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Manager Project

Powell, Ohio, United States
March 19, 2019

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Powell, OH *****



Positioned to deliver leadership excellence, proven resource maximization methodology, innovative operational efficiency, used waterfall and agile development, scrum methodology, team development and cost reductions while driving healthcare project executions. Domain Skills: IT Product Development, Healthcare Data Management – Web Development Digital Development – Data Migration – Health Services - Vaccine and Drug Development Team Acquisition & Retention – Stake holder Management – Revenue Growth - Training & Team Leadership – Agile Practitioner - Financial Analysis – Vendor Management – Workflow strategies – Risk Management – Project Management Reporting – Telehealth - FACETS - Healthcare Data Analytics – EDI – PBM - Claims – HEDIS Measures – CMS Files – Medicare – Medicaid - ADT – HIPAA Compliance – Medical Record Retrieval – Healthcare Payer – EDW - HL7 Platform – BI tools PROFESSIONAL SUMMARY

Accomplished healthcare Project & Program Manager with hands-on experience in managing projects with Behavioral Health Care Coordination, Medicaid, Medicare, and Marketplace member’s clinical data for Population Health Analytics. Exceptional track-record of integrating the clinical data from Center for Medicare and Medicaid Services (CMS) files, claims, providers office, county immunization records, third-party healthcare database to enterprise data warehouse (EDW). Top performer who successfully managed the development of large-scale cloud-based EHR project with telehealth for a full life cycle from high-level planning to implementation, rollout and enhancements; manages strategic alignment and integration across projects/programs in support of business unit process and administrative efficiency, defines project required to support programs, partners to ensure their implementation on time, within budget, with scope, and quality. Experience in enterprise data warehouse (EDW), business intelligence, reporting, data analytics especially within the context of patient data, enrollment and claims in healthcare business. Provided data integration best practices, technologies, and resolving data warehousing issues.

Excels in participating in pre- and post-implementation feasibility studies, business planning, KPI, benefit analysis studies, rollout planning, and telehealth billing. In-depth knowledge of CPT codes, PBM, Healthcare Payer, RCM, and Claims. Excellent understanding of HIPAA and HL7. PROFESSIONAL EXPERIENCE

PROJECT MANAGER July 2018 – Present

CareSource – Dayton, Ohio

CareSource is a non-profit offering health care program including Medicaid, Medicare, and Marketplace

Developed detailed project plan, conducting JAD sessions, managing resources, budgeting, and status report updates for the Behavioural Healthcare and Coordination project to accommodate new rules from the Ohio Department of Medicaid for providers claims management & payment

Monitored and evaluated project resource needs ensuring the continuity of projects and timely communication, reporting to stakeholders and project implementation SHARAD V. RAWALE


Improved healthcare services to members by managing a program for data integration from Encounter, Prior Authorization, Payer, PBM, EDI, CMS files, Claims, HEDIS, ADT, providers office, county immunization records, and third-party healthcare database for different line of businesses to enterprise data warehouse (EDW) for the consumption to the Population Health Analytics team to render disease prevention and management PROJECT MANAGER Jan 2013 – June 2018

Healthiva – Mansfield, Ohio

Healthiva offers a cloud-based proprietary EHR suite for opioid addiction treatment, prevention, patient scheduling, billing, laboratory reporting, RCM, Payer, telehealth, and video conferencing.

Interacted with stakeholders to understand the provider’s office, medical insurance, Medicare/ Medicaid regulations, requirement gathering for the development of EHR software using SDLC

Successfully managed the creation of coherent project content, task breakdown, estimation of work, scope documents, project knowledge base adhering to HIPAA compliance and HL7

Managed an in-house and overseas team responsible for the development of screens for patient portal, provider portal using front end, and back-end technology, and vendor management

Managed the development of SMS alerts system, laboratory report integration to the core patient medical records, integration of payment gateway, billing, and patient database using JIRA software. Integrated FACETS system, EDI, Claims, Payer, medical records and Twilio telehealth

Web development of Patient & Providers portal. User management on HIPAA compliant database KEY ACHIEVEMENTS

Implemented project goals, UAT, motivated the team to meet the tight deadlines for the completion of the project on time, with the scope, within budget, and quality

Fostered Healthiva’s success by supporting the sales team with technical presentation, product configuration, educated new users in classroom, online and developed user manual

Spearheaded all planning activities from concept to execution for the EHR project from initiation, design, project scoping, resource planning, budgeting, contracting, implementation, and enhancements. Migrated to new system via change management to improve office efficiency

Managed effective integration of patient medical record data, HEDIS data, CMS files to EDW IT PROJECT MANAGER April 2010 – Dec 2012

Ohio PTECH – Dublin, Ohio

Ohio PTECH provides services for the design of e-Commerce websites and software development.

Analyzed business requirements, software specifications, work assignment, managed the project and the team for web development, digital development, and file server management

Extensively managed the web design project with HTML, CSS, WordPress, PHP, JavaScript, MySQL database, production support and enhancements. Managed SEO projects

Demonstrated expertise in change management, project and time management, organizational communication, team facilitation, and negotiation skills; managed the development of B2B portal and performed UAT testing, payment gateway integration and implementation

Managed the performance of data validation via SQL queries to ensure data integrity and application functionality. Managed software development using SDLC and contract negotiations KEY ACHIEVEMENTS

Increased project efficiencies by 40% from previous months by overseeing the payment processing gateway using File Server, SOAP/WSDL based services hosted by providers. SHARAD V. RAWALE

Escalated as needed to resolve issues/ roadblocks thus ensuring project deliverables are met in a timely fashion.

Ensured resource availability, used appropriate tools and management techniques to manage changes in project scopes, schedules, and cost maintaining the product quality PROGRAM MANAGER Oct 2001 – Mar 2010

The Ohio State University Wexner Medical Center - Columbus, Ohio

Managed end to end vaccine development program from initiation, design, production, preclinical studies to the phase-1 clinical trial of peptide-based immunotherapy vaccine aimed to treat HER- positive breast cancer patients and extensively used Laboratory Information System (LIS)

Managed the Core-facility for peptide synthesis, antibody production, drug development, and vaccine research. Participated in writing request for proposal (RFP) & mentored graduate students

Managed several projects aimed to develop the vaccine, therapeutic agents for various cancers, VEGF, HCV, HTLV diseases using preclinical and Phase-1 clinical trials

Participated in grant proposal writing from NIH, managed entire project and budgeting.

Presented the scientific data in internal review meetings, national/ international meetings, co- authored patents, and manuscripts for publication in peer-reviewed journals KEY ACHIEVEMENTS

Re-engineered epitope design for potential vaccine and business opportunity

Implemented the NIH funded a multi-specialty phase-2 clinical trial for Sunitinib in treating patients with Relapsed or Refractory Esophageal or Gastroesophageal Junction Cancer

Improved efficiencies and cost-effectiveness of contracted services and vendor management through collaborating with Medical doctors, researchers within the Wexner Medical Center, Nationwide Children’s Research Institute, industrial clients for research projects, and clinical trials T ECHNICAL SKILLS

Project Management : MS Project, SharePoint, Waterfall, Agile, and JIRA Project Management Reporting : Project Manager, JIRA and Power BI Project Management tools : Gantt charts, PERT charts, and WBS Project Languages : Java 1.7, J2EE, .NET, HTML, PHP, CSS, and JavaScript Internet Technologies : jQuery, AJAX, REST, SOAP, WSDL, HTML, CSS, and XML Data tools and Data warehousing : SQL, Teradata and Oracle Databases : MSSQL, MySQL 5.6, and MS Access

Version Control : TFS, Tortoise, and SVN 1.6

Build Tools : TeamCity, and ANT 1.9

Platforms : Linux and Windows family

Office Tools : MS Office 2007, 2010, and Office 365, VISIO, BI tools Cloud Services : Microsoft Azure

Automation Solutions : ServiceNow

Healthcare Data Exchange : HL7 and HIPAA


HIPAA Certification: Jan 2018 and working on PMP certification Publication’s: Over 40 research papers, patents, conference papers, and presentations PhD. Peptide and Protein Engineering, June 1992- July 1997 Indian Institute of Technology Bombay (IIT) Powai, Mumbai, INDIA

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