EXPERIENCE SUMMARY

• Project Management professional having 16 years of IT experience including 10 years in Project Management and 6 years in application software design/development
• Expert in managing large multimillion dollars budget projects of software Development, Implementation & Customization, Integration, Infrastructure and Testing projects
• Sound experience and functional noledge in Healthcare (Insurance, Health Connect, Medicare, Medicaid), General Insurance (Auto, Home, Commercial, Life) and Financial Services
• Worked for tier 1 organizations including Confidential, Kaiser Permanente, Confidential, Farmers Insurance, American Express and AXA Life
• Capable of delivering large size and complex projects through all phases of project life cycle (SDLC): Charter, Planning, Scheduling, Execution, Control Cost/budget, Milestone tracking and closing
• Proficient in Project Management Processes: Scope Management, Resource allocation & management, Stake holder management, communications and Risk management
• Expertise using Project Management tools: MS office, MS project, Primavera, SharePoint, ALM, CA Clarity, ITSM, Project server, Jira, RFI, RFP, WSM, RM, OPPM and EPMO tools
• Experience Project Management methodologies: Waterfall, Agile and hybrid
• Expertize in US Healthcare Domain (Payer and provider): Health Plans, Medicare, Medicaid, Market place, Health Connect, Care Management, Managed Care
• Moderate experience in infrastructure projects, coordinating for Infrastructure builds, security controls and DR plans
• Experience in Agile development; Scrum iteration plans, Sprint Cycles, Development cycles
• Expert in Healthcare claims processing systems: MCG, EDI files, HIPAA transactions
• High Experience coordinating wif Business teams, Product managers, cross functional teams/focus groups, Vendor teams, Solution design teams, Build (IT) and QA teams
• Highly involved in Converting business/product requirements into IT requirements/solutions
• Managed project teams up to 30 people (offshore/onsite, matrix) and up to $15M Budget
• Extensively worked in EPMO for building tools, standards & processes and process improvements
• Experience in Release Management process through all phases of SDLC
• Involved in System Requirements analysis, technical requirements reviews, Application Integration Testing, Functional & Non Functional Testing, System Workflow/Process Maps Testing (SWT), Regression testing, compatibility, mobile testing, E2E testing and UAT
• Strong Knowledge in Change Management and Deployment processes

PROFESSIONAL EXPERIENCE

Healthcare (73 Months): Health net/Clinical systems (EPIC), Ambulatory, Resolute Billing (PB&HB), Tapestry AP claims (EPIC), MCG, EDI Claims, Eligibility/Enrollment, Benefits, Membership, Medicaid/Medicare, Revenue Cycle, Provider Payments, Encounters

Insurance (94 Months): Home/Life/Auto/Commercial, Policy Processing, Premium Processing, Claims processing, Agent commissions and BI reports

Financial Services (22 Months): Credit Cards / Banks, Customer Statementing, Loyalty and Membership programs

Technical Skills: Mainframes, COBOL, JAVA Script, DB2, CICS, JCL, SSRS, SSIS, SQL server

Tools: Endeavor, Changeman, File Aid, File Manager, QMF, SPUFI, HP QC, QTP, Track, LinkEPIC: 2012/2014, TFS, BI Reports, QNXT 5.3

PROFESSIONAL EXPERIENCE

Confidential, Long Beach, CA

Project/Program Manger IV

Environment: UPIM, QNXT, Medicare, Medicaid, Enrollment, Eligibility, Data migration, Claims, Portals, CRM, Encounters

Responsibilities:

• Project Management for entire IT deliverables and manage project teams made up of internal and external resources for UPIM implementation program: $15 M Budget and 30 people
• Manage all aspects of UPIM program throughout teh project life cycle including project scope, schedule, resources, quality, costs/budget estimate, tracking and change management
• Project Management for MAPD 2018 Expansions and ID MMCP/D - SNP implementation projects in Enrollment, Eligibility outbound/inbounds and Vendor extracts: IT development, QA testing, UAT and business process development, Vendor Coordination: CVS Caremark, Secure transportation, Quest, March Vision, Change Health, Avesis (Dental)
• Project Management for Connecture Enrollment implementation in Consumer, Broker/Agent and Call center channels: IT development, QA Testing, UAT, Vendor Management and Business process
• Project Management for private exchanges (eHealth, WTW) enrollment implementation and Integration project: IT development, QA testing, UAT, Vendor Management and Business process
• Project Planning, Execution, Monitoring, Risk identification/analysis, status reporting, EVM
• Manage stake holders and project communications: weekly status meetings, daily check Ins, weekly status reports, risk/issue register, work plan updates, budget trackers, Implementation checklist,RTM
• Managed UPIM implementation in Medicare and Medicaid domains
• Managed entire Molina downstream impact analysis and remediation for QNXT configurations/data changes as part of UPIM implementation
• Interacted closely wif internal staff, external corporate departments, and Health Plans to define teh project parameters and develop detailed project plans for conducting data migration impact analysis through all business processes
• Partnered wif Business, IT, Health Plans, Corporate departments and operations for data governance, standardizations, clean up and Data Migrations (iterative)
• Coordinated wif EIS for UPIM product infrastructure builds, security and disaster recovery (DR) planning and implementation
• Managed communications between Business and IT streams for UPIM business solution customizations and impact analysis
• Managed multiple IT work steams in matrix organization
• Used tools such as MS Office, MS project, Primavera P6,ALM, RFI, RFP, SharePoint, Project Server, QNXT 5.3,SSRS and OPPM

Confidential, Pasadena, CA

Senior IT Project Manager

Environment: EMR EPIC 2012/2014, Tapestry AP (EPIC), Clarity, Data warehouse, ETL, Revenue Cycle, Health Connect, In Patient billing, Out Patient billing, EDI claims

Responsibilities:

• Project Management for Claims Connect Tapestry AP implementation and system testing in Revenue cycles, KP health connect areas
• Manage and update Microsoft Project Plan (IPP) for tasks and milestones completion status, adjust timelines as required, Prepare weekly status reports including Burn down charts and Defect metrics
• Monitoring Planned vs Actual Project status on weekly basis and adjusting teh resource allocation plans to meet teh schedule for critical path tasks
• Identify project risks, log in SharePoint and escalate to Program. Manage and Maintain Project issue/risk log and review them wif team and PMO group weekly basis
• Manage Implementation of Clinical and Resolute (PB & HB) application builds and configurations as part of new claims system Tap AP implementation
• Manage Payer builds and configurations (Commercial HMO,DHMO,HCR, Medi-Cal/Medicaid and Medicare)
• Manage Provider (PSA) builds in Heath Connect and Claims System Tapestry
• Manage communications wif Business, EPIC and Focus groups
• Manage ICD 10 builds and configurations in Clinical ( Cadence, Prelude, Ambulatory) and Resolute billing modules
• Manage ICD 10 Implementation and E2E testing for KP Health Connect (KPHC) modules
• Partnered wif cross functional teams for building Work Flow/Process Map Testing Scenarios (SWT)
• Manage SWT testing following quality measurements and SLAs
• Partnered wif external providers for external claims configurations, data and testing
• Extensively worked wif product management for Phased Roll out plans and cutover plans
• Defect Management, coordination wif multiple work stream PMs for issue(s) resolution

Confidential, Bloomington, IL

Scrum Master/ Project Manager

Environment: Mainframes, JAVA, .NET, SharePoint, Track, Link, Agile, Jira, Claims

Responsibilities:

• Report a claims is a UI web portal application developed for mobile devices compatible wif different versions of OS and browsers
• Mobile compatibility testing, systems testing (functional/nonfunctional) and performance testing are teh key deliverables
• Builds release and scrum/iteration/Sprint plans
• Coordinated wif product team to define & prepare sprints
• Reports on teh health/status of teh development cycle/iteration/sprint
• Schedules and facilitates planning sessions
• Helping teh team maintain their burn down chart
• Responsible for system testing (Compatibility, SOAP UI, Mobile testing) in release process
• Coordinate wif cross functional team for system integration and set up
• Coordinate wif case manager and release manager
• Report daily status metrics on system test execution including defect metrics

Confidential, Los Angeles, CA

Project Manager/Release Manager

Responsibilities:

• Project Management for Sofia Application Platform Services (APS) project: Manage service delivery activities like test environment setup, batch job setups and Job scheduling
• Coordinate wif DBAs for data backups, storage space allocations and loading test data
• Coordinating wif Development and Testing teams for Environmental/ISP Requirements
• Involved in test Environment refresh, code migrations, retrofits to ensure test environment is up to date wif teh latest version of teh code
• Part of Data Center move project ( LADC to CDC) for PLA applications
• Responsible to Gather Application Inventory for Data Center move
• Responsible to Prepare Application, Server, Storage dependency maps
• Part of move Discovery, Analysis, Planning and execution
• Release Manager for Farmers Bi-Monthly release process
• Handled teh Release Management tasks ( 6 releases for year) right from SRS reviews up to Production Migration
• Involved in ROM validations and had negotiations wif Farmers SD team if ROM conflicts between Dev team and SD team
• Work Order processing using WSM & RM tools
• Project allocations, tracking resource efforts & Project status in EPMO
• Ensuring all teh projects in teh release meeting teh milestones as per teh Release Calendar
• Reviewing Project status, quality and delivery status
• Accommodating new projects and CRs during teh release by adjusting milestones and resource allocations
• Coordinated wif CMT for migrations and deployments
• Worked wif test Env support, batch support, ISP teams for new project test setups
• Coordinating wif several application development & AIT,AFT, Regression and UAT testing teams