SUMMARY

• Strategically focused and value driven performer who leads hands on by setting examples and builds teams with positive energy and motivation
• Currently managing a large portfolio of multiple critical programs in Enterprise Program Management Office of a leading health insurance payer
• Leads and leverages decision making on Strategic Planning, Financial Planning and Budgeting, Vendor Management, IT and Business Operations and Transformation
• Oversees Planning, Execution, Governance, Reporting and Compliance of EPMO programs
• Eighteen years of industry experience with ten plus years in Leadership positions, Program and Project Management with top tier organizations
• Lead Healthcare Government Programs for complete Medicaid MMIS and MITA implantations and CMS Compliance initiatives
• Managed EPMO, IT Operations and Transformations in Insurance, PBM, Banking and Financial Services business domains
• Managed large client accounts of fortune 100 clients, yielding value driven inside sales, up - sales and cross sales. Successfully developed business and new client base
• Lead innovation and process restructuring resulting higher efficiencies and patenting
• Expertise in strategic planning, analytics, critical thinking and problem solving, decision making, effective communications, team building, leadership and stakeholder management
• Self-motivated with innovation and value-oriented transformation of large-scale portfolios
• Expertise in Waterfall, Agile and scrum methodologies and PMBOK
• Managed Pre-sales, RFQ, RFP, SOW and Vendor Contracts Management and Invoicing for accounts
• Expertise in Program and Project Planning and Execution, Schedule Management, Delivery Management, Operations Management, Governance and Project Controls, Business Continuity Planning, Change Management, Risk Management and Conflict Management
• Experienced in Financial Management, Forecasting, Variance and controls, Budgeting, Reconciliation and Reporting
• Expertized in Customer relationship Management with fortune 100 clients
• Experience in business development and presales; motivated hunter, successful with new business logos and farming within existing accounts with innovative cross platform sales
• Expertise in the business domains of Medicaid, MMIS, MITA, Pharmacy Benefit Management (PBM), Radiology Benefit Management, Utilization Management, Appeals, Member Enrolment and Eligibility, Provider enrolment and Management, Managed Care, Encounter and Claims Management, EDI, and HIPAA Compliances
• Experience of working with seven different State Medicaid Agencies in the US
• Experienced in BFS, payment systems issuer, acquirer and card associations, authorization, card issuance, clearing and settlement, ACH, billing and collections, risk and fraud prevention management
• Expertise in tools like Microsoft Project, Smart Sheets, Planview, JIRA, PeopleSoft, rTrace, SharePoint, ClearQuest etc.

PROFESSIONAL EXPERIENCE

Project Manager

Confidential

Responsibilities:

• Managed multiple teams for six different Medicaid States as CO, MS, MT, NM DC and WY
• Managed Commercial Health Insurance Payer processing
• Managed teams with different functionality and platforms across the country, working from different sites complying to PMBOK (Project Management Body Of Knowledge) and ELC (Enterprise Life Cycle processes)
• Multiple intellectual patents submitted on behalf of the organization
• Managed full life cycle of large-scale development, maintenance and production support projects

Manager

Responsibilities:

• Won new business deals and developed 35 members project team from scratch
• Managed delivery and operations yielding extensive business growth
• Managed PBM claims processing and operations along with mail delivery prescription processing systems
• Managed customer communications for onshore and offshore operations
• Managed end to end solutions and developments of Pharmacy Benefit Management (PBM), Healthcare eligibility and claims systems, and home delivery pharmacy systems with cross platform technologies
• Managed full life cycle of large-scale development, maintenance and production support projects in IBM Mainframe platform with Agile and Scrum methodologies.

Project Manager/ lead

Confidential

Responsibilities:

• Managed and trained large teams from Seattle WA and Kolkata India
• Managed delivery and operations yielding account growth
• Managed customer communications for onshore and offshore operations
• Managed full life cycle of system integration and conversion projects; development and support projects of complete credit card processing
• In depth business analysis of credit cards, banking and financial systems
• Project leader of PayPal and Vision Plus payments projects
• Managed project development delivery production support
• Trained and lead large teams
• Managed onshore and offshore customer communication and relationships
• Managed very large-scale software developments, implementations and supports
• In depth business analysis of credit cards, store cards, PLCC, bank cards, banking and financial systems

Team Leader

Confidential

Responsibilities:

• Lead project modules and teams for manufacturing and engineering client, for the MES system enhancements and database migration projects and maintenance
• Innovated tools and development methodologies for rapid software development.
• Achieved customer appreciations and satisfaction for before schedule and zero-defect deliveries
• Managed customer communications for onshore and offshore operations
• Lead database conversion and system conversion projects
• Trained on control system software, PLC, DCS, manufacturing processes and project management
• Completed hands on control system project implementation in atomic energy plant