Project Manager Management

Kiran Vanchithattil, PAHM®

Consulting Project Manager

Tel: +1-347-***-****; E-mail: **************@*****.***

Professional Summary:

Experienced Project Manager and Senior Healthcare Consultant with over 10+ years of extensive experience working in both product and service based organizations across the US Health Care industry with knowledge of Healthcare Payer and Provider Business Process, Business Case Development, Development of IT Enabled Business Solutions and Business analysis.

Executed various advisory services/management consulting roles for compliance related mandates

Strong knowledge of Software Development Life Cycle (SDLC) Models and Methodologies like Waterfall, Agile, and Rational Unified Process (RUP).

Knowledgeable about health industry data standards/normalization required for data interoperability and health information exchange (i.e. HL7, CCD/CCDA, ICD-9/ICD-10 etc.) and experience in working with clinical data integration within a healthcare system

Excellent knowledge in end to end Payer business processes especially claim processing systems like QNXT and its supporting systems, NASCO, Benefits, Medical Policy, Claim Check and System Configuration.

Profound experience in with HIPAA X12 EDI transaction codes such as 270/271(Inquiry/Response health care benefits), 276/277(Claim-Status), 834(Benefit-Enrollment), 835(Payment/Remittance advice), 837(Health care claim).

Knowledge of Patient Protection and Affordable Care Act (PPACA), Electronic medical records (EMRs) and Electronic health records (EHRs).

Proactively communicate and collaborate with external and internal customers to analyze information needs and functional requirements and deliver the following artifacts as needed: Functional requirements, Business Requirements Document, Use Cases, Prototypes and Wireframe designs.

Proficient in creating Business Requirements Documents (BRD), Functional Requirement Document (FRD), Use Cases, Business Systems Design and Requirements Traceability Matrix (RTM) using MS Visio and Rational Suite.

Rich Experience in translating Business requirements into IT system requirements and also designing business process models using MS Visio.

Experience in facilitating Joint Application Development (JAD) sessions and interviewing Business users & SMEs, providing recommendations to resolve issues for various business/technical groups and defining strategic solutions to business problems in a multiple project environment.

Experienced in change management, process improvement and customer relationship management.

Broad knowledge in creating User Acceptance Scenarios, Test Strategy, Test Plan, and reviewing the detailed test plans for UAT.

Knowledge of Relational Database Management System (RDBMS), data warehouse, Extract Transform and Load (ETL)

Strong team player with excellent interpersonal and communication skills. Self-motivated and focused individual with great attention to detail. Team builder with strong leadership qualities. Works in a collaborative environment with the ability to manage multiple priorities.

Self-starter and quick learner who is comfortable working in a fast-paced, deadline driven environment across multiple business units

Professional Experience:

Currently Working as a Consulting Project Manager – Professional Services at Edifecs Inc Since Jul 2013

Worked as a Technology Analyst/Senior Consultant at Infosys Technologies Limited from Dec 2005 to Jul 2013

Worked as a Technical Associate for Tech Mahindra from May 2005 to Sep 2005.

Academic Profile

Bachelor of Technology (Electronics and Instrumentation) - M.S University, India.

PAHM® Certified Health Care Professional

AHIP Health Insurance Advanced Certification

AHIP Managed Care and HIPAA Certification

Six Sigma White Belt Certification - Horizon BCBSNJ PBA Training

Pursuing PMI-PMP certification

Areas of Proficiency:

Programming Languages

C#, VB.Net, SQL SERVER 2000/ 2005, SAS

Configuration Management

Visual Source Safe, Microsoft Share Point, Tortoise SVN

Health Care Products

QNXT, NASCO claim engines, Portico Provider Manager, Claim check, HL7 ADTs

QA Expertise

System Testing, Integration Testing, Regression Testing, END-END Testing

Tools and Technologies

Visual Studio, Microsoft Office, Microsoft Access, Microsoft Visio, Clear Quest, Share Point 2010, Bugzilla, NetSuite OpenAir

Operating Systems

Windows Server 2003, Windows 7/Vista/ XP

Project Experience:

Organization: Edifecs Inc

Role: Consulting Project Manager /Sr. Healthcare Consultant

Client(s): Multiple

Duration: Jul 2013 - Present

Responsibilities:

Part of the clinical solutions delivery team for implementation of Edifecs clinical solution at one of the biggest State Medicaid agencies to facilitate the exchange of clinical ADT feeds from their trading partners

Key player in delivery of advisory services within the professional services team at Edifecs for ICD-10 product suite implementations

Maintain active communication with clients to manage expectations, ensure satisfaction, and lead change efforts effectively.

Work closely with senior management to develop appropriate work plan to meet client needs.

Responsible for day-to-day work plan and engagement delivery in accordance with expectations.

Consult, work with, and service client base to make recommendations on business and process improvement.

Successfully manage project scope and client expectations, leading to strong client references and follow on engagements

Actively develop and maintain peer relationships with other Advisory Services practices and other firm Service Lines to promote an integrated cross-discipline sales and delivery model and actively pursue cross-sell opportunities appropriate to the client needs.

Play key role in all aspects of proposals including pre-sales and RFI/RFP activities

Experienced in managing multiple projects and work in a self-directed manner in a collaborative group environment with sensitivity to tight deadlines

Manage, develop, train, and mentor staff on projects and assess performance for engagement and year-end reviews

Organization: Infosys Technologies Limited

Role(s): Technology Analyst/ Sr. Business Analyst/ Healthcare Consultant

Client(s): Multiple

Duration: Dec 2005 – Jul 2013

Responsibilities:

Worked under various capacities to that of Senior HealthCare Consultant, Project Lead and Business Analyst over a period of 8 years with one of the top US Healthcare payers

Involved in system up-grade, system enhancements, product development and system analysis using various Relational Database Management Systems (RDBMS) and Extract Transform and Load (ETL) techniques

Excellent knowledge in end to end Payer business processes especially claim processing systems like QNXT and its supporting systems, NASCO, Benefits, Medical Policy, Claim Check and System Configuration

Excellent customer relationship management skills and experienced in working with senior leadership and office of the PMO

Experienced in facilitating Joint Application Development (JAD) sessions and interviewing Business users & SMEs, providing recommendations to resolve issues for various business/technical groups and defining strategic solutions to business problems in a multiple project environment

Led teams in customization and implementation of multiple interfaces of Provider Portico Manager (Product of McKesson)

Excellent facilitation skills in conducting Walkthroughs, Brainstorming Sessions with Vendors and BRRB (Business Requirements Review Board)

Strong team player with excellent interpersonal and communication skills. Self-motivated and focused individual with great attention to detail. Team builder with strong leadership qualities. Works in a collaborative environment with the ability to manage multiple priorities

Managed a team of business analyst and QA staff as part of the Benefit coding and configuration project both onshore and offshore

Involved with senior leadership as part of sales and closure activities by participating in proposal meetings and providing subject matter expertise

Utilize project management techniques to establish roles and responsibilities, monitor project and request status and workload, and ensure deliverables of high quality, effectiveness and timeliness

Facilitate knowledge sharing sessions and team collaboration. Coach, mentor, motivate and supervise project team members, and influence them to take positive action and accountability for their assigned work

Organization: Tech Mahindra

Role: Technical Associate

Client: AT&T

Duration: May 2005 – Sep 2005

Responsibilities:

Analyze and understand detailed business requirements

Test Planning and Scenario Design, Test Case Development, Test Execution and Test Result Analysis

Played pivotal roles in End to End system testing and load testing which included running huge volumes of data through the system and maintaining records for comparison reports

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