Management Project Manager

ATUL KUMAR GUPTA, PMP

916-***-****(M)

abikfo@r.postjobfree.com

http://www.linkedin.com/in/atulkumargupta

Results oriented IT manager with successful track record leading teams of

professionals in the consistent on-time on-budget delivery of complex

medium and large-scale projects in highly challenging environments.

Extensive hands-on and leadership experience with information technology in

diverse industries and corporate environments. Expertise includes project

and budget management, staff development, vendor and contract management,

managing client relationships, systems analysis, testing, and all aspects

of SDLC. Recognized for strong work ethics, exceptional business insight,

analytical and technical aptitude.

11+ Years plus in MIS 6+ Years in Project 7.5 Years in Healthcare

Management Industry

Budget Management SDLC, JRP & JAD, Agile Strategic Planning

Software Development Customer Relationship Business Process

Management Improvement

System Evaluation & Vendor/Contract Management IT Management

Implementation

Health Insurance Change Management 6+ years experience in

Membership, Billing, and Offshore-Onsite Model

Authorization, HIPAA, EDI

processes

Roles & Responsibilities

Health Net Inc - Rancho Cordova, CA

March 2003-Present

Project Manager - March 2006 to Present

Health net is one of the leading health Insurance companies. MHN is a

Health net subsidiary and has in-house application system MC400 written in

SYNON/RPG. Responsible for managing new development and enhancement

projects for various health care applications e.g. claims, benefits,

provider relations, care management, eligibility, finance etc on MC400,

MC400 Interfaces and on the web.

. Successfully enhanced the claims payment system on MC400. Automated

the claims recovery system.

. Managed/Implemented web based care management software managing 6

million members. It cut down the operating cost by 5%

. Successful implementation of Autism mandate for various states with in

given time, cost and resources.

. Successful implementation of CAQH process to upload/update the

provider information on MC400. This process included receiving the

information from web in XML format, Converting MCL format to MC400

format, validation of key data elements, accepting/rejecting the data

and sending back the acknowledgement in XML format.

. Increased the claim auto adjudication rate from 25% to 40% by

automating claims processes like adjudication, rejection, claims

review and re-adjudication.

. Successful implementation of New York Parity mandate within given

time, cost and resources.

. Increased standardization, efficiency, and quality by developing new

processes and change management templates based on IEEE and CMM

standards.

. Improved consistency by designing and implementing a new version of

control software which supports many parallel developments

. Claims extracts to third part clients - Managed several EDI 837

inbound and outbound project, Played a key role in the design and

coding process for all small/big size assignment to send claims data

to the

Health Net's internal and external Clients, Involved in getting

the requirements, design, coding, testing and

implementation

System Analyst - June 2005 to March 2006

. Analysis and implementation of mandatory Sarbanes Oxley and pre-

payment review regulations.

. Analysis, Design and implementation of web portal for provider

authorization system. Automation of process saved money as no more

manual processing of authorizations

. Development of use cases, traceability matrix, user stories

. Design and implementation of California assembly bill AB1324 on MC400

system.

. Create various MHN interfaces with parent company health net and with

third other party vendors. The interfaces are created to accept data

in standard EDI formats as well in health net's proprietary formats.

. Worked as architect / analyst in integrating Atlantes Care management

system with MC/400 (which is the claim engine for MHN).

Sr. Programmer Analyst - March 2003 to June 2005

. Conversion of RPG400 programs to SYNON -Design, coding and testing

. Claims auto adjudication and pricing process - designed, coded and

tested the claims process for MHN (a subsidiary company for Health

Net) without assistance

. Individually Designed and implemented FIRST HIPAA 837 outbound process

for 120,000 member client. All future HIPPA outbound transactions are

based on this model.

. Individually Analyzed, documented the existing clinical process, found

gaps, re-design and implemented more efficient clinical management

system,

. Parsing/building of XML for various EDI/HIPAA transactions.

Design Engineer, Walgreen Corp, Chicago

Feb'2002-Feb'2003

Onsite Coordinator, Project Leader, Requirements gathering, study of

existing system, design, implementation, documentation, Coding in SYNON

COOL: 2E, Unit and system testing. Preparation of the design/testing and

user documents for Warehouse management systems. Designed email software to

send automatic emails to the vendors from AS400 system. Managed team of 15

people (offshore), including QA and development teams.

Design Engineer, Target Corp, - Minneapolis

Nov'2000Feb'2002

Onsite Coordinator, Team Leader, Providing business and technical solutions

to Target Corporation and being a part of decision support system. Work

included ordering fulfillment support system, SYNON/COOL 2E Programs

maintenance, gathering design requirements, writing code specifications,

suggesting business enhancements. Also learned and supported the

supply/chain system and the Internet order processing system. Managed team

of 21 people (offshore) including development and QA teams.

Offshore Design Engineer, West Marine Products, CA

Jul'2000-Nov'2000

Designed and developed the code using RPGILE and CL400. Involved in the

unit test preparation, unit testing, system testing and acceptance testing

EMU System Compliance, GE Finance System, Ireland

Feb'99- July'2000

Involved in the planning and the testing of pilot programs. Studied the

Lease loan and stocking system and did the analysis of the impact of the

conversion. Involved in the unit testing and the system testing

Skills and trainings

Operating system: Windows 95/NT/2000/XP, MS-DOS, UNIX, AS400, LINUX,

MAINFRAME

Language: RPG400, ILE 400, CL400, COBOL, JAVA, HTML, SYNON COOL: 2E

Software Packages: Euro Kit, MSOFFICE (MSWORD, MSEXCEL, MSPOWERPOINT), Ms

Project, MAPICS, SQL, Qcare, File Manager, Mc400, Ms Visio, Web Sphere,

Xml, PLANVIEW, MC400, UNITY(Atlantis)

Database: MS Access 2000, DB2

Courses/Workshops Attended:

Advanced Project Management, Agile Project Management, Basics of Project

Management,, ITIL Foundation, Computer Organization & Architecture,

Software Engineering, Requirements Engineering, Structured Systems Analysis

& Design,, QMS, Quality Assurance and ISO 9000, Data Communication &

Networks, Object Oriented Methodology, IBM AS/400 Concepts, Work

Management, AS/400 Security Concepts, RPG/400, CL400, SQL/400, QUERY/400,

CMM Overview, JAVA 1.1.5

EDUCATION & Certifications

Master Project Management Certification - UC Davis,

Project Management Professional - PMP

ITIL Foundation Training - Internal training at Health Net, December 2009

HIPPA training - Health Net 2009

Masters of Science (M.S.) Indian Institute of Technology, Roorkee, India

(Aug'97-Jan'99)

Bachelor of Engineering (B.E.) Indian Institute of Technology, Roorkee

India (Aug'93-May'97)

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