Customer Service Data Science
Resume:
GirishKumar (Girish) Nair, MBA, CSM, PMPO
Cumming, GA 30028 *********@*****.*** www.linkedin.com/in/girishkumarpnair/ US Citizen
PROGRAM/PRODUCT LEAD
Strategic Planning Analysis & Analytics
Strategic and accomplished leader with extensive experience leading all aspects of program management activities by identifying business requirements, creating project roadmaps, and strategizing product features.
Consistent delivery of pragmatic solutions and MVP.
Managed $MM integrated customer service technology programs that consist of multiple, high-profile and complex projects that span multiple fiscal years, business units and carry significant enterprise-wide impact.
Expertise in Integrations (CVS-Aetna), Enterprise Products, BOT/Automation Projects, On Boarding New clients to PBM, Data Science Payment Optimization Analytics.
Stellar record of spearheading large-scale and complex projects from conception to completion within pre-defined timeline, budget, and scope.
Monitor, measure and report on program status to senior leadership. Accountable to Steering Committee and Operating Committee for enterprise/strategic goals, including efficiency and functionality of project completions, timeline adherence, budget and resource management.
AREAS OF EXPERTISE
E2E Program Management Program Plans Retro-Reviews Software Documentation PRF Generation
Statement of Work Standard Operating Procedures Risk Mitigation Relationship Management Design Thinking
Strategy Development Team Building & Leadership Continuous Improvement Agile & Waterfall
Payment Optimization Analytics I Clinical Products I EPIC I
PROFESSIONAL EXPERIENCE
CVS HEALTH, Atlanta, GA 2021 - Present
Business Program Manager – Data Science – Payment Optimization.
Launched Payment Integrity – Analytic Detection Product FWA (Fraud, Waste & Abuse) within Aetna with Potential revenue of $9.2M in year 1 & $42M for next 5 years. Worked with Special Investigating Unit, SMEs, IT delivery.
Delivered advanced analytical model & business rules to detect provider level billing fraud & generate savings.
Integrated workflows between 5 applications across various domains.
Provided tactical solution for 2024 & followed by strategic solution in 2025.
Program Manager - Enterprise Products Domain/Transformation
Launched Home Health – Clinical Product within CVS in Q2 2023 with Potential revenue of $22M in year 1.
Served high-risk members discharge from hospital to home with bedside and home-based interventions.
Increased scalability of the product to handle increase in membership from 60k to 360k
Integrated workflows between 9 applications across various domains.
Recommended to use existing pipeline from Aetna which resulted in reduced cost from original budget using existing billing platform availity. Inception to Delivery
Presented TDC Pilot (Transform Diabetic Care) - Clinical Product. Worked with TCNs on EPIC FE & EPIC BE.
Targeted 0.7M members of diabetics’ patients’ program with timely & tailored interventions.
Provided financial strategy and guidance for above programs to be delivered within allocated budget.
COGNIZANT TECHNOLOGIES, Hartford, CT 2018 – 2021
Senior Project Manager (Aetna-CVS Post-Merger Integration Program) – M&A
Launched Ariba procurement On-Prem to SAP-Ariba Cloud program budget $4.5M.
Standardized purchasing/contract/billing application to Aetna/Ariba Cloud Solution from Aetna On-Prem
Oversaw due diligence to post merger integration of Aetna & CVS Procurement teams. IT network & applications.
Boeing New PBM Set-up - Go-live Q4-2021, $1.5M – Clinical Product
Moved Boeing Rx vendor from ES to Prime Therapeutics creating a new PBM set up with Prime Therapeutics.
Worked with Enterprise data interface, Claims, Recons/OOB report, ID cards, Pharmacy claims, Infra Aetna & Prime.
GirishKumar Nair *********@*****.*** Page 2 of 2
EWC LLC, Berlin, CT 2014 – 2018
Controller, Finance, Tax, Statutory Compliance, Procurement, IT/PMO Dept (State & Federal), Report to CEO
Provided Due Diligence to approve Estimates/Cash Release for execution by Project Team. (State & Federal Projects) $20M Sales
Managed the Monthly Estimations Budget and Forecast, Track Actuals vs Forecast. Cost Study Analysis. Controls Billing Function in Alignment with Effort/Work Progress and State & Federal Project Execution.
Oversaw and managed the Accounts Payable, Accounts Receivable, Fixed Assets, Payroll, Tax - Federal & State Quarterly filing and deposits.
Directed and prepared monthly management reviews and adhere to company reporting packages.
Partnered with lenders, external auditors, tax advisors, and various taxation or financial regulatory bodies.
TESCO HSC, Bangalore, India 2011 – 2013
Manager - Projects
Transitioned all IT Finance & Reporting activities from Central Europe to India
Provided consulting, Due Diligence, managed services Change Management Feasibility Study of 5 countries (Hungary, Poland, Czech Republic, Slovak and Turkey) with a team size of 24 team leads & 78 Team Members on all systems, tools, and applications related to Finance & Procurement domain.
Delivered Monthly Governance with 5 countries Vice President on health of the process showcasing achievements, benefits, concerns and Do Next. (ABCD).
ADDITIONAL EXPERIENCE
IBM INDIA LTD, Bangalore, India
Client Supported: Intuit Inc, San Diego CA Williams Energy, Tulsa, OK PepsiCo, India
Deputy Manager, Transitions/Projects
WIPRO LTD, Chennai, India
Client Supported: Agilent technologies - Singapore.
Team Lead – Transitions/Operations
GENERAL ELECTRIC, Bangalore, India
Client Supported: GE Power Controls, GE Healthcare, GE Advanced Materials
Process Developer, FPA Team
TECHNICAL PROFICIENCIES
MS Office Rational Product Suite JIRA Business Objects Rally Agile Central SAP Oracle Visio. Clarity
EDUCATION
Master of Business Administration, MBA, Symbiosis Institute of Business Management, Pune, India
Bachelors in finance, Bangalore University, Bangalore, India
CERTIFICATIONS
Lean Six Sigma GREEN BELT Certified, Certified Scrum Master (CSM)
Safe Agile Product Owner Product Manager (PMPO) Safe Agilist
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