SUMMARY

• Trusted business partner and delivery - oriented IT professional and program manager with over 25 years of experience (Over 15 years in Healthcare IT) in leading the design, development and implementation of high-performance technology solutions including product installation, testing, product/software upgrades, system integration and release/defect management with a particular focus on customer service, operational efficiency, automation and business process improvement.
• Risk assessment and mitigation, disaster recovery, preparing department budget, Familiar with proposal review process and negotiations.
• Successfully lead a team of professionals including FTEs and consultants including onshore/offshore model.
• Ability to utilize IT services and tools to partner with business into delivering applications & infrastructure that lower its operational cost and mitigate risks.
• Sound knowledge of Project management and familiarity with Agile methodology, Vendor management. Familiarity with DevOps

PROFESSIONAL EXPERIENCE

Confidential, California

Project Manager

Responsibilities:

• Worked on AAA project for upgrading their existing Claims system to use SmartComm and Guidewire products for better performance and better capabilities and that replaces their homegrown system. Used Agile methodology for project management. The first phase is successfully completed.
• Worked on HiTrust certification project for Datum. We are expected to get certified later in year 2021. Worked to ensure we have updated policies and procedures in place as per HiTrust requirements. Managed the procurement of necessary tools and services in order to meet the security needs as prescribed by HiTrust. All the proofs of records have been submitted to HiTrust and expected to go for assessment soon.
• Successfully completed BRE (Business Rules Extraction) Project for our client HiMark as a project manager with responsibilities such as Resource Management, Stakeholders management, Budget management, Risk management, Change Management, Scope Management, Defining various controls for the projects such as delivery and approval methodology, Quality Control and fully responsible for its timely delivery with quality. Used Agile methodology for project management

Confidential, California

Sr. Project Manager

Responsibilities:

• As a senior project manager provided consulting services to many different clients like IBM Watson Health, City of Hope and currently supporting Conduent (Healthcare) for DocFinity upgrade project.
• The specific responsibilities included resource management, managing project schedules, management reporting on various projects like application development, Infrastructure, Operations and maintenance, MMIS implementation.
• Supported onshore/offshore model project execution

Confidential, Orange County, CA

Program Manager EDI

Responsibilities:

• As a program manager, had the complete responsibility for the department and was fully responsible for all Application development, customization, product implementation, system integration, third party interfaces development activities. Supervised about 30 resources including project managers, operations managers and consultants. The main technology used was Informatica and Java along with Oracle database
• Helped develop effective information assurance procedures and policies including change management, security policies, release/defect management, systems maintenance and operations.
• Responsible for maintaining department’s disaster recovery policy and procedures (Disaster recovery plan) and making sure that periodically the processes are tested to ensure that they all work appropriately and make necessary adjustments as necessary. This also included timely patch management, access management, up-to-date documentation, have preventive controls in place.
• Collaborate with business community to understand their day to day needs and help translate them into IT system requirements and provide roadmap for development, testing and final delivery of the solution
• Collaborate with other teams such as Security, Helpdesk, Network, Infrastructure, Data
• Center to ensure 24/7 functioning of the department
• Helped define department policies and procedures around system outages, system maintenance and defect and release management to ensure that business is aware of complete IT plan and had their buy-in that helped them to priorities their activities and in turn helped create synergy needed to function very effectively. Prepared department budget. Help develop risk management and mitigation plan.
• Key member of Change Control Board
• Lead a major time critical application customization initiative to convert the software systems to handle both 4010 and 5010 HIPAA format files. The project was done in extremely tight timeline as there are many different type of healthcare files is received in a 24/7 environment from various channels (hyper terminal, web portal, SFTP, Switch vendors etc.). This was all done with business as usual for the current processes so that the existing business is not impacted.
• Lead the implementation of HIPAA operating rules (CAQH CORE).
• Managed Release management process for product releases across multiple environments (Development, system integration, Performance environments, UAT)
• Review vendor proposals for technical solutions, provide recommendations and negotiate on behalf of company
• Worked on product development team for a product called HES (Health Enterprise System) that was being developed for Conduent and supported MMIS implementation for claims processing, provider maintenance and eligibility intake.
• Managed onshore/offshore model for nightly batch jobs to provide 24 hours support to business stakeholders and ensured minimum interruption
• Familiarity with DevOps

Confidential

IT Manager/Program Manager

Responsibilities:

• As a Core Systems Manager, fully responsible to handle the project portfolio of about 20 small and major projects and supervised about 30 professionals including project managers, developers, support staff and consultants. Molina mostly uses Microsoft technologies such as BizTalk, .Net along with MS/SQL
• Implemented major changes in existing processes to bring in automation, optimization and business process improvement and reconciliation. Help preparing department budget. Help develop risk management and mitigation plan.
• Helped design a major improvement project and led it all the way to its implementation. The purpose of this project was to streamline, automate and optimize the eligibility files intake from various States, in variety of formats (X12, Proprietary) and in various frequencies. The design ensured scalability for future increase in volume. This was a major business process improvement initiative and resulted in great customer satisfaction along with drastic reduction in cost, incorrect processing and defects.
• Lead the effort to integrate many diverse and homegrown software systems with the core system including third party product installations, testing, upgrades and its releases to ensure business continuity
• Review vendor proposals for technical solutions, provide recommendations and negotiate on behalf of company
• Supported QNXT (A third party product) implementation for various States health plans.
• As an Operations manager, fully responsible for all nightly batch processing and ensure proper completion of each job and in case of issues the help ticket is opened automatically and assigned to the right team with defined priorities.
• Managed onshore/offshore model and various vendors for nightly batch jobs to provide 24 hours support to business stakeholders and ensured minimum interruption
• Worked with business and clearing houses to define the files intake process so that the file processing can happen in an orderly manner and all the SLAs can be honored and any deviation can be properly controlled
• Responsible for applying effective information assurance procedures and policies including change management, security policies, release management, systems maintenance and operations.
• As part of business process improvement initiative architected, automated and streamlined over 1000 batch processes using AutoSys and UC4 and including automatic defect monitoring and logging process to appropriate teams.

Confidential

Development Lead

Responsibilities:

• Lead a team of over 12 offshore and onsite development resources on multiple projects, production support and provided technical guidance and mentoring.
• Managed the maintenance, enhancement and upgrade of RIMS (A Trizetto product) used for PPO insurance
• Manage the design and development of third party interfaces.
• Providing technical leadership on multiple cross functional application projects such as PERFORM (Data warehouse), IFS-AR (Account Receivable).
• Worked on integration of RIMS with another home grown system NICE for a project for consolidated invoicing.
• Designed procedures to generate and document the test results consistent across the project.