Management Project

Saima Adil, PMP

*** ******** ****, *************, ** 17050, U.S.A.

717-***-**** – ********@*****.***

Skill Set

Management & Architectural Skills

• Provided leadership to establish processes for healthcare operation excellence using best

of breed technology

• Provided leadership on design and implementation of cross function and complex

integration projects for Legacy Modernization

• Managed and formalized operational analytics processes and governance across all

healthcare domains including claims, members, provider etc.

• Managed and established processes to create metrics to measure business operations

• Managed team to optimize business process outsourcing involving multiple vendors

• Managed a large team of professionals both on-shore and off-shore locations

• Project Management Skills - PMI Certified PMP

• Mentored a number of team members on various process and tools

• Led design and implementation of number of cross functional interfaces to support

enterprise-wide applications

• Architected integration components for Provider, Member, Claim, Client domain

• Designed and developed enterprise services that included CPR, CMR and Claim services

• Championed strategy for cross domain integration

• Used cutting edge technologies to design business solutions using various reengineering

techniques and process

• Led internal and external review of the designed solution for Legacy Modernization

Provider, Member, Claim and Client services.

• Proficient knowledge of using all 9 PMI knowledge areas ( integration management,

scope management, time, cost, quality, human resource, communication, risk and

procurement management) and 42 processes depending on project needs

• Build credibility, establish rapport, and maintain communication with stakeholders at

multiple levels and managed scope of the deliverables

• HPLC - Extensive background in managing the SDLC for application development.

• Highmark RUP - Leveraged on a number of projects at Highmark

• Provided architectural leadership on complex data/service modeling and business

processes modeling

• Architectural Methodologies - TOGAF

Professional Experience

Manager, Data Management & Metrics Group February 2012 – Present

Highmark Blue Cross Blue Shield – Camp Hill, PA

(leads team of 20+ professionals)

Manages the operational analytics and decision support function for this ~$15B health insurance

company. Responsible for complex data analysis, predictive analysis, data mining and other

projects related to operations; integration of different types of data (call center detail, pending

claims, service inquiries, benefits, membership, billing history, financial and organization

hierarchy); design, evaluation and development of computer-based modeling and simulations, and

the development of process and/or data changes to accomplish goals and objectives.

• Responsible for the overall data management across the enterprise and ongoing

refinement of predictive analytic models and general analytics to improve Client

Management, Member Management, Customer Service, Claims Processing, and Billing

processes.

• Oversees the total reporting solutions for all operational processing areas for all internal

Highmark customers; includes developing dashboards, scorecards, forecasting, trending

and tracking results to enhance customer business operations performance and

effectiveness.

• Manages professional staff to develop and implement application systems; responsible for

all aspects of system development life cycle, providing technical expertise and functions

as an intermediary system integrator of other impacted corporate systems and business

processes

• Manages and oversees success of multiple projects typically involving complicated and

unique business, financial and clinical/operations issues facing the enterprise and its

business partners. Areas of research include determinants of process performance,

process costs, related drivers and opportunities for cost reduction; determinants of

client/group/member/provider satisfaction; client/group/customer profitability; individual

staff performance and productivity; staff forecasting, including consideration of internal and

external determinants such as workload, productivity, system performance and health care

reform.

Tools and Methodology Used:

• SAS, BI/DI Studio, OLAP Cube,

• DB2, EWD, Teradata, Oracle, DB2, Avaya CMS, TotalView, Mainframe, Claims Process

System, Member and Client Manage Management systems, Enrollment systems,

• Card processing system, Workforce Planning, Vendors SLA management,

• SSAE 16 Standards

Team Lead July 2007 – Feb 2012

Highmark Blue Cross Blue Shield – Camp Hill, PA

Worked as team lead for integration architecture group to design and implement integration

services across various business domains like Client, Member, Provider and Claims etc. Designed

the integration strategy for Legacy Modernization project and created framework for integration

between different technology and business domains. Designed the security framework Legacy

Modernization projects to provide an integrated authentication and authorization model across all

domains. Designed and developed integration components across various business domains

using Enterprise Service Bus (Message Broker). These integration component included message

broker flows and mainframe DACT components, providing open system to mainframe, mainframe

for open system integration patterns using REST and SOAP based SOA services. Led Message

Broker flow development and Unit and Integration testing. Provide support after production

release.

Leveraged PMI project management methodology and processes to contribute through the

lifecycle of the projects from initiation phase to closing phase. Led and contributed to requirement

gathering session for projects of various sizes. Created design document and led internal and

external cross team review meetings. Created the implementation plan for production release for

a number of projects. Contributed to business services governance across different domains.

Used PMI project management best practices to identified risk to the projects, created risk

response strategy, assigned risk owners and allocate risk to relevant owners. Used various tools

to manage risks. Acted as key contributor to risk management sessions.

Tools and Methodology Used:

• Project Management Skills - PMI (PMP), Highmark RUP

• IBM WebSphere Message Broker and IBM WebSphere Message Queue

• IBM Rational Clear Case, Requisite Pro and Rational tools. CA Harvest

• SOAPUI, PATHWAI, RFUTIL

• Standard Architectural Methods

Systems Consultant July 2006 – July 2007

Highmark Blue Cross Blue Shield – Camp Hill, PA

Provided technical support to business domain sub-projects that are creating business process

models using Websphere Business Modeler.

Performed business process modeling as a team member on the business domain sub-projects.

Developed reusable technical standards and guidelines pertaining to Websphere Business

Modeler that will be used across all Legacy Modernization projects for years 1-5.

Provided customized training and presentation to LM project teams pertaining to Websphere

business modeler.

Provided mentoring and coaching to LM project teams on the best techniques for using

Websphere business Modeler.

Provided trouble shooting for LM project team related to WBM.

Performed testing of new versions of WBM as part of the Software Management Process.

Participated in the testing and research of related software that WBM needs to send data to or

receive data from.

Worked on advanced features of reporting in WBM.

Generated customized reports in WBM for each and every feature of processes.

Reviewed process models for every business domains as individual as well as team.

Made good ideas to buiness team to do process modeling in efficient way.

Systems Consultant Sept 2005 – July 2006

Highmark Blue Cross Blue Shield – Camp Hill, PA

Worked on Highmark Information System Knowledge Base (ISKB) system to manage enterprise

wide metadata..

Used Adaptive system to manage and standardize application codes used at Highmark.

Designed and developed batch jobs for ISKB to export data from Adaptive/ISKB to different stake

holder according to their requirements using Java/J2EE technology

Provided technical support to business domain sub-projects that are creating business process

models using WebSphere Business Modeler.

Perform business process analysis and modeling. Working on Member Management, Provider

and Claims sub domains.

Help Highmark develop technical standard and guidelines for business modeling using

WebSphere Business Modeler.

Communicated business and technical challenges, risk and mitigation to the business users.

Provided mentoring and guidance on best practices and techniques for using business tools.

Performed testing and research of technologies related to business modeling.

Software Analyst Nov 2003 – Jan 2005

DataSoft Technology Inc – Mississauga, ON

Worked on web portal and designed and developed an intranet based portal for company

employee communication. Portal included different tools to make the communication effective.

These tools include internal memo publication, company announcements and calendar and event

announcement. Employees to get connected with the company policies, trends and

announcement in an effective way using this portal. This project was done on WebSphere

Application Server using Java, J2EE, JSP, XML, JDBC etc. Also helped the company to deploy

and administer the solution. Also used Struts framework for presentation layer. Utilized tiles in

Struts.

Technical Skills Utilized

• Java, JavaBeans, JSP, JavaServlets, EJB, JDBC, JNI, JTI, JNDI

• Oracle, PL/SQL, TSQL, Stored Procedures

• WebSphere Application Server 5, JBoss, Apache, Tomcat

• HTML, DHTML, CSS, XSL, XSLT, XMLHTTP, JavaScript

Web Developer Oct 2002 – Aug 2003

Trimafor Corporation – Windsor, ON

Designed and developed an XML transformation engine to extract data from a relational data

source and expose it as XML feed to be used in other external system. Extensively used Java API

for XML and JDBC. Deployed the solution on WebSphere Application Server. Also involved in

performance tuning and fine tuning to maximize the throughput of the system. Technology used

includes Java, J2EE, JSP, Servlet, XML and JDBC.

Software Engineer May 2000 – Sept 2002

DataSoft Technology Inc. – Mississauga, ON

DataSoft – a web based customer relationship management (CRM) solution provider. Worked on

system to develop middle tier components for the work order management sub system.

Extensively used Java and its component technology to write complex workflow based business

objects. Used different object oriented technology and patterns to develop components. Used

RMI, XML, XSD and other technology to communicate and pass data to and from different

component of the system. Also used JAX (Java API for XML) to process XML files. Used Log4J to

log all exception into centralized logging repository. Also worked on front end of the system using

JSP/Servlets, used Struts as the framework for the front end. Used Apache and WebSphere as

the platform for the deployment of the application. Also used Oracle as the back end database.

Wrote Oracle stored procedures, functions and cursors to develop back end logic of the system.

Used JBuilder, PL/SQL Developer and WebSphere Application Developer as the primary tools.

Also used BEA WebLogic for the initial release of the system. While writing client tier also used

JavaScripts and DHTML extensively to provide a rich and user friendly interface to the user of the

system.

Technical Skill Utilized

• Oralce, SQL Server 6.5, CodeBase, PL/SQL, TSQL, Stored Procedure

• Write Shell scripts on Unix environment and used different utilities like “chop utilities”

• Java, JavaBean, JSP, Java Servlets, EJB, JBDC, JNI, JTI, JNDI

• WebSphere., WebLogic, Apache Tomcat

• JBuilder, JDeveloper

• HTML, DHTML, CSS, XML, XSLT, XMLHTTP, JavaScript, VBScript

• SOAP, XML, HTTP, WSDL, UDDI, XSD, DOM, XPATH

Oracle Developer Sept 1997 – Feb 2000

Pycon Inc. – Karachi, Pakistan

Pycon Inc. is the leading provider of Retail Merchandize Optimization software that helps retailers

make more profitable buying, allocating and pricing decision based on customer demand.

As a database developer, designed and developed generic schema for the company’s new

product. Developed PL/SQL stored procedures, packages and triggers for data load and

transformation and data extraction. Optimized SQL queries for efficient data load for terabyte size

backend database. Provide interface queries and procedures for the front-end Java application.

As the technical leader of the database group in the professional services department, worked in

team of engineers to deploy product to new clients. Towards this end, gathered client

requirements, modified existing load procedures and other database objects, and provided

technical solution to the client and deployment team. Designed and developed client specific

database objects and load procedures. Developed shell scripts for automating load scripts. Create

and maintained project plans and successfully deployed products on time.

Technical Skills Utilized:

• Oracle 6 – 8i, PL/SQL, Stored Procedures, Functions, Triggers

• JDBC, Oracle ODBC, OCI, Proc C, PL/SQL Developer, TOAD, SQL Plus, SQL Loader,

Reports & Forms

• Java, JavaBeans, JSP, JDBC

• Shell scripting, JavaScript for client side interface

Developer Sept 1996 – Jun 1997

Creative Web Solutions – Karachi, Pakistan

Worked for Creative Web Solutions, a vertical solution provider, on product named ISPBill, which

is used for accounting, authentication and authorization of Internet services provider customers.

This application is used to track all customer information, measure their internet usage and

provide authorization on resource available from the service provider, report billing information

and prepare capacity planning reports. This is a completely integrated solution targeted to

address the complex needs of modern service providers.

My involvement in the project was of dicer nature; I was involved from requirement gathering to

analysis, design, development and implementation. Interacted with the customer to get the details

of the business requirements. Provided feedback to the managers to help them come up with a

feasible solution for the given problem. Stayed focus on the objectives, was not carried away wide

side issues. Worked in a team environment and used result driven and motivated approach to

solve business issues.

I worked on ASP and HTML. Developed portals for both broadband and regular speed customers.

Expensively used Macromedia Flash and other associated tools to develop feature rich interactive

front end of the application. Also developed graphic contents of the application using Adobe

PhotoShop and Ilustrator. Used Visual InterDev and Microsoft FrontPage for the development for

the Web page. Also evaluated Dream Weaver for time. Extensively used client side JavaScript

and DHTML for interactive contents.

Visual Basic Business objects for the middle tier. Also used Oracle stored procedures and

PL/SQL. Used different debugging techniques to trouble shoot application issues.

Technical Skill Utilized:

• HTML, Java, JDBC, Applets, JavaScript

• Oracle, PL/SQL

• SQL Server 6.5, TSQL, Stored procedure

• Visual Basic, Visual C++, MFC, ODBC API, Win32 API

• DHTML, CSS, XSL, XSLT, XMLHTTP, JavaScript, VBScript

• Macromedia Flash, Dream Weaver, Adobe PhotoShop

Professional Qualification

Bachelor of Electrical Engineering – 1996

N.E.D. University of Engineering & Technology

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