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Project Product Specialist

Location:
Clifton Park, NY
Posted:
April 21, 2022

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Resume:

Summary

Around * years of experience in problem solving, business analysis and solutions development

Strong understanding of the business processes and the IT systems used in the US healthcare payer industry

Advanced level knowledge in software development/testing life cycles followed in SEI CMMI Level 5 Company. Performed Requirement Gathering/Analysis, Data analysis, Design & Data Modeling, Development, Testing, Performance tuning and functional consulting.

Responsible for co-ordination with various teams including offshore and working on daily deliverables and other related activities. Also responsible for making Status Report, Reviewing the deliverables, Training the new resources and other process activities.

Specialist in FACETS, a product used widely in the Healthcare Payer industry. Specialized in Claims Processing (both Paper and EDI). Enrollment, Eligibility. Also have experience in Finance, Capitation and Providers module.

Involved in the analysis of the requirements and perform a complete impact analysis with standard workflow and documentation.

Worked on Facets version upgrades, Inbound/outbound Applications and Extensions.

Professional experience in PL/SQL, Sybase, Data stage (ETL tool) and hands-on experience on UNIX, VB, C# and dot net.

Ability to communicate strongly with customers and business users within a team-oriented environment, closely work with team members and offshore folks in meeting the timelines with quality deliverables.

Winner of various awards in recognition of exceptional contribution to the project as part of Rewards and Recognition Program.

Education

Degree

College/University

Year of Passing

Percentage

BE – CSE

Syed Ammal Engineering College(Affiliated to Anna University)

2010

82

12th

State Board

2006

82

10th

State Board

2004

94

Software Skills

Category

Technology/Tools

Database

Sybase,PL/SQL

ETL Tools

Data Stage 8.7, Unix

Front End

MS Visual Studio 2017

Project Support Tools

Tidal, GIT, JENKINS

HealthCare

FACETS v4.61, v5.1, v5.6,V5.8 R1

Certifications

Certification Name

Type

Year of Completion

C# (Windows Based Application)

Cognizant Certified Professional

2010

Introduction to Managed Healthcare

Cognizant Certified Professional

2012

Medicaid

Cognizant Certified Professional

2012

SQL Server 2000

Cognizant Certified Professional

2012

Medicare

Cognizant Certified Professional

2013

Healthcare Membership for Practitioners

Cognizant Certified Professional

2013

Experience Summary

1.September 2019 – Till date working in Cognizant Technology Solutions

2.H4-EAD valid until Feb 5th, 2025.

Project Details

Client: AmeriHealth Caritas, Philadelphia, Pennsylvania

Domain: Healthcare

PROJECT PROFILE #1:

Duration: May 2020 – Till date

Project Title

Enhancement

Duration

May 2020- Till Date

Location

US

Operating Systems

Windows 10

Programming Languages

Sybase 16, PL/SQL, UNIX Shell Scripting, FACETS 5.8 R1,DataStage, Microsoft Visual Studio 2017

Role

Facets Product Specialist

Functional Skills

Requirement Gathering, System Analysis, Impact Analysis, Full scale development, Unit/User acceptance testing and Production implementation and support

PROJECT DESCRIPTION:

AMFC Healthcare Apps Support project includes providing support services for custom processes and applications on Facets, enhancing the custom applications build to support the customer business and developing new interfaces to support new business needs and/or to comply with State requirements for various plans it organizes across the country.

This project requires expertise in Facets 5.8, Sybase, Unix/Linux, Data Stage and MS Visual Studio .Net technologies, Tidal Scheduler and Medicaid business

ROLES AND RESPONSIBILITIES:

Performing the role of technical lead, coordinating with offshore to help deliver quality work on time

Design and development of custom applications to meet the business objectives of the project using FACETS and Trizetto Elements.

Pivotal in providing metrics and statistics to the client which serves as the basis for enhancing existing business in the Membership and other applications.

Acts as Subject Matter Expert to ensure business needs of critical functional areas such as Enrollment modules

Review offshore deliverables which include conducting review sessions, suggesting improvements to add value to the client and have a continuous delivery model.

Leverage resources as required according to the severity of customer’s issue and priorities; serving as an advocate on behalf of client for issues requiring immediate solution.

Highlight any potential risks to the Leads and seek inputs to resolve issues identified. Support integration of managed code and Non-managed code components which is deployed in distribution network, as required.

PROJECT PROFILE #2:

Duration: September 2019 – April 2020

Project Title

PA CHC (Includes Medicare, Medicaid and dual membership)

Duration

September 2019 – April 2020

Location

US

Operating Systems

Windows 10

Programming Languages

Sybase 16, PL/SQL, UNIX Shell Scripting, FACETS 5.6 R4, DataStage, Microsoft Visual Studio 2017

PROJECT DESCRIPTION:

The Health plan has been operating Medicare, Medicaid and both Medicare/Medicaid Line of business from its facilities, on Facets 5.6 R4. It includes different zone implementation for Medicare, Medicaid and dual members.

ROLES AND RESPONSIBILITIES:

Responsible for the functional and technical analysis, design, coding and testing

Responsible for QA Support, Creating deployment plans and for packaging and deployment migrations for the deliverables.

Worked as system analyst for the below Process.

1.ID Card

2.Welcome KIT

3.Home Health Aide Extract

4.SubCon Eligibility Extract

5.Panel roster Provider Extract

6.Pended claims report.

7.GL and Financial Summary report,

8.Billing Extract.

9.claims inbound and

10. Check write process.

PROJECT PROFILE #3:

Duration: June 2011 – November 2014

Project Title

Production Support

Duration

July 2012 – November 2014

Location

Chennai, India

Programming Languages

T-SQL, Ksh, C#/VB .Net,PL/SQL

Commercial Products

Facets, DataStage, Crystal Reports

PROJECT DESCRIPTION:

In continuation, Post-Implementation Cognizant is providing support services for all the applications considered in scope for the Client’s Unified Platform Consolidation Project. The project activities include performing root cause analysis, maintenance, enhancement and testing activities related to the following work items:

Production Support / Heat Tickets (ITSM)

Work Requests

ROLES AND RESPONSIBILITIES IN THE PROJECT:

Understand the business requirements by doing a complete analysis of the client’s requirements and preparing possible approaches for the requirement. Involved in activities like design, coding and testing. In coding, SQL objects are created to meet up the business requirement followed by testing to make certitude the expected outcome. Expertise in Kentucky line of business.

Also, responsible to make affable coordination with onsite including daily deliverables and other related activities. Accompanied with that making Status Report, DPP Coordinator, Daily Task assignment to offshore, Handling audit for production support, reviewing the code changes and other process activities were also involved.

PROJECT PROFILE #4:

Project Title

NJ upgrade

Duration

March 2012 – June 2012

Location

Chennai, India

Hardware

Intel Pentium D machines

Operating Systems

Windows XP

Programming Languages

Transact SQL, Sybase 12.5/15.1, UNIX Shell Scripting, FACETS 4.6, MS Office, MS Visual SourceSafe 6.0

PROJECT DESCRIPTION:

The Health plan has been operating several Medicaid Lines of business from its facilities, on Facets 4.21 platform. Client initiated a project to upgrade the Medicaid Lines of business for New Jersey from 4.21 to 4.61.

ROLES AND RESPONSIBILITIES:

Responsible for the entire software development life cycle of the process, including requirement gathering, analysis, design, coding and unit testing. At the same time daily deliverables to Onsite was also taken care. Responsible for Estimation, Reviewing the codes delivered and Process activities.

PROJECT PROFILE: #5

Project Title

Production Support

Duration

Jan 2012 – Mar 2012

Location

Chennai, India

Hardware

Intel Pentium D machines

Programming Languages

T-SQL, Ksh, C#/VB .Net

Commercial Products

Facets, DataStage, Crystal Reports

PROJECT DESCRIPTION:

In continuation, Post-Implementation Cognizant is providing support services for all the applications considered in scope for the Client’s Unified Platform Consolidation Project. The project activities include performing root cause analysis, maintenance, enhancement and testing activities related to the following work items:

Production Support / Heat Tickets (ITSM)

Work Requests

ROLES AND RESPONSIBILITIES IN THE PROJECT:

Understand the business requirements by doing a complete analysis of the client’s requirements and preparing possible approaches for the requirement. Involved in activities like design, coding and testing. In coding, SQL objects are created to meet up the business requirement followed by testing to make certitude the expected outcome.

Also, responsible to make affable coordination with onsite including daily deliverables and other related activities. Accompanied with that making Status Report, Reviewing the code changes and other process activities were also involved.

PROJECT PROFILE #6:

Project Title

Louisiana Implementation

Duration

September 2011 – December 2011

Location

Chennai, India

Operating Systems

Windows XP

Programming Languages

Transact SQL, Sybase 12.5/15.1, UNIX Shell Scripting, FACETS 4.6, MS Office, MS Visual SourceSafe 6.0

PROJECT DESCRIPTION:

The Health plan has been operating several Medicaid Lines of business from its facilities, on Facets 4.61 platform. Client initiated a project to extend the Medicaid Lines of business in Louisiana.

ROLES AND RESPONSIBILITIES:

Responsible for the entire software development life cycle of the process, including requirement gathering, analysis, design, coding and unit testing. Also taken care of entire TPL Processes for the new requirements. At the same time daily deliverables to Onsite was also taken care.

PROJECT PROFILE #7:

Project Title

KY upgrade

Duration

June 2011 – August 2011

Location

Chennai, India

Operating Systems

Windows XP

Programming Languages

Transact SQL, Sybase 12.5/15.1, UNIX Shell Scripting, FACETS 4.6, MS Office, MS Visual SourceSafe 6.0

PROJECT DESCRIPTION:

The Health plan has been operating several Medicaid Lines of business from its facilities, on Facets 4.21 platform. Client initiated a project to upgrade the Medicaid Lines of business for Kentucky from 4.21 to 4.61.

ROLES AND RESPONSIBILITIES:

Responsible for the entire software development life cycle of the process, including requirement gathering, analysis, design, coding and unit testing. Also taken care of entire Membership module, TPL Processes. At the same time daily deliverables to Onsite was also taken care. Responsible for Estimation, Reviewing the codes delivered and Process activities.

Client: UHGIT - Dental Benefit Providers, Inc.

Duration: December 2010 – June 2011

Domain: Healthcare

PROJECT PROFILE #8:

Project Title

Dental Benefit Providers

Duration

December 2010 – June 2011

Location

Chennai, India

Operating Systems

Windows XP

Programming Languages

SQL Server, Sybase 12.5/15.1, FACETS 4.6, MS Office, Perl

ROLES AND RESPONSIBILITIES:

Responsible for the entire software development/testing life cycle of the process, including requirement gathering, analysis, design, coding and unit testing. Gained Good knowledge in all the Facets Modules.

Personal Details

Date of Birth

December 23,1988

Sex

Female

Nationality

Indian

Experience

Around 7 Years

VISA Status

H4-EAD (Valid Until 02/05/2025)



Contact this candidate