and per program objectives, communicate results to the SHs involved.
• Ensure compliance with regulatory requirements, reporting needs, audit & security requirements, including analysis and remediation of exposures, assist management in data gathering for performance tracking and for regulatory and third party reviews.
• Evaluate program performance, monitor, and manage risks across the program, escalate as necessary. Manage contractors and some vendor relationships on behalf of business owners during project execution where cost factors become a risk.
• Saved multimillion dollar with vendor negotiation, process redesign, utilization control and project planning during the life cycle of implementation & integration of the product.
• Used Clarity S/W for PLM, Time Management, Tracking and Reporting purposes, use excel, pivot and formulas for reports and charts.

Confidential, Philadelphia

Sr. Project Manager

Environment: Cross Functional, EDI (837, 834, 277/276, 835, 999s, ) Windows, .net, SPE Engine-ICD10 Upgrades, java, Eclipse, WTX-Design studio, IBM-WTX - Compliance server, DSX, Data Stage 6.x/7.x, Clusters, infrastructure, TFS-2008, Facets, tfs-2013, tfs-Cloud using Microsoft azure, SaaS, WTX Compliance server, RN Support, MS Project, ITSM Change Mgt, Enrollment, Claims, COB, PPO, Perform RX, Project Budgeting, Performance Tracking, Configuration, Risk management, EVM, Datastage, Oracle, ETL, QA, SAP-BO (BOBJ), SAP-Business Explorer (BEX) SAP-Hana, Crystal Reports

Responsibilities:-

• Involved in project scope, budget, risk, responses, resource requirements, and project activities; manage PLC, ALM, SDLC, Product life cycle.
• Managed assimilation of the Proprietary and non-proprietary data integration into the MMIS Data-Warehouse, this is meeting the quality and regulatory data requirement needs for DC-Alliance, MI-MMIS, FL-Prestige integration and supporting data for 2 way exchange of information of state reporting data needs.
• Train team on a methodology suitable for the project as such Agile, WF, Phased/Iterative development, serve as HIPAA-SME for client discussions.
• Create Confidential and sequencing activities, develop n/w diagram leading to risk mitigation and project approvals
• Conduct meetings for requirement gathering, JAD sessions, UML diagrams, use case development, requirement elicitation, project iterations, data model evaluation and resolution, ETL Jobs.
• Spearhead Reporting & Analytics Development using BOBJ, BEX, WeBI, Hana for the B2B Transaction analytics and monthly financial/membership reconciliation, transition relevant reports from .net platform to BO.
• Customize SharePoint for the Projects, Workflow, develop Trend, and conduct demand analysis, plan budget, control and forecasting.
• Serve as POC for the client, vendors, trading partners for the evolving business requirement.
• Conduct weekly meeting with various team for gathering status and reporting to the management.
• Address quality control and assurance related with product, emergency production issues, vendor releases, deployment plans, and offshore coordination.
• Managed project related with the Facets upgrade, MMIS, Enrollment, Presumptive Eligibility, Claims Adjustment, Remittances, EDW, Reports, Transactions, Change Management, Versioning and upgrades.
• Develop resource forecasting, manage RAID, handle technical issues and business issues with the state Medicaid, and ensure timeliness of the deliverables, weekly status reports, stakeholder management and management reporting.
• Create value for the client thru deliberations, collaboration, and bringing in insight for managing gaps and uncertainties across the projects, business, financial and management.

Confidential, Philadelphia

Environment: Clarity, MS-Project, EDI/HIPAA-4010/5010, Infrastructure upgrades, DW, IBM-WTX, Webservice, Claims Inventory System, Eligibility, Enrolment, Provider, Clinical Mgt. System, CMS Encounter Management System, COB, OPL, Subrogation, Claims/Encounter integration with CMS, Imaging, Crystal Reports, ITIL V3, PMBOK, Vendor Management ToolsTools: PowerPoint, Visio, MS Project, Imaging, Web Services, Oracle 11g, SQL, ColdFusion, Java, ITIL, Webservices, Oracle 11g, EDI-B2B

Principal Consultant

Responsibilities:

• Lead, Facilitate & Manage conceptualization of reporting needs for various Providers and customers, evaluated infrastructure needs for the reporting, developing secure exchange of the RA, THIN and Provider Online Reports, using OLAP, DSX, WMB/WTX.
• Lead PMO team (Accenture) for ICD10 upgrades impacting various domain, devising strategy for documentation, review testing and aligning infra and other resources.
• Facilitated automation requirement, configuration management, managed data hosting and subscribed analytics requirement development serving as the long term needs of the provider and the payer organization in mitigating contracting issues and faster payment appeal reconciliation & adjustment within the provision of the regulatory needs .
• To manage multiple projects/program and provide support to management for HC-SME needs, Risk Identification, HLE, Financial Plan, Scope Determination, Product Requirement Identification, Vendor Alignment, Presentation, Team Building, Confidential, Cost controls, Monitoring and Control of timelines and cost where necessary.
• Involved in change management and senior stakeholder management
• Perform overall strategic management, and planning
• Conduct planning, Confidential development, HLE, and Detailed plan using MSP/Clarity
• Conduct SDLC analysis for the project/program and align with the project plan
• Perform SH analysis, conduct relationship building for defining long term/short terms goals in compliance with the regulatory requirements,
• Conduct sessions to resolve highly complex technical and risk related issues
• Manage coordinate and guide project teams at various stages over the period of program
• Provide leadership & integration skills in bringing the team together and work collaboratively
• Conduct meeting, provide weekly Status reports to the management
• Used Clarity S/W for PLM, Time Management, Tracking and Reporting purposes.

Confidential, Newark, NJ

IT Project Manager/Analyst

Environment: HIPAA 5010 - CFR 42 (837, 276/277, 834, 270/271, 835), HL-7,LO INC, Blue Exchange, ITS, ICD9/ICD10, Code Sets, PHI, EMR, PHR, Claims, Payment, Authorization, Enrollment, ONC, Provider network management, Informatica HIPAA Engine, Physician Service Mgmt, Release management, UML, Rational-CQ, ReqPro, MSP2007.

Responsibilities:

• Provide business and architectural lead support for HIPAA 5010
• Conduct technical discussion for making decision related with Licensing, infrastructure building, prototype design, and customer related issues and real time requirements involving COTS products and other commercial product integration.
• Create presentation documents for the management evaluation of a product, supplementing with information needed to support decision-making using product portfolio model.
• Assist program manager with the project timeline, network diagrams, scope, critical path, vendor discussion, Confidential, costing, monitoring and project control.
• Make recommendations for decision making and its future implications involving competitive forces.
• Establish deadlines, project risk assessment, provide alternative solution, project monitoring, enhance coordination and cooperation among the teams involved, help top management in making effective decision and making decisions for better project/product outcome.
• Lead client team to perform consulting engagements and engage in billable consulting activity, mapping, companion guide development and review with the internal and external SHs.
• Manage evolving client expectations, needs and priorities, and collaborate with client team members to ensure effective navigation of the project and integration with key systems.

Confidential

Sr. PM/BA- Consultant

Environment: MS Project, HIPAA (Remit, Payments, Billing, Lockboxes, Eligibility, Provider Electronic Enrollment, benefits, Prior-Auth, Etc., 835, 837, 276/277, 270/271, 278, 834 997s), WMB, EDIFECS, Contract Management, Medicare-Scrape, Egistics-Image Handling, Electronic EMR, ABN, Medical Credit Card/Debit Card, VIANT, Oracle BI, COTS integration, SOA based project.

Responsibilities:

• Conceptualize and evaluate business needs for the project, define the scope of the project, assure customer buy-in and conduct vendor evaluation for COTS product integration, align resources and perform activities necessary for successful delivery of the Project/Releases .
• Conduct scope identification, requirement development, technical impact analysis, cost benefit analysis, risk assessment, feasibility studies, business valuation, and assets life cycle for Enterprise decision making. Architect homegrown data migration to the new database for the faster and online access.
• Ran program for the Web development where multiple screens identified to support member and provider integration into the hub, where provider could access their information on a seamless basis related to payment, reconciliation, messaging to the customer service. This involved quality data access, claims payment, claims reconciliation, claims authorization, union payment, ASO claim review adjustment, maintain billing and receivables information, exchange with the payer entities.
• Project require determining project methodology, scope assessment, presenting comprehensive scope requirements, Confidential determination, estimation, risk assessment, and development of schedule mainly on AGILE methodology but meeting SDLC requirements for the product, training team on AGILE, defining backlog items, determine sprint cycles, platform infra requirements, reporting integration.
• Develop Project Chrter, RACI, RAID, Confidential, schedule, financial plan, resource plan, HLE, Project Plan, CPA, CCA, LOC Estimating, RE Analysis, Prototyping, Spiral Modeling for Risk Management,
• Conduct scrum calls, review backlog and agile impediments, product increments, conduct review meeting with Business and Technical teams, measure & monitor progress and aligning project on a EVM basis to keep it close to the baseline cost, update EPMO, coordinate with CAB for changes & Finance as needed for the resource/vendor management.
• Conduct ROI analysis for the opportunity assessed., conduct sessions for COTS evaluation and integration into the infrastructure.