Mar 2022 – Present · 4 yrs

• Coordinate with various areas of Operations, Middle Office, Finance, Technology, and Senior Management to build business requirements, procedures, and processes including project plan development, resource management, requirements management (elicitation, documentation, prioritization, etc.), process mapping, process design, procedure authoring, org design, capacity sizing, etc.
• Conduct data analysis, data collection, and synthesis to translate into empirical solutions or evidence that can optimize project reporting
• Work with business partners to design, introduce, or re-engineer existing processes and business applications
• Conduct project planning and analysis, including creating detailed project plans, documenting business requirements, detailing issues and problems, and drafting business and technical work/data flows
• Facilitate or support project facilitator, create materials for presentation, and provide reporting/metrics as required
• Managing complex customer projects from design to development to production, with end to end delivery responsibility.
• Work closely with business teams across geographies in understanding project requirements and issues for successfully implementing business projects.
• Managing technical engagements spanning Automation, Transformation and Data Visualizations
• Ensure overall program lifecycles development by defining resources and schedules for program implementation.

Mar 2020 – Feb 2022 · 1 yr 11 mos

• Support and lead in the planning of projects within the programme of work ensuring that the corporate SDLC standards are adhered to and deviations from the standards are documented, agreed and communicated to the relevant stakeholders.
• Support and lead process enhancement initiatives and business requirements definition to drive operational efficiencies and improve the customer experience.
• Support key project implementation activities such as implementation planning; systems integration; training plan development and execution; procedure development; performance management modifications; business case tracking and realization; user acceptance testing planning and execution.
• Develop and maintain robust and accurate end-to-end knowledge of business processes and applicable procedures.
• Lead and work with IT project teams and business units to help gather business requirements to aid in the design and development of software applications.
• Understand the business objectives and processes of current systems. Perform analysis and evaluation of options, alternatives, and system capabilities. Where appropriate, recommend enhancements through the application of technologies, systems and process changes to solve problems or enhance business processes.
• Understand and meet Business Unit goals with regard to implementation, revenue, and performance metrics.

Sep 2017 – Feb 2020 · 2 yrs 5 mos

• Define project scope, goals and deliverables supporting business goals with senior leadership.
• Developing full-scale project plans and associated communication documents
• Driving of new project development (in technologies - VB.NET, UiPath, Macro Express,
• Tableau, DB and Web Servers) by adhering to applicable enterprise development methodologies and processes anticipating future business models/needs and inclusion
• in business requirements
• Manage the capacity and forecasting of the automation team ensuring capability and
• numbers match the pipeline of approved projects
• Perform risk management to minimize project risks
• Measure project performance using appropriate systems, tools and techniques
• Design, development and maintenance of information systems followed by training and
• sharing of the best practices with other business units

Sep 2015 – Aug 2017 · 1 yr 11 mos

• Experience in validating and updating Provider information’s including – address, name, accessibility, health plan product participation, network affiliations, privileges, work history, specialty, malpractice coverage, fraud & abuse, Taxpayer Identification Number (TIN) etc.
• Developed automated business solutions by creating new and modifying existing software applications over mainframe, windows and web based applications for Provider business
• using technologies – VB.Net, SQL Server, web server, SharePoint etc.
• Primary contributor in designing, coding, testing, debugging, documenting and supporting all types of applications consistent with established specifications for the creation and maintenance of Provider information in the organization
• Liaison with subject matter experts, business analysts, product owners, scrum-masters, developers, testers and architects to ensure that the proposed solution is mapped to business outcomes

May 2013 – Aug 2015 · 2 yrs 3 mos

• Thoroughly review, analyze and research on complex healthcare claims in order to identify discrepancies, verify pricing, confirming prior authorizations and finally processing them for Medicare and Retirement
• Responsible for providing expertise and general claims support to Medicare and Retirement teams in reviewing, researching, investigating, negotiating, processing and adjusting claims
• Design, code, test, debug, document and support automations following the waterfall
• methodologies in SDLC using technologies – VB.Net and Macro Express
• Analyze and investigate process flows for automation opportunities in Medicare and
• Retirement business in the organization
• Assist in projects and implement initiatives to update, re-engineer and/or write macros
• and automation tools based on US government compliance initiatives, system
• enhancements or organizational needs
• Assess and interpret the facts and needs of the business to provide innovative solutions to
• complex, nonstandard requests and problems. Support ongoing system enhancements and process change activities SOP’s in Medicare and Retirement
• Authorizing the appropriate payment or refer claims to investigators for further review for Medicare and Retirement

Sep 2012 – May 2013 · 8 mos

• Build from grounds-up a robust Management Information System (MIS) platform and solutions for smooth operations by initiating automation and converting manual MIS into fully automated MIS for Medicare and Retirement
• Provide support and maintenance to existing MIS by developing documentation allowing smooth operations, strategy planning and for training
• Generate and distribute management reports in accurate and timely manner
• To prepare and issue instructions concerning generation, completion, and distribution of reports according to new or revised practices, procedures, or policies of reports management for Medicare and Retirement
• Participate in application validation and QA efforts as they pertain to reporting, data,
• metrics, and report creation and execution
• Extract existing data to manipulate/ calculate/ format into presentable reports, charts, and graphs in Excel, Access and Tableau
• Analyze data and reporting solutions to understand business impact, correlations/
• discrepancies, and to propose changes/alternate solutions for Medicare and Retirement
• Perform analytical requests and research projects for internal parties. Special projects as assigned by management to identify and track fraud and abuse by members and providers in the Medicare and Retirement segment of business