SUMMARY

• 9+ years of experience in Product & Project Management and Business Analysis with exposure to Healthcare industry, 5+ years of it in the IT Healthcare services industry.
• A strong exponent of the Project Management Body of Knowledge (PMBOK) principles and ITIL best practices.
• Strong customer facing skills due to frontline customer facing roles for 7+ years.
• Experience in bills and claims management systems and Project Management methodology of major healthcare companies
• 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.
• Develop process improvements to meet customer needs.
• Proven experience in drafting detailed Product Requirement Documents (PRD), Business Cases, Use Cases, Proposals and Return on Investment (ROI) templates.
• Experience in mapping UML diagrams for data flows, system diagrams, 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.
• Experienced in project planning, scope management, costing and estimation. Hands on with project management tools like MS-Project, Clarizen for project and resource planning
• Experienced in all phases of the Software Development Life Cycle (SDLC) as well as software engineering methods like RUP, Waterfall Method & Agile
• Exceptional Documentation Skills for writing Use Cases and Functional Requirement Documents as well as for creating Use Case diagrams and Activity diagrams based on UML Methodology and business process flow diagrams using MS Visio
• Experience in defining test cases, bug triage, conducting User Acceptance Testing (UAT). Led improvements in QA and release process (Iterative deployments)
• Strong capability in Conceptualization, Planning and Implementation.
• Familiar with business environment of major healthcare companies in Asia & North America.

TECHNICAL SKILLS

Business Skills: SDLC and Agile Project Management Methodologies, Requirements Gathering, Team Management, Claims and Case Management Systems

Programming languages: R, Python

Operating Systems: Windows Server 2000/R2, Windows XP, Windows 7, Windows 8

Software Tools: MS Office, MS Project, MS Visio, MS SharePoint, Tableau 8.2, Data mining and Statistical Analyses using JMP (SAS), Oracle SQL 11i, SAS Enterprise Miner 13.1, Rapid Miner, SAS 9.4, SAS Enterprise Guide 6.1, Rational Requisite Pro Multi Project, Rational Rose, SQL, Clear Quest, MS-Visio, Cognos ReportNet, MS-Outlook, Lotus Notes, XML, Wiki (Content Management System), Documentum, Crystal Reports, Clarity, Planit

PROFESSIONAL EXPERIENCE

Confidential, Albany, NY

Senior Consultant / Project Manager

Responsibilities:

• Assigned to Health Information Technology (HIT) workgroup for NY Department of Health NYSIM Project
• Advised NYS DOH on APD and APC infrastructure including billing, enrollment and claims management.
• Adopted and understood Confidential work culture and integrated self into the client (NYSDOH) environment; building rapport and positive professional relationships
• Worked and assisted Engagement Manager and other Business associates in associated workgroups of Integrated Care, Access to Care, Healthcare Workforce·
• Support meeting coordination, pre- and post-meeting communications, documentation of meeting minutes, support to produce progress reports relating to HIT workgroup
• Active participation in Problem Solving sessions and gathering of information pertaining to various requirements identified during the Problem solving sessions.
• Conduct research and build business case studies as requested and required by the Team
• Do a comparative study of other SIM states and bring potential ideas based on the comparative research
• Participate in meetings and create presentations as directed for the meetings.
• Create Project Deliverables Status Report by tracking various deliverables and ensure the deadlines are being met.
• Work on ad hoc requests and to assist the team in any possible manner.

Confidential, Bloomington, IL

Project Manager

Responsibilities:

• Initiated and created Project Charter for 3 major projects for Confidential Future State Program for migration to Hadoop Environment and building of 2 new Datacenters
• Defined objectives, requirements and assumptions necessary to structure management project.
• Managed projects and related specific activities within given constraints of time, budget and quality.
• Ensured scope, schedule and costs are reasonable and achievable by developing a custom priority constraint matrix for each project.
• Allocated work among team members and provide guidance regularly.
• Conducted periodic and post-project reviews to ensure project is on track and learning from the project is accurately documented.
• Coordinated functional perspectives from within and outside project teams.
• Ensured all project documentation is updated and conveyed to relevant stakeholders on time
• Performed Project initiation by Planning, scheduling and controlling activities to fulfill identified objectives applying technical, theoretical and managerial skills to satisfy project requirements.

Confidential, Buffalo, NY

Project Manager

Responsibilities:

• Defining the overall scope for several multidisciplinary Business and Technology oriented SDLC projects in agreement with Business Unit and Chief Technology Officer respectively.
• Facilitating JAD/JRD sessions with client SMEs and Business to give shape and understanding to the requirements with the help of Business Analysts and Developers and ensuring all requirements are documented in the BRD (Business Requirements Document).
• Employing rapid prototyping from Business Analysts to verify design and solicit customer feedback.
• Proposing Design and performance solutions to development teams from a Solutions Architect standpoint.
• Forecasting resources based on the upcoming and pipeline projects, ramping up and down as needed.
• Identifying appropriate internal resources for the project and helping them come up to speed.
• Assigning responsibilities to project resources, organizing daily meetings to discuss technical roadblocks and resolutions, risks and ways of mitigation, fostering growth, setting milestones and encouraging resources to meet them and evaluating performance against the goals set.
• Maintaining resources, tracking timelines, costs and risks using Microsoft Project plans and Planview from Design up to Implementation for up to 5 mid-size to large SDLC projects ranging from few hundred thousand to multi-million dollar projects and maintaining one consolidated Enterprise Release project plan.
• Escalating to client management for urgent issues requiring their involvement.
• Reporting weekly project status to the Business and Confidential Management in Microsoft Excel document with the % completion, highlighting the risks and means of mitigation.
• Overseeing the Requirement traceability Matrix (RTM) across all phase of the project.
• Performing Gap Analysis, SWOT analysis, Risk Analysis and Cost/Benefit analysis.
• As first point of contact for the project, meeting weekly with external vendors, conducted site visits and communicated daily with technicians.
• Serving as the IT program coordinator and Vendor coordinator coordinating with internal teams and external vendors to oversee smooth progress of the projects in the Enterprise Release.
• Demonstrated fiscal accountability by frequently delivering projects under budget.
• Excellent negotiation skills with the client and external vendors alike for timelines and cost.
• Triaging post production issues and expediting resolution for the same by assigning to appropriate folks.
• Ensuring all the project documentations are in place to achieve Sarbanes-Oxley (SOX) compliance.

Confidential, Thousand Oaks, CA

Project Manager

Responsibilities:

• Management and coordination of multiple modules of enhancement program of 4010 standards of healthcare transactions to federal mandate HIPAA 5010 standards.
• Directed and managed different teams to do SIT, UAT, automation and performance testing for implementing the new Medicaid system.
• Worked with internal and external resources to organize components of a major project.
• Responsible for creating new Work Request / Change Request and follow-ups.
• Supervising and tracking project activities and assuring completion by baseline time. Creating and tracking Risks and Issues and escalating them to leadership team if required.
• Establishing and maintaining project performance metrics and measures.
• Perform as project SharePoint site Administrator and maintaining the project library housed on SharePoint.
• Responsible for managing and coordinating Budget management activities between project teams and finance department as well as forecasting budget (impact/effort analysis) and Accruals.
• Coordinate with customers to develop project plan including project scope, release schedule, milestones, deliverables etc.
• Improve customer relationship by providing timely and accurate responses to their inquiries..
• Coordinating Resources management with Sr. manager along with other project teams on board to understand their requirements and provide Resource forecast to management.
• Maintaining the resource allocation of project schedule while working with a project scheduler. Ensuring resources are appointed appropriately and to the requirement.
• Prepared weekly Status Report and support executive level reporting. Also preparing Progress reports to track progress and report possible issues, delays and risks.
• Facilitate and refine critical processes related to project and program management as well as the software development life cycle (SDLC).
• Worked under the direction of a Program Manager and Project Manager and may also serve as the Project Manager for isolated components of a larger project.
• Coordinated initiate activities of preparing ICD 10 project charter, program resource matrix, high level budget proposal, SharePoint document Library and Clarity account.

Confidential

Sr. Business Analyst

Responsibilities:

• Worked on HIPAA 4010 & 5010 ANSI X12, EDI series (Insurance/Health Series) (INS) such as 270/271, 276/277, 278, 834, 835, 837.
• Maintained the insurance record of customers through EDI (ANSI ASC X12 standards) for better privacy and security, compliant with HIPPA regulations.
• Responsible for discussing with business team and technical team various business scenarios and planning solution for meeting business need.
• Responsible for coordinating test data preparation, validating data and ensuring testing cycle is completed with necessary test scenarios reviewed.
• Identified and documented issues, risk and gaps, their descriptions, their impact and provided recommendation and alternatives to develop the application to meet the user requirements
• Worked in a team to develop use cases for their newly added application layout and understood all the business processes related to newly added layout and designed use cases that helped developers to build application
• Interacting with the developers on resolving the reported bugs and various technical issues
• Involved in UAT to confirm that the system under test meets the user needs and provides confidence in its use
• Performed verification tests to validate the data integrity
• UML diagrams such as activity and use case diagram were used to document the requirements and ensure creation of high level business requirements documentation.
• Worked cross functionally with developers, QA and project managers to make sure each the data could address their needs
• Performed verification tests to validate integrity of data

Confidential

Business Analyst

Responsibilities:

• Worked with the clinical managers to document the current processes.
• Gathered and documented BRD, FRS, and URS during user interviews.
• Facilitated brainstorming sessions to understand data capture, data management, and data validation functionalities in clinical trials.
• Worked on Accounts Payable, Payment Generation and Integration with Lawson.
• The current administration system is comprised of an internally developed claims processing platform, Destiny. Additional commercial software, home-grown applications, and manual processes are used to supplement any of the missing functions within the two claims processing systems. The purpose of this project was to replace existing system with a new system that addresses deficiencies with current system and provides a single platform and eliminate multiple vendors.
• Deliver a complete set of Business Requirements focused on claims processing, Benefit administration, member management and Customer Service.
• Deliver platform related specifications such as security, performance, and capacity
• Elicit, analyze, specify, and validate the business needs of project stakeholders. This Includes interviewing stakeholders and gathering and compiling user requirements.
• Responsible for meeting 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. Manage and track the status of requirements throughout the project lifecycle; enforce and redefine as necessary and leveraging these processes.
• Prepare and deliver recommendations or alternatives for improving processes in operating systems across the organization.
• Assist in conducting research on software and hardware products to justify recommendations and to support purchasing efforts.