Candidates About

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PROFESSIONAL EXPERIENCE

COGNIZANT TECHNOLOGY SOLUTIONS (PROJECT MANAGER)                                                                          April 2010 – Present

CLIENT (KAISER PERMANENTE) - Pasadena, CA, (Oct 2017 –Present)

Member of Application Service Group, PMO Chief of Staff in Project Manager role with proven track record for managing multiple high-profile initiatives and activities for production support team.

·         Collaborating with portfolio teams to complete business case assessment and findings

·         Ensured good, transparent and effective reporting & documentation

·         Delivered all documents in a timely manner so that progress can be fully communicated

·         Responsible for tracking business case from inception to delivery and facilitating the outcomes with the leadership team

·         Accountable for tracking all the business cases from IT application support group

·         Contributes to the accuracy of components in the business case

·         Understands and applies appropriate methods or recognized equivalents in completing assignments.

·         Support triaging production support request to the appropriate IT teams

·         Develop requirements document, user adoption, training plans

CLIENT (MOLINA HEALTHCARE) - Long Beach, CA, (Dec 2010 – Sep 2017)

Member of Enterprise Project Management Office in Program/Project Coordinator role for planning and organizing programs and activities supporting project directors/managers for the successful delivery of multiple high-profile programs from inception to implementation. Implementations include in-house application development, vendor products, as well as combined implementation.

Responsible for supporting Clinical, Analytics (Data Warehousing and Business Intelligence), and Data Governance portfolios, as well as management of large and complex program implementations of key compliance initiatives, including mClinical, HIPAA 5010 and Healthcare Reform.

·         Ensured that all documentation meets internal standards, procedures & specifications

·         Ensured good, transparent and effective reporting & documentation

·         Delivered all documents in a timely manner so that progress can be fully communicated

·         Responsible for tracking multi-year program budgets of up to $30M+, including internal and external labor, professional services, hardware, software, and related expenses

·         Managed cross functional matrixed teams, including a combination of internal, external, with total team size spanning up to 250 resources and core team size of approximately 25 team members

·         Worked with Methods and Services team to co-develop a hybrid PMO Agile methodology and piloted one of the initial large-scale adoptions of Agile framework for Enterprise Data Warehouse portfolio, which included the development of processes, templates and tools, and customizing Agile framework to work in Molina environment, while continuing to meet audit requirements

·         Facilitating to manage vendor selection process, including review of vendor product and service offerings, RFI and RFP development, RFI/RFP response evaluation, and recommendation process

·         Key member of PMO Management Team responsible for set up of new clinical implementation of integrated vendor solution with the goal of replacing three disparate mission critical clinical systems which support Medical Therapy Management (MTM), Case Management (CM), and Utilization Management (UM), and the objective of leveraging out-of- box functionality with minimal customization to meet regulatory requirements.

·         Supported large programs or sub-projects, managed by separate workstream PMs

·         Responsible for tracking and reporting, including development and management of Program Level integrated project plans, including inter-workstream dependencies and impacts

·         Setup program level toolkits to enable tracking and management of risks, action items, issues, and decisions, within individual workstreams as well as impact to other program workstreams

·         Managed as junior project manager for smaller scale of projects/enhancements as needed

·         Support client meetings and checkpoints

·         Monitor performance metrics and project dashboards

Technical Project Coordinator (Dec 2010 –May 2012)

·         Supporting project team responsible for development and deployment of a .Net web-based application that replicated and enhanced the functionality of legacy system. Implementation of web-based application reduced user rollout and licensing costs, while providing better productivity tools and features to claims processors

·         Coordinate implementation of custom in-house “add on” solution to support functionality not available in vendor core

administrative system.

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·         Support vendor deployment of HIPAA compliance tracking application, which had several key deliverables to meet regulatory and reporting requirements under the HITECH Act.

·         Analyzed and monitored the project reports to sort out issues in documentation section

·         Maintained and documented reports on a daily/weekly basis regarding the projects assigned to various departments; progress, schedule, budgeting and forecasting

·         Worked with project team members, clients and vendors to coordinate activities, provisioning, environment setup, installation, and integration testing

·         Prepare weekly and monthly reports on project financial aspects and progress

·         Manage and coordinate change activities

·         Engaged with Third Party vendors for Vendor testing for several transactions such as 837 claims, 834 enrollment etc. to ensure compliance requirements are being followed

·         Tracking Risks, Issues, Actions Items to ensure proper closure

CLIENT (WELL POINT) –Denver, CO, (Apr 2010 – Nov 2010) (Business System Analyst)

·         Writing technical requirements to develop the CMS mandated quarterly reports

·         Documenting and updating the functional requirements document in the SharePoint

·         Track Change Request identified during the lifecycle of the project

·         Defined, developed specs for federal reporting specific to Medicare Advantage

·         Tested claims adjudication and group and enrollment in Facets for New Medicare advantage members

·         Followed a structured approach to organize requirements into logical groupings of essential Business Processes, Business Rules, and Information Needs, thus ensuring that Critical Requirements are not missed

·         Involved in the peer review of Test Plans, Test Cases with the QA team to verify implementation of new features and system enhancements

SOURCESOFT SOLUTIONS,  (BUSINESS ANALYST)                                                                                                Aug 2008 – Mar 2010

CLIENT (HEALTHATION), Lisle, IL

·         Supporting the process development of Pharmacy Claim improvement including formulary, pharmacy, physician, and Medicare Part D benefit procedures

·         Responsible for clearly articulating and documenting business requirements for system enhancements

·         Documenting SLA Reporting requirement for the business and IT owners which included analysis of Cases Outstanding, Case Status (Open, Pending, etc.)

·         Conducting JAD Sessions, Peer Review sessions with the project team

·         Work with business partner to elicit high-level requirements and capture business needs

·         Assessing the risks of various solutions and prioritizes competing business demands

·         Managing ongoing relationship with business partner to drive satisfaction with IT

·         Coordinating project delivery by participating in design reviews and walk-throughs to communicate systems designs

·         and validate proposed solutions

·         Engaging with knowledge workers to incorporate usability and user interface needs when designing systems

·         Managing relationships, and monitors vendor performance against SLAs

CLIENT (CNSI), Pierre, SD

·         Responsible for writing and organizing business requirements for COB, Finance, Drug Rebate modules to implement Enterprise wide Medicaid Management system for proper claim adjudication solution

·         Created AS-IS and TO-BE business process flow for the claim application

·         Document and reviewed business/functional requirements documents with key stakeholders to obtain approvals

·         Complete and refine data mapping between data sources

·         Assisted informational needs in mapping of Test Cases

·         Provide training and knowledge transfer in transitioning the new South Dakota Medicaid Management Information System (SDMMIS) to the customer