SUMMARY

• 19 years of experience in providing information - technology solutions in Healthcare, healthcare insurance, pharmacy benefit management (PBM), retail and manufacturing industries. 11+ years of experience in project management and leadership.
• Proven program and project management, process management, product development and IT delivery management experience at various functional and technical levels.
• A seasoned project manager worked under PMO umbrella for 5 years. Delivered medium to large multi-year, multi million budget projects. Proficient in executing projects under client defined project management process framework, PMI framework and PPM tools.
• Certified Project Management Professional (PMP) and certified HIPAA professional. Scrum Certified master (SCM).
• Strong experience in project life cycle model through initiation, planning, execution, monitoring and control and closure. Also, experienced in discovery, due diligence and root cause analysis (RCA).
• Strong people and team managements skills. Managed team size of 50+ team members across multiple location, multiple time zones and multiple technology vendors.
• Rounded experience in multi-million and multi-year project deliveries with waterfall SDLC, agile project methodologies and hybrid delivery models (Waterfall + Agile) of software development and services.
• Strong hand-on on project management including change management, scope, time, cost, quality management, communication management, resource management, vendor and procurement management.
• Experienced and expertise in transformation projects, transitioned several legacy systems to new advance platform within stipulated time.
• Experience in business development activities including benchmarking, financial analysis, SLA formation, proposal preparation, RFP responses, IT Policies, Quality Assurance and Quality control processes, risk management, sales support and assistance.
• Strong presentation, reporting and governance skills. Expertise in managing stakeholder’s expectations through data gathering and quantitative metrics management.
• 10 years of broad experience in building healthcare enterprise applications, care management software, EHR, EMR, Medical Billing, Practice Management (PM) software’s, Patient/Member and provider portal, healthcare data warehouse, data analytics and bio-metric device integration platforms.
• 14 years of strong functional experience in US Healthcare across continuum of care, medical billing functions, NCQA, HIPPA, PHI, HIDIS, PQRS, meaningful use, institutional /provider and pharmacy claims, X 12 EDI standards, HL7, healthcare reform/ACA, InterQual and MCG (for evidence-based research).
• Strong hands on experience in web and enterprise technology, database management, Microsoft BI, MicroStrategy, SQL, Crystal report, cloud computing, SharePoint, Clear Quest/Clear Case, HP-PPM, T-SQL, PHP, iOS, Android, data warehouse and project management tools, HP-PPM, PlanView (PV) as portfolio management tool.
• Proven initiator, critical coder, Subject Matter Expert (SME), business analyst (BA), leader and manager.

TECHNICAL SKILLS

Programming languages: SQL, PL/SQL, ORACLE, C, C++, VB, JAVA, .NET, HTML, Xcode

Operating Systems: Sco-Unix, AIX UNIX, WINDOWS NT/98/95/2000/XP

Databases: MS SQL SERVER 7.0/2000/2005/2008 , ORACLE 9i,10g,11i

Web Related: HTML, JAVA, JAVA SCRIPT, XML, EJB, WEBSPHERE

Software Methodologies: OOPS, UML, SDLC/AGILE/SCRUM/WATERFALL

Tools: /Change Management Tools: Putty, Visual Source Safe 6.0, FTP Client, AIX SCCS, PVCS Serena version control, TOAD, MS Office, Project Management, Software Engineering, SharePoint.

Web technologies: ColdFusion MX/10, PHP, ASP.net, ASP, IIS, WCF, HTML

Business Intelligence: Microsoft Management Studio, SSRS, MicroStrategy

ETL: Informatica PowerCenter 8.1, Microsoft SSIS

PROFESSIONAL EXPERIENCE

Confidential | Plano, TX

Project Delivery Manager

Responsibilities:

• Deliver large complex IT projects across various verticals including various legacy platform, cloud and Pharmacy operations.
• Responsible for managing technical IT delivery functions in multi disciplinary, cross matrix environments including, on prem and cloud platforms.
• Responsible for managing project management activities, tracking budget, managing scope, issues and risk.
• Coordination between application teams/scrum teams, portfolio, security and infrastructure teams.
• Follow SAFe agile framework,work with Large Scale Scrum (Less) and disciplined agile delivery (DAD) environment.

Environment: SAFe Agile, Jira Enterprise, Plan View, Confluence, Agile Health,SharePoint, AWS Cloud

Confidential | Irving, TX

Project Manager (PMO)

Responsibilities:

• Responsible to deliver multiple, large size enterprise and client integration projects of 40 thousand hours, 260 resources, 15 different team (cross operational)
• Responsible to manage end to end project activities and customer satisfaction within organizational norms.
• Responsible for conducting project pre-planning, planning and initiation activities including PRF approvals, due diligence, pre-kick-off, kick-off meetings.
• Responsible for managing collaborative communication across various functional, technical and operational teams, consist of total 300+ team members for huge size projects.
• Responsible to manage multi-million projects across various verticals like IT, operations, business.
• Responsible for managing project scope, budget (Capex, Opex, ETC, EAC, ATD), resource forecast, change request, project change request, risk register, RAID log effectively through hands on Clarity, Agile Central (Rally) and SharePoint tool.
• Responsible for reporting project status to leadership through executive status reporting process.

Environment: Clarity (Project Management), CA Agile Central (Rally) (Agile tool), MS Office, ALM (Quality Management Tool), Visio, SharePoint (process Control)

Confidential | New York City, NY

Project Manager (E PMO)

Responsibilities:

• Responsible to manage and execute multiple enterprise projects under PMO environment.
• Responsible to adhere PMO project management processes, practices and guidelines.
• Responsible to create project charter, ROM, kick-off meetings, WBS and detail level project plans for all assigned projects. Update projects status, risk, issues, resource assignment, cost in HP PPM.
• Responsible to monitor critical dependency at program level for assigned projects.
• Facilitate high level JAD, white board sessions with relevant stakeholders to define and design high level business process, requirement discussion, and timelines.
• Responsible to track project budget, project expenses, Capex. Quantify project cost matrices, track project timeline, disseminate overall projects status and risk to relevant stakeholders periodically.
• Create task order, work orders, service orders, proposal and all required business and technical artifacts. Maintain all documents to current version in PMO document repository or SharePoint.
• Responsible to manage project management activities including staffing, scoping, budgeting, change management, quality, implementation, go-live, post go live and project closures
• Responsible for status reporting, stakeholder reporting and governance reporting for client work groups and implementation partners and leadership (steering committee) members.
• Identifying any issues or risks associated with a project, escalating them and possibly implementing mitigation strategies for risk prevention and timely resolution by conducting periodic risk, issues status meetings
• A successful liaison between client, vendor, implementation partner and internal work groups for all transitional and project activities.
• Manage communication and task with cross-functional metrics business team, team spread across multiple location and time zones. Teams located at onsite and offshore.
• Responsible to manage end to end projects deliveries including requirement gathering/sign off, planning, design, development, testing, implementation, post production RCA, warranty and support
• Responsible to manage business, operations and IT functions across different line of business and vendor operations
• Responsible to manage all delegated claims activities and in-house vision claims, accumulation processes to new platform.
• Responsible for managing legacy application platform (Mainframe and Web) and transitioning legacy applications to FACETS (new platform).
• Successfully delivered membership/enrollments, claims, accumulators, providers, actuarial, underwriting, HEDIS, APD and communication (state/federal/member/provider) deliverables in stringent timeline.
• Successfully delivered operational deliveries like transition letters, ID cards, welcome kits, benefit information to near about 3 million members comprises Medicaid, Medicare and Commercial line of business members.
• Successfully managed all vendor requirements, communication including operational and IT needs. Primarily managed all vendor communication and co-ordination.
• Closely work with member experience, customer service work group to streamline member and vendor communication within stipulated timeline

Environment: Mainframe, JCL, COBOL, .Net, Cloud computing- Windows 7 onwards, Web Services, Microsoft BI- SSIS, Ajax, Oracle, My SQL 5.5/6, MSSQL 2008 R2, MS Office, HP PPM, Visio, MPP, ALM, QCare, CPF

Confidential | Chattanooga, TN

Project Manager (PMO)

Responsibilities:

• Responsible to manage and execute multiple enterprise projects (business and Infrastcrure) under PMO environment.
• Responsible to adhere PMO project management processes, practices and guidelines.
• Responsible to create project charter, ROM, kick-off meetings, WBS and detail level project plans for all assigned projects. Update projects status, risk, issues, resource assignment, cost, financial budgeting OPEX (Operating expenditure), CAPEX (Capital expenditure) in HP PPM.
• Defines, monitors, executes, and controls assigned projects through the project development life Cycle. Document and completes all project management deliverables required by the project.
• Performs integration management services for program issues, risks and deliverables in collaboration with Program Manager.
• Responsible for status reporting, stakeholder reporting and governance reporting for client work groups and leadership (steering committee) members.
• Responsible to manage project management activities including staffing, scoping, budgeting, change management, quality, implementation, go-live, post go live and project closures.

Environment: Cloud computing- Windows 7 onwards, Web Services, Microsoft BI- SSIS and SSRS, Ajax, Oracle, J Query, My SQL 5.5/6, MSSQL 2008 R2, MS Office, HP PPM, Visio, MPP, Bugzilla, SFTP, FACETS, Care Advance.

Confidential | CT

Sr. Project Manager

Responsibilities:

• Responsible for managing various IT functions, support services, product roadmap and quality reporting including enterprise application development and support, business intelligence solutions (healthcare analytics). A liaison between technical, support, clinical, leadership and client teams.
• Responsible for periodic product rollouts, version deployments, user training and customer feedback collection for enhancing product and service features
• Identifying any issues or risks associated with a project, escalating them and possibly implementing mitigation strategies for risk prevention and timely resolution by conducting periodic risk, issues status meetings. Responsible to monitor critical dependency at program level for assigned projects
• Responsible to create project charter, ROM, kick-off meetings, WBS and detail level project plans for all assigned projects. Update projects status, risk, issues, resource assignment, cost, financial budgeting OPEX (Operating expenditure), CAPEX (Capital expenditure) in PPM tool.
• Responsible for status reporting, stakeholder reporting and governance reporting for client work groups and implementation partners and leadership (steering committee) members.
• Responsible to maintain and track SLA progress, license management, escalations handling and monitor support help desk functions.
• Responsible for technical project delivery (CR), data load process, robot jobs reports and analytics.
• Research various technology options and leverage product features in-align to project goals and product roadmap.
• Prepared MS Project plans for various ongoing projects, services, operations and track the respective status closely until closure. Sending weekly status reports to the senior management and presenting monthly governance with client and stakeholders.
• Responsible to track project budget, project expenses, Capex. Quantify project cost matrices, track project timeline, disseminate overall projects status and risk to relevant stakeholders periodically. Accomplish financial objectives by forecasting requirements; initiating corrective action.
• Managed cross-functional teams and followed up on action items in integration issues, and change request and facilitated sessions among cross-functional teams for system integration and data flow across systems. Established and maintain constructive working relationship with stakeholders.
• Facilitate high level JAD, white board sessions with relevant stakeholders to define and design high level business process, requirement discussion, and timelines
• Create task order, work orders, service orders, proposal and all required business and technical artifacts. Maintain all documents to current version in PMO document repository or SharePoint.
• Key translator of technology and business specifications to technology team with effective transition process advanced and organized communication methods
• Successfully implemented ICD conversion (CMS mandate) project and Medicare Fee for Service program changes. Responsible for managing support for patient / member postal services.
• Responsible for maintaining PHI and HIPAA safeguards and procedures in align with federally defined healthcare standards and compliances.
• Subject Matter Expert (SME) and product owner for intriCare- a Care management and utilization management application.
• Integration of third party biometric devices like weight scale, BP monitor, glucometer, pulse-oximeter etc. and their services into care management system. This integration reduces significant readmissions and saves in-patient hospitalization, SNF cost.
• Worked with HIPAA/ (EDI) transaction sets - 270/271, 835, 276/277, 834 and 837.
• Worked on clinical integration of different code sets and various cross walk like ICD9 to ICD 10, HCPCS Codes to ICD Codes, and Procedures Codes (CPT) to ICD Codes etc.

Environment: Cloud computing- Windows 7 and Linux 3.x, ColdFusion 10, PHP 5.5/6, XAMPP 1.7, Web Services, Microsoft BI- SSIS and SSRS, MicroStrategy 9.5 and 10, Ajax, Oracle, J Query, My SQL 5.5/6, MSSQL 2008 R2, Omniview, HP-PPM, MS Office, Visio, MPP, Bugzilla, SFTP

Confidential

Sr. Project Manager

Responsibilities:

• Responsible for managing support of millions of claims data traffic, hundreds of users, in-house and in-field mobile users with more than 2 dozen provider’s data.
• Responsible to modernize current operational platform without impacting existing service of operations. Transitioned legacy system components to new advanced and scalable platform.
• Responsible for conducting and facilitating daily stand up meeting, updating backlog, user stories and burn charts. Update Sprint deliverables and communicate Sprint progress to stakeholders.
• Create and execute timely project work plans and effectively manage multiple projects, vendors and customers through integrated agile development approach.
• Responsible to create project charter, ROM, kick-off meetings, WBS and detail level project plans for all assigned projects. Update projects status, risk, issues, resource assignment, cost in PPM tool.
• Responsible to track project budget, project expenses, Capex. Quantify project cost matrices, track project timeline, disseminate overall projects status and risk to relevant stakeholders periodically. Accomplish financial objectives by forecasting requirements; initiating corrective action.
• Extremely efficacious in managing data complexities and data integration activities. Migrated multi-vendor platform data into customer’s medical billing platform without compromising data integrity.
• Responsible for managing healthcare product development and service deliveries.
• Responsible for managing multi-platform development units including enterprise web application, mobile app development and analytical services. Achieve seamless integration among all platforms.
• Responsible for bridging the gap between business requirements and technology implementation through working with technical team and industry experts. Experience in managing technical staff, and coordinating development activities with cross-functional teams across multi locations.
• Responsible for managing competing demands for scope, time, cost, risk and quality.
• Responsible for status reporting, stakeholder reporting and governance reporting for client work groups and leadership (steering committee) meetings.
• Creating task order, work orders, service orders, proposal, RFP and all required business and technical artifacts. Maintain all documents to current version in common SharePoint location.
• Achieve seamless transformation of product development into product support and maintenance service activities.
• Responsible for periodic product rollouts, version deployments, user training and customer feedback collection for enhancing product and service features
• Responsible to manage end to end projects deliveries including requirement gathering/sign off, planning, design, development, testing, implementation and post production/warranty support.
• Facilitate high level JAD, white board sessions with relevant stakeholders to define and design high level business process, requirement discussion, and timelines
• Responsible to track project budget, project expenses, revenue. Quantify project cost matrices, track project timeline, disseminate overall projects status, risk to relevant stakeholders periodically
• Involved with developing high-level business and technical requirements pertaining to Paper Claim Forms, UB-92, Prior Authorizations Forms, and Crosswalk.
• Experienced working with PQRS measures and various clinical compendiums
• Hands on experience on developing ETL process and customized ad-hoc data integration process.
• Documenting functional and technical data flows of 4010/5010 HIPAA Transactions.
• Performed gap analysis for HIPAA 4010A1 and 5010. Leaded a QC team for testing 837 electronic and Paper claims for successful implementation of 5010.
• Provided technical vision to the team in diversified technology including PHP, Cold Fusion, SQL Server, MicroStrategy, Microsoft SSRS, and SSIS.

Environment: Cloud computing- Windows 7 and Linux 3.x, PHP 5.5/6, XAMPP 1.7, iOS 5.0-9.1, xCode 4/5/7.x Series, Android Ice cream sandwich- Lollipop, Eclipse, Android SDK, Web Services, Microsoft BI- SSIS and SSRS, MicroStrategy 9.5 and 10, Ajax, J Query, My SQL 5.5/6, MSSQL, DB2, Oracle, MS Office, Visio, MPP, Bugzilla, SFTP

Confidential

Project Manager

Responsibilities:

• Responsible for managing gigabytes of pharmacy claims data at central location.
• Primarily responsible to support data warehouse functions and ensure continuity in the services.
• A key liaison between various functional group, technology vendors and internal support team.
• Primarily responsible for undertaking federal guidelines project and implementations.
• Responsible to maintain PHI and HIPAA compliance standards across all controlling groups using administrative safeguard procedures, secure sites and PGP encryptions.
• Responsible for support tickets resolution with the help of technical team based on severity of the tickets.
• Responsible to maintain business continuity during the merger and acquisition process.
• Responsible for managing incident and SLA levels for internal departments, upstream and downstream systems, external customer, vendors and supplier’s systems.
• Responsible for conducting governance and periodic status reporting.
• Responsible for process formation, process alteration, process improvements as cost saving options.
• Evaluate ETL process and measuring process outcomes and tune the process to achieve desired goals with minimum negative or no impact.
• Responsible to support and lead teams engaged in project administration and co-ordination at global level.
• Responsible for facilitating communication and execution plan for severity 1 tickets and maintain SLA for various customer / stakeholders.
• Update projects status, risk, issues, resource assignment, cost in PlanView (PV) PPM tool.
• Hands on experience on SSAS, SSIS packages, PGP encryption and Unix batch schedulers.

Environment: Microsoft BI- SSIS, SSAS, SSRS, MS SQL Server, Oracle, MS Office, Flat Files, Db2, Visio, MPP, PlanView PPM, SFTP