Project Manager Senior

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Ms. Helen Burford

**** ******* ***** *** ** ● San Ramon, CA 94583 ● 925-***-**** ● **************@*****.*** Senior Project Manager

SELECTED ACHIEVEMENTS & HEALTHCARE PROJECT MANAGEMENT

• Results-oriented Operational and Technical Project Manager with 13+ years of experience managing diverse technology initiatives within the healthcare domain, specializing in strategic planning, system implementations, and optimization.

• Successfully managed vendor partnerships and project delivery for diverse healthcare technology solutions, such as Epic EHR, QNXT Claims/Eligibility platforms, and Cognizant/TriZetto/McKesson engagements, alongside leading MS Azure Cloud migration planning initiatives.

• Deep understanding of healthcare data standards (HL7, EDI X12, FHIR) and interoperability, ensuring secure and efficient data exchange and system integration to meet critical organizational and regulatory requirements, contributing to successful project outcomes. PROFESSIONAL WORK EXPERIENCE

Wipro - Domain & Consulting - United Health Group/Optum Health ● February 2024 to October 2024 Senior IT Project Manager

• Sr. Project Manager with UHG Optum, overseeing the implementation of Curo Care Management and Utilization Management during Optum's Mountain Region West market strategic expansion, integrating select Epic CM and Prior Auth workflows.

• Collaborated with Product Owners and developers to align on user stories and features, managed dependencies, and provided oversight of respective sprints.

• Generated reports to communicate program status, proactively addressed risks and issues during team meetings, and ensured transparency and timely escalation for effective mitigation.

• Provided critical Epic expertise with prelim sales proposals for prospective Wipro global healthcare clients, rapidly upskilling on their specific needs based on limited information to inform compelling business and partnership proposals developed in collaboration with technical and vendor teams. San Mateo County Health, County of San Mateo ● May 2024 to Aug 2024 Healthcare IT Project Manager

• Led the conversion of the San Mateo MMIS Materials Managment and Inventory System replacement wo a SaaS-based Finance & Supply Chain Management application.

• Re-established a clear and achievable project baseline for the MMIS implementation by conducting a thorough reassessment of scope, artifacts, and timelines, incorporating resource dependencies and regulatory mandates.

• Maintained transparent project communication with leadership and sponsors by proactively tracking and reporting risks, issues, and overall status, facilitating informed decision-making. Page 2

Hill Physicians Medical Group - PriMed Management ● June 2009 to March 2023 (14 yrs) IT Healthcare Project Manager II, Enterprise PMO

• Led end-to-end implementation of 100+ Epic EHR systems within an IPA Medical Group, specifically incorporating Healthy Planet and Happy Together to enhance population health management, care coordination, patient outcomes, and overall ecosystem interoperability.

• Managed five major Epic EHR Upgrades (2019-2021), using extensive knowledge of Epic Upgrade resources

(Nova Notes, Sherlock, Orion, Galaxy) and overseeing build, configuration, and testing, communication and cutover, production go live, post go live support.

• Co-led the formation of an enterprise PMO within IT, developing core policies, procedures, best practices, templates, and a project intake form/workflow using SharePoint v2019, demonstrating strategic alignment and project initiation expertise.

• Managed project budgets exceeding $25 Million, consistently controlling scope and quality while proactively identifying, mitigating, and resolving critical risks and issues. Ensured strict adherence to healthcare data privacy standards (EDI X12, APIs, FHIR, HL7) and facilitated seamless data sharing and integration with downstream systems, hospitals, and labs,

Project Supervisor ● QNXT Claims and Eligibility System Replacement Project

• Supervised the Trizetto QNXT Claims & Eligibility replacement lifecycle, managing scope, schedule, and budget for Project Managers while ensuring accurate QNXT configuration (benefits, contracts, payment cycles, DOFR) based on CMS codes for precise claim payments.

• Provided key Project Lead support during QNXT testing, using SharePoint Admin UI to track progress and proactively communicating issue triage/remediation status to stakeholders and C-level executives, ensuring on-time go-live.

• Leveraged in-depth QNXT knowledge to oversee CMS code integration and configuration of benefits, contracts, payment cycles, and DOFR for accurate claims. Managed stakeholder communication and schedule during testing, directly supporting successful go-live readiness. Administrative Assistant, Claims Operations and Enrollment Department

• Supported the director of Claims Operations and a team of 50+ by managing daily procedures for medical claims, grievances, appeals, and HealthPlan enrollment departments.

• Coordinated interviews and pre-employment reference checks, streamlining the onboarding process.

• Maintained Key Indicator Reports (KIR) for Claims, Membership, and Enrollment (daily, monthly, quarterly) and provided critical support to managers during 12 major health plan/compliance and regulatory audits. EDUCATION and CERTIFICATION

• B.S. Business Administration – Finance, California State University SJSU, San Jose, CA, January co2001

• Project Management Professional, PMP, Project Management Institute PMI, January 2018 TECHNICAL SKILLS

• Project Management Tools: SharePoint, MS Project, Smartsheet, Azure DevOps, TFS (Team Foundation Server) ServiceNow for ITIL.

• Business Efficiency Tools: Microsoft 365 Suite: Word, Excel, PowerPoint, Outlook, Teams, SharePoint, OneDrive, Access, Publisher, Project, Visio; Tableau, Skype, Zoom

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