Project Manager
Resume:
DEEPA
GOVINDARAJAN
JACQUELINE
DR,
APT
E62,
W ILMINGTON,
DE
19810
*****.************@*****.***
978-
317-
3056
Product
Consultant
/
Manager
–
Solution
Delivery
End-
to-
End
Solution
Delivery
~
Technology
Leadership
~
Account
&
Team
Management
Accomplished
Product
Consultant
/
Project
Manager
with
13
years
of
experience
and
a
verifiable
track
record
of
leading
/
managing
complex
IT
engagements,
predominantly
in
the
Healthcare
Payer
space.
Experienced
in
managing
end
to
end
implementations,
performing
gap
analysis
between
goals
and
existing
procedures/skill
sets,
and
designing
process
and
system
improvements
to
increase
productivity
and
reduce
costs.
Experienced
in
managing
and
orchestrating
large
data
migration
projects,
defining
and
executing
Playbook
activities
for
successful
implementation.
Extensive
experience
in
solutioning,
effort
estimation,
ROI
calculation
and
responding
to
RFPs.
Good
interpersonal
skills,
adept
at
facilitating
discussions
and
negotiations
with
stake
holders.
Additional
areas
of
expertise
include:
Project
Management
&
Tracking
Project
Risk,
Scope
&
Cost
Solution
Architecture
Management
of
Cross-
Change
Control
Talent
Development
&
Functional
Teams
Management
Resource
Management
Education
Masters
in
Computer
Applications,
Bharathidasan
University,
INDIA
Bachelors
in
Mathematics,
University
of
Madras,
INDIA
Certifications
AHM
250
certified
–
An
Introduction
to
Healthcare
Management
AHM
510
certified
–
Governance
and
Regulation
Cognizant
Certified
Professional
in
Managed
Healthcare
Competencies
Management
Domain
/
Technology
Expertise
Solution
Delivery
&
Client
Management
Medicaid
–
On-
boarding
and
end-
to-
end
implementation
of
new
Project
Management
in
a
multi
vendor
LOBs
for
Medicaid
on
Facets
core
claims
processing
platform
environment
Medicare
–
Implementation
of
a
Medicare
Dual
Eligible
Special
Project
Management
across
multiple
horizontals
/
Needs
(D-
SNP)
program
on
Facets
and
Trizetto
suite
of
products
verticals
/
specialties
and
locations
(TMS)
Manage
stakeholder
expectations
Consolidation
–
Consolidation
of
several
Facets
product
Scope
and
Risk
Management
instances
Project
invoicing
&
Profitability
monitoring
Regulatory
Projects
–
Assessment
and
implementation
of
a
People
and
Performance
Management
solution
to
address
NPI
regulations
Recruitment
&
Retention
Product
Upgrades
–
End-
to-
end
assessment,
remediation
and
Business
development,
RFP
responses,
implementation
of
the
Facets
product
upgrade
and
change
packs
Opportunity
Identification
and
definition
of
Migration
–Migration
/
Conversion
from
Legacy
platforms
to
statements
of
work Facets
PROFESSIONAL
EXPERIENCE
Cognizant
Technology
Solutions
–
Sep
2000
to
Current
Led
globally
diverse
teams
consisting
of
Project
Managers
/
Leads,
functional
consultants
and
•
software
developers;
oversaw
multiple
projects
simultaneously.
Experience
in
functional,
techno-
functional
consultant
roles
for
various
healthcare
customers
such
•
as
United
Health
Group,
Blue
Cross
Blue
Shield
of
MI,
Claims
Sphere,
Dental
Benefit
Providers,
TMG
Health,
Fidelis
Care
NY,
WellPoint,
Blue
Cross
Blue
Shield
of
RI
and
AmeriHealth
Mercy
Family
of
Companies
(AmeriHealth
Caritas).
Managed
teams
of
size
35
(direct
reports)
and
budgets
of
10M.
•
Managed
complex
projects
in
a
multi-
vendor
environment
that
included
the
plan’s
employees
and
•
numerous
vendors
for
IT
solutions
and
specific
plan
functions.
Managed
cross-
functional
teams
across
multiple
locations.
•
Planned
and
oversaw
all
phases
of
software
development
life
cycle
(SDLC)
in
large,
complex
•
technical
environment,
including
assessment
and
feasibility
studies,
scheduling,
budgeting,
resource
allocation
and
status
reporting
to
higher
management.
Handled
multiple
projects,
requiring
extensive
IT
Healthcare
experience
using
TriZetto’s
Managed
•
Care
application
&
its
conversion
and
implementation.
Led
the
selection
of
3rd
party
software,
including
Healthplan
CRM
vs.
Salesforce.com
for
Medicare
•
implementation
meeting
CMS
requirements.
Led
Data
and
Application
design
and
architecture
aspects
to
seamlessly
fit
in
new
LOBs
into
the
•
existing
landscape.
Provided
product
configuration
recommendations
for
combining
working
models
across
LOBs.
•
Led
Data
Conversion
processes
for
migration
/
conversion
projects
and
Facets
product
upgrades.
•
Developed
solution
approaches
and
architecture,
guidelines
and
provide
IT
strategic
viewpoint
•
associated
with
the
Medicare
Implementation
solution
design
activities.
Executed
IT
strategies
and
objectives
to
maximize
short
term
impact
utilizing
existing
systems
and
•
positioning
systems
for
scalability.
Created
system
interaction
models,
addressing
business
and
technical
needs.
•
Supported
multiple
application
releases
in
parallel
utilizing
milestone
based
development
•
implementations.
Defined
and
developed
the
go
live
Playbook
that
includes
critical
line
of
path,
sequences
and
•
action
steps
for
successful
implementation.
Managed
end-
to-
end
go
live
planning
and
execution
ensuring
timely
delivery;
work
with
business
•
to
identify
cut-
over
windows
in
the
production
schedule
and
facilitate
conversion
loads.
Provided
subject
matter
expertise
associated
with
Medicare
and
the
customer’s
IT
environment
•
throughout
the
entire
project
development
life
cycle.
Worked
with
customers
to
define
business
and
processes
from
an
IT
perspective,
functional
•
requirements
and
data
element
requirements.
Devised
a
plan
and
successfully
managed
the
automation
of
the
PMO
reporting
processes.
•
Responsible
for
coaching
leads
on
the
various
projects
on
methods
and
means
to
improve
overall
•
performance
by
maximizing
the
contribution
of
individuals
and
teams.
Problem
resolution
recommendation
for
escalated
issues.
•
PROJECT
PROFILE
P ROJECT(S)
–
B CBSM
N EW
B USINESS
IMPLEMENTATION
C LIENT:
A MERIH EALTH
CARITAS
R OLE:
P ROJECT
M ANAGER
/
IS
IMPLEMENTATION
L EAD
D URATION:
FEB
2 01 3
–
CURRENT
Description
-
AMFC,
a
premier
Medicaid
company
in
the
US
healthcare
industry
currently
operates
its
lines
of
business
in
various
states
either
through
partnerships
or
as
TPAs.
BCBSM
acquired
Amerihealth
Mercy
in
April
2013
when
the
company
was
renamed
to
Amerihealth
Caritas.
AmeriHealth
Caritas
(formerly
Amerihealth
Mercy
Family
of
Companies)
is
a
majority-
owned
subsidiary
of
Independence
Blue
Cross;
Blue
Cross
Blue
Shield
of
Michigan
holds
a
minority
interest.
Prior
to
this
partnership,
BCBSM's
Medicaid
business
was
hosted
at
Trizetto.
With
this,
a
decision
was
made
to
maintain
BCBSM's
Medicaid
business
at
Amerihealth
Caritas,
which
led
to
BCBSM
being
implemented
as
a
new
line
of
business.
As
an
IS
Implementation
Lead
/
Project
Manager
on
the
BCBSM
Medicaid
New
Business
Implementation:
Implemented
a
new
line
of
business
offering
augmented
ability
to
claim
adjudication
and
claim
processing
-
Lead
the
IT
data
and
application
aspects
to
seamlessly
fit
in
Michigan
business
into
the
Amerihealth
Caritas
-
landscape
Lead
analysis
of
Michigan's
Facets
data
and
conversion
to
AMFC's
structure
for
data
and
maintenance
-
Lead
the
migration
of
Michigan's
data
on
Facets
4.71
into
the
Amerihealth
Caritas
instance
and
Facets
upgrade
to
-
5.01
Make
config
and
design
recommendations
combining
Michigan's
and
Caritas's
working
models
-
In
coordination
with
other
IT
teams,
define
and
execute
/
coordinate
execution
of
the
Playbook
activities
providing
-
critical
information,
sequences
and
action
steps
for
successful
implementation
Work
with
business,
Amerihealth
and
Michigan
batch
IT
teams
to
identify
cutover
windows
in
Facets
production
-
schedule
to
facilitate
conversion
loads
Go-
live
and
post
go-
live
planning
/
execution
and
timely
delivery
-
Project
Management
activities
including
managing
scope,
effort,
resources,
schedule,
risks,
issues
and
change
-
requests
Staff
management,
interviews
and
recruitments
-
P ROJECT(S)
–
M EDICARE
D -
SNP
IMPLEMENTATION
C LIENT:
A MERIH EALTH
M ERCY
F AMILY
OF
C OMPANIES
(AMFC)
R OLE:
P ROJECT
M ANAGER
/
IS
IMPLEMENTATION
L EAD
D URATION:
M AY
2 012
–
JAN
2 013
Description
-
Dual
eligible
D-
SNPs
are
a
high
cost
sub
population
within
Medicare,
representing
16%
of
the
Medicare
beneficiaries,
but
accounting
for
24%
of
the
total
Medicare
spending.
In
addressing
this
issue,
CMS
is
working
to
facilitate
integration
of
Medicare
and
Medicaid
services
(dual
eligible
population)
and
to
create
incentives
for
States
and
plans
to
work
together
to
produce
a
well-
coordinated
service
delivery
experience
for
dual
eligible
beneficiaries.
AMHP
is
planning
on
offering
Medicare
Advantage
Special
Needs
Program
for
dual
eligible
members
by
01/01/13
(D-
SNP).
As
an
IS
Implementation
Lead
/
Project
Manager
on
the
Medicare
D-
SNP
program:
Lead
the
implementation
of
the
program
on
Trizetto
Facets
and
TMS
suite
of
products
Provide
subject
matter
expertise
associated
with
Medicare
and
AMHP's
IT
environment
through
the
entire
project
development
life
cycle
Work
with
clients
to
define
business
and
processes
from
an
IT
perspective,
functional
requirements
and
data
element
requirements
Consistently
make
decision
recommendations
and
takes
actions
which
fully
support
targeted
strategic
changes
Develop
solution
approaches
and
architecture,
guidelines
and
provide
IT
strategic
viewpoint
associated
with
the
Medicare
Implementation
solution
design
activities
Identify,
design
and
facilitate
the
delivery
of
IT
based
solutions
to
meet
Medicare
business
needs
Creation
of
a
system
interaction
model,
addressing
the
needs
of
both
the
business
and
technical
teams
Participate
in
recruitment
efforts,
management
of
resources
and
performance
appraisals
Responsible
for
staff
development,
mentoring
and
supervision,
also
ensuring
timely
delivery
Create
and
manage
project
schedules,
effort
and
cost
estimates
Define
statements
of
work,
manage
change
control
and
change
requests
P ROJECT
–
B LUET RANSIT
C LIENT
-
B LUE
C ROSS
B LUE
S HIELD
OF
R HODE
ISLAND
R OLE:
P ROJECT
M ANAGER
D URATION:
A UGUST
2 010
–
M AY
2 012
Description
–
Rhode
Island’s
leading
health
insurer,
BCBSRI
covers
more
than
600,000
members.
BCBSRI
decided
to
migrate
to
a
new
operating
platform,
FACETS
as
the
existing
(legacy)
system
reached
its
functional
capacity.
BCBSRI
is
taking
a
phased
approach
over
a
span
of
three
years
to
ensure
that
the
new
system
can
appropriately
administer
the
required
functions.
As
a
BCBSRI
Project
Manager,
responsible
for:
Responsible
for
coaching
leads
on
the
various
projects
within
this
account
on
methods
and
means
to
improve
overall
performance
by
maximizing
the
contribution
of
individuals
and
teams
Problem
resolution
recommendation
for
escalated
issues
Project
delivery,
planning,
schedule
alignments
with
client’s
project
plans,
risk
management,
quality
assurance
and
other
aspects
involved
with
Release
4
of
this
large
program
Suggested
approaches
/
execution
methodologies
on
Medicare
Implementation,
generic
solution
for
Multi-
format
to
single-
format
conversion,
CM
data
migration
to
FACETS
Devised
a
plan
and
successfully
managed
the
automation
of
the
PMO
reporting
process
for
the
BlueTransIT
program
As
a
key
member
of
the
Cognizant
Leadership
team
at
the
muti-
vendor
BCBSRI
environment:
Identified
business
development
opportunities
and
provided
implementation
solutions
in
multiple
areas
Conceived,
built,
presented
and
drove
FACETS
initiatives
including
Medicare
Implementation,
FACETS
Config
proposals,
UM/CM
data
migration
to
FACETS
and
SRP
(Service
Related
Parameters)
claims
baseline
and
sync
Initiatives
on
FACETS
Configuration
were
perused
to
help
penetrate
an
area
that
constantly
has
been
high
on
demand
and
a
win
over
other
existing
vendors
Presented
the
Release3
AES
approach
to
the
client
CIO
that
re-
established
client’s
confidence
in
Cognizant
P ROJECT(S)
-
A MFC
U NIFIED
P LATFORM
C ONSOLIDATION
C LIENT:
A MERIH EALTH
M ERCY
F AMILY
OF
C OMPANIES
(AMFC)
R OLE:
DELIVERY
M ANAGER
D URATION:
N OVEMBER
2 008
–
JULY
2 010
Description
-
AMFC,
a
premier
Medicaid
company
in
the
US
healthcare
industry
currently
operates
its
lines
of
business
in
various
states
on
different
instances
of
FACETS.
Owing
to
the
high
level
of
similarity
between
the
business
processes
of
various
Lines
of
businesses
(LoBs),
AMFC
is
consolidated
the
different
instances
of
FACETS
across
the
LoBs.
Project
scope
included
an
Assessment
/
Feasibility
Study,
providing
recommendations
and
implementation
of
remediation
strategies.
As
a
Project
Manager,
was
responsible
for:
Managing
a
35
member
team
executing
in
multiple
locations
and
across
multiple
horizontals
/
verticals
/
specialties,
also
ensuring
timely
delivery
and
high
quality
Instrumental
in
the
ramp-
up
and
responsible
for
managing
the
induction
of
over
30
resources,
both
internal
and
external,
into
the
project
Directly
involved
in
interviews,
recruitment
and
project
on-
boarding
Project
Planning,
Scheduling
and
Estimation
Prioritize
requests
for
customized
work
plans
/
adhoc
requests
to
ensure
that
adequate
staffing
is
in
place
to
meet
anticipated
needs
Establish
the
work
plans
for
execution
and
ensure
that
appropriate
processes
in
support
are
derived
Determining
appropriate
revenue
recognition,
ensuring
timely
and
accurate
invoicing
Risk
Management
and
handling
Change
Requests
Status
Reporting
to
higher
management
Providing
Design
and
overall
architecture
recommendations
P ROJECT
-
S ENIOR
M A
F ACETS
C LIENT:
W ELLP OINT,
INC
R OLE:
P ROJECT
M ANAGER
/
L EAD
D URATION:
N OVEMBER
2 007
–
O CTOBER
2 008
Description
-
Client
is
a
leading
health
plan
in
the
U.S.
with
over
35
million
Medicare
members.
Senior
MA
FACETS
is
a
maintenance
project
with
the
Development
team
assisting
WellPoint
Wisconsin
on
several
work
requests
such
as
Operational
Reports,
Interface
Balancing
Reports
and
implementation
projects
including
NPI,
iHealth,
Provider
loads,
ITS.
This
project
involves
the
scrubbing
of
existing
providers
and
loading
of
new
providers
to
Senior
MA
FACETS
so
that
the
number
of
claims
pended
because
of
Provider
mismatch
is
reduced.
The
project
also
involves
developing
new
reports
using
Crystal
Reports
11,
developing
new
interfaces
and
solutions,
fixing
issues
faced
in
the
existing
applications
and
tuning
the
existing
applications
for
better
performance.
As
a
Project
Manager
/
Lead,
was
responsible
for:
Preparing
project
plans
and
monitoring
/
tracking
the
progress
of
the
as
per
the
project
plan
Managing
a
team
of
15
associates
and
ensuring
that
the
tasks
allocated
are
completed
and
delivered
within
the
scheduled
time
Develop
SOW
and
schedule
Management
of
staff,
recruitment,
performance
assessment
appraisals
and
feedback
Estimations
and
managing
change
control
process
Functional
requirement
Analysis,
Design
reviews,
estimation
reviews
Ensuring
that
laid
down
procedures
and
processes
are
followed
by
the
offshore
team
Involved
in
Business
development,
RFP
responses
and
Opportunity
Identification
P ROJECT
–
M VP
M EDCO
C LIENT:
M VP
R OLE:
P ROJECT
L EAD
D URATION:
JULY
2 007
–
O CTOBER
2 007
Description
-
To
build
a
system
to
automate
the
load
of
the
member
group’s
files
received
from
MEDCO.
As
a
Project
Lead
/
Manager,
was
responsible
for:
Review
of
project
scope
and
schedule
for
compliance
with
customer
specifications
Identified
non-
conforming
issues
to
the
client
and
assist
in
resolution
Drafting
and
implementing
the
functional
architecture
Requirements
gathering
and
final
review
of
project
deliverables
Sending
appropriate
and
timely
written
communications
to
all
project
team
members,
customers,
and
IT
management
throughout
the
life
of
the
project
P ROJECT
–
A MHP
N PI
C LIENT:
A MERIH EALTH
M ERCY
F AMILY
OF
C OMPANIES
(AMFC)
R OLE:
P ROJECT
L EAD
D URATION:
JANUARY
2 007
–
JUNE
2 007
Description
–
AMHP
has
been
operating
several
Medicaid
books
of
business
from
its
facilities,
on
FACETS
4.21
platform.
This
project
involves
providing
NPI
Remediation
services
on
the
current
IT
systems
supporting
the
different
Line
of
Businesses,
including
FACETS.
As
a
Project
Lead
/
Manager,
was
responsible
for:
Managing
a
team
of
15
associates
and
coordinating
activities
with
the
offshore
/
onsite
teams
Requirements
Gathering
and
Analysis
to
formalize
functional
specifications
Suggest
re-
engineering
approaches
and
provide
recommendations
in
determining
the
best
approach
Identify
performance
improvements
for
existing
production
applications
Ensure
on-
time
delivery
and
quality
of
deliverables
Received
accolades
“Associate
of
the
Quarter”
for
the
comprehensive
FACETS
knowledge
and
commitment
towards
successful
completion
of
the
project
P ROJECT
–
W ELLP OINT
M EMBERSHIP
C ONSOLIDATION
C LIENT:
W ELLP OINT,
INC
R OLE:
P ROJECT
L EAD
D URATION:
A PRIL
2 006
–
D ECEMBER
2 006
D escription
–
WellPoint
has
multiple
Operational
Systems
running
at
Mid-
West
(OH,
KY
and
IN),
Wisconsin
and
Missouri.
WellPoint
consolidated
the
Membership
and
Billing
information
in
FACETS
from
the
Wisconsin
(Mainframe)
and
Missouri
(FACETS)
systems
by
consolidating
them
with
Mid-
West
to
form
a
single
instance
of
FACETS.
As
a
Project
Lead,
responsible
for:
Handling
a
team
of
11
resources,
primarily
responsible
for
all
development
and
testing
activities
Project
Estimation,
planning
activities
and
work
management
Guiding
the
team
members
through
complex
technical
requirements
OTHER
HEALTHCARE
PROJECTS
Sierra
Health
Case
Tracking
and
Reporting
System
(CTRS)
–
Sierra
intends
to
automate
their
Case
Tracking
and
•
Reporting
Systems,
which
will
facilitate
the
users
to
work
with
their
Case
information
as
required.
Fidelis
Care
FACETS
Upgrade
Assessment
and
Remediation
–
The
project
involves
Impact
Assessment
at
the
•
functional
level
and
code
level
on
the
custom
objects
due
to
version
upgrade
from
FACETS
3.11
to
FACETS
4.11.
Fidelis
Care,
Claims
Mass
Adjudication
(CMA)
–
Claims
Mass
Re-
adjudication
project
involves
development
of
a
tool
•
to
support
re-
processing
of
“Paid”
ad
“Processed”
claims
using
FACETS.
TMG
Health
Care
Implementation
–
TMG
Health
Care
Implementation
project
(including
Medicare
and
Medicaid)
•
involved
developing
Operational,
analytical
and
Ad-
hoc
reports
using
FACETS.
The
project
also
involved
generating
extracts
in
Membership
and
Claims.
Trizetto
BCN
FACETS
Reporting
–
The
Project
involves
developing
Reports
out
of
the
FACETS
database,
creation
of
•
data
stores
and
Data
Migration
for
BCBS’
business
processes.
Specialized
Care
Services
–
UHG
–
For
reporting
purposes,
relevant
data
would
be
fetched
from
FACETS
and
•
populated
in
the
custom
R&I
database.
Cognos
would
then
use
the
data
to
generate
appropriate
reports.
IMS
European
Production
-
Territory
Planner
–
TP
application
consist
of
software
and
data
components
which
will
•
provide
timely
answers
to
the
specific
business
questions
each
customer
considers
important
to
drive
efficient
sales
force
(Sales
representative
and
regional/area
management)
activity.
Contact this candidate