Product Owner Scrum Master
Resume:
Sreeram Vedururi
*******.********@*****.***
PROFESSIONAL CAREER
An Experienced, Project Management Essentials Certified, SAFe® Agilist (SA), Certified Scrum Product Owner® (CSPO), Certified Scrum Master® (CSM), PAHM®/AHIP® & BCS® ISEB Certified Product Owner/Business Analyst with 18+ years of IT working experience in a string of roles such as Program Product Manager, Product Owner, Scrum Master, Lead/Sr Business Systems Analyst, Change/Defect Manager.
Hands on Experience in Hospital Management & US Health Care domain/Modules such as Health Insurance Operations, Payer, Membership, Administrative Billing - Member eligibility, Provider Management, Provider Medical Claims, Healthcare Products (Plans & Benefits Associated) & Sales, Clinical modules such as- Utilization Management & Care Management and exposure on Clinical Trials (CRO) Pharma.
Expertise in Analyzing the Business-Member Data (Eligibility & EHR/EMR Data)/Provider Data abiding HIPAA compliance & US Federal & State Governance.
Proficient in performing data analysis, querying databases, and utilizing SQL query tools.
Have a good working Knowledge of both Federal and state, U.S Government Sponsored Health coverages/LOB’s such as Medicare and Medicaid- SNP Plans such as FIDE, HIDE, ISNP, CSNP.
Knowledge and Experience on Membership, Billing, Claims Payment Processing in line with HIPAA Act, 4010/5010 ANSI X12, ICD-9 ICD-10, CPT, and EDI codes such as 834, 837i/837p,835,278 and 270, 271 and HL7 Version 2.5.1 Messaging Standards.
Good Understanding and Knowledge on Healthcare’s Performance Improvement tool such as HEDIS (Healthcare Effectiveness Data and information set.
Demonstrated a Brilliant track record of successful ability to manage large and complex consulting engagements, including a role of Business Systems Analyst, Product Owner, Program Product Manager, Scrum Master, Defect/Change Manager, and interfacing/Liaising with senior level Client executives/Business Stakeholders.
Expert in Understanding and Interpreting the Business requirements and customizing/Configuring the existing workflows/Applications or Develop new workflows/Applications by Conducting/Facilitating brainstorming sessions and interviews to elicit requirements from various stakeholders and reduce ambiguity associated with the complex requirements. Have excellent problem solving and analytical thinking skills to design customized solutions and perform gap analysis and possess skills of a LION.
Expertise in creating & maintaining various documents such as Business requirements document (BRD) and Functional Requirement Document (FRD) & Requirement Traceability Matrix (RTM).
Expertise in resolving complex business requirements and creating UML diagrams such as use case diagrams, activity diagrams to communicate the Business requirements using leading industry tools like MS word, MS Excel, and MS Visio, Balsamiq to develop various project deliverables.
Experience with various business process operations, Data Migration, Cleansing, Integration in line with C.R.U.D and change management projects.
Solid Knowledge of XML & SAS.
Hands on experience in performing Mainframe Testing.
Expert in mapping business requirements & design customized solutions with strong analytical skills and ability to analyze business practices and define optimal procedures.
Expert in performing the QA/STLC (Software testing life cycle) and UAT.
Well versed with Use Case & Test Cases, creating a Test scenario, executing the Test cases, capturing the Test results, and maintaining the RTM and Own and perform the Overall End to End system Integration testing.
Expertise in managing client’s expectations through efficient offshore – onsite client co-ordination.
In depth knowledge of various phases and methodologies of software development including SDLC such as Waterfall & Agile.
Expertise
Systems Administration
Strategic Technology Planning
Data, Business & Systems Analysis
Data Flow & Process Mapping
Database Design & Management
Major Software/Systems Implementations
Systems Security & Disaster Recovery Planning
Testing/Scripting/Documentation
Technical Writing (Functional/System Specs)
SQL Queries & Data Modelling
PROFESSIONAL EXPERIENCE
Skillgigs Inc.
Product Owner
Client/ Project: Elevance Health – Hartford, CT
Feb 2023 – Till Date
Role Description
As a Product Owner, I am a part of Anthem Care management Platform (ACMP). We predominantly work on the workflows within the clinical space to support the Approval/Denial Letters for the Prior/Pre-Authorization submitted by the providers for the cases created within the Utilization Management for both Medicare & Medicaid LOB’s which includes the FIDE, HIDE Plans around the LTSS benefits.
Responsibilities:
As a Product Owner, I fulfil the development team’s need for product direction and a core component is understanding the detail of the regulations.
I have been a part of both Development and Configuration teams which included both SIT and E2E QA resources.
Supported the Non-Standard UM Letters implementation that got migration from the Care management platform to Utilization Management platform based on the recent CMS regulations that took place.
Responsible for development and implementation of new ideas that supports work and team.
Key responsibilities of my role include driving IT prioritization, assisting with program increment planning, implementing product vision and development with a clear focus on regulatory, customer and end-user needs as well working collaboratively with IT, Architecture, Legal and the Program Management Office to deliver technology to comply with the regulations.
Managed the backlog and document stories, objectives, and features.
Identified the gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad view of the organization.
Collaborated with upstream and downstream application/workflow IT Teams as a part of the Program Increment planning and communicate the interdependencies that are identified and plan for the upcoming releases accordingly.
Assisted others to identify solutions to issues that negatively impact program and/or project plan.
Influenced the change to improve performance results, organization effectiveness and/or systems/quality/services.
Facilitated Brainstorming sessions with the cross functional teams.
Coordinated with Program UAT Lead to complete testing.
Skills:
Agile, QA, SAFe, JIRA, MS Word, MS Excel, ServiceNow, Confluence.
Skillgigs Inc.
Program Product Manager/Technical Product Owner
Client/ Project: Aetna – Hartford, CT
April 2021 – January 2023
Role Description
As an Interoperability Technical Product Owner (Program Product Manager), I am a part of the Interoperability and Transparency Program Management Office (PMO) working on Interoperability regulations that are implemented in a multi-year program. I have led the implementation of Provider Directory, Formulary functionality and capabilities (API’s) in support of Interoperability rules and technical standards as per the DaVinci CARIN PDex FHIR Implementation Guide to be at par with the HL7 standards and at present I also have supported these modules within their maintenance phase and am supporting the P2P Access Authorization module.
I also handled the Duals Migration of FIDE, HIDE EAE, I-SNP, C-SNP Plans under Medicare Platform.
Responsibilities:
As a Product Owner, I fulfil the development team’s need for product direction and a core component is understanding the detail of the regulations.
Responsible for development and implementation of new ideas that supports work and team.
Critical components of my role include driving IT prioritization, assisting with program increment planning, implementing product vision and development with a clear focus on regulatory, customer and end-user needs as well working collaboratively with IT, Architecture, Legal and the Program Management Office to deliver technology to comply with the regulations.
Managed the backlog and document stories, objectives, and features.
Identified the gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad view of the organization.
Collaborated with IT and Architects on Program Increment planning and partners with other functional managers, business areas across/within segments or other business areas to ensure all workflow processes and interdependencies are identified and addressed.
Assisted others to identify solutions to issues that negatively impact program and/or project plan.
Influenced the change to improve performance results, organization effectiveness and/or systems/quality/services.
Facilitated Brainstorming sessions with the cross functional teams.
Coordinated with Program UAT Lead to complete testing.
Skills:
Agile, QA, Data mapping, SAFe, RTC, MS Word, MS Excel, ServiceNow, Confluence.
Skillgigs Inc.
Product Owner
Client/ Project: CareSource – Dayton, OH
Jan 2020 – April 2021
Role Description
As a Product Owner, I am a part of Enterprise data warehouse (EDW) project. As a part of it, I Predominantly work on the database, or collection of databases, that centralize a business's information from multiple sources and applications and makes it available for analytics and use across the organization.
Responsibilities:
As a Product Owner. I work closely with business owners to design solutions and define requirements for enhancements and new features development.
Support and assist the business users on the new features and enhancements. Resolve the reported issues and fix the bugs. Also provide training to the users as and when required.
Analyse the requirements and document the functional and technical specifications.
Work with the design team to deliver scalable and efficient solutions for new features and enhancements.
Work with the Agile teams to validate the new enhancements and features.
Review the test scripts prepared by the QA team and test the bug fixes, new solutions/enhancements.
Work with the team to organize and manage UAT and production deployments during quarterly sprints.
Support production org help production support team debug the support tickets, analyse, and fix the issues and support the Business users.
Participate in monthly and quarterly releases to ensure successful production deployments.
Evaluate new apps, lightening features, and leverage these to enhance the existing functionalities and suggest new functionalities. Direct the business analysts in executing and delivering various tactical and strategic plans.
Inspect & Adapt to the performance of the application from various dimensions.
Skills:
Agile, QA, MS SQL Server, Scrum, TFS, MS Word, MS Excel, ServiceNow.
Accenture Solutions Pvt Ltd
Business & Integration Arch Team Lead/Product Owner
Feb 2019 - Dec 2019
Client/ Project: Assurecare/ Medcompass: State of Montana & CVS Health- Aetna- Houston, TX
Role Description
I am into the MedCompass / Assurecare module. It is the technology that facilitates proactive Medical Care Management software and Utilization Management software with the State of Montana & CVS Health-Aetna by using a fully integrated database of member and provider information—coordinating all interactions using collaborative workflow management and business rules automation. MedCompass supports real-time communication and coordination of care among all members of the care team, inside and outside the four walls of traditional healthcare settings.
Responsibilities:
Used team foundation server (TFS) feature level requirements to create relevant user stories and develop acceptance criteria/Definition of Done, for product backlog items (PBI).
Identified and analyzed cross functional requirements for cross agency system and data integration.
Facilitated efforts for cross team synchronization in preparation for the data migration process.
Shared complicated technical terms and concepts to varied audiences with different levels of techno-functional knowledge.
Worked on EDI Transaction 278-Health Care Services Review Information and possessed in depth working knowledge on:
Advance notification – for scheduled inpatient, specialty care or other services Completion notification – for patient arrival to or discharge from a facility
Information copy – for any health services review information sent to service providers.
Change notification – for reporting changes to previously sent information.
Liaised with key stakeholders and system integration partners.
Used and Implemented the HEDIS (Healthcare Effectiveness Data and Information Set) to measure Effectiveness, Availability, Accessibility, Experience of the Care as a part of CM and Utilization and Risk Adjusted Utilization and progressive Measures within UM, which is reported to and maintained by the NCQA (National Committee of Quality Assurance).
Built relationships with key stakeholders within Procut & the Client Teams, that represents the team's interests, coordinate, and drive impacts across teams to achieve objectives.
Identified the data migration impact of all proposed changes.
Owned the quality of the migrated data and the validity of the migration processes and operations.
Managed end-to-end complex data migration, conversion, and data mapping.
Overseen and ensured delivery of all aspects of data analysis, mapping, and transfer.
Supported and performed User Acceptance Test activities for data conversion, cleansing and integration solutions.
Demonstrated sensitivity to perspectives or feedback received from stakeholders as part of process improvement considerations to obtain support to achieve benefits for improvement and/or change.
Lead root cause analysis discussions & actively participate in change impact discussions, KPI measures and metrics improvements.
Performed tasks such as project administration, coordinating meetings, communication releases, consolidated project status reporting and maintenance of tracking logs such as issues, risks, and change requests.
Demonstrated track record of defining systems that lead to increased efficiency and productivity using technology.
Skills:
MedCompass, TFS, UAT, SQL, Data Migration, Data Mapping, Data Cleansing, .NET, HTML, Configuration, RDBMS, SharePoint.
Accenture Solutions PVT LTD
Business& Integration Arch Sr Analyst/Change/Defect Manager
Apr 2017 - Jan 2019
Client/Project: Anthem – Mason, OH
Role Description
I am into the Enterprise Product Document Generator Module and as a part of it I have supported EPDG application along with SOB, SBC, EOC, BCC Documents for all Enterprise States and all the Market segments of it including all plan types within Anthem.
Responsibilities:
Created and documented full SDLC lifecycle artifacts-based project applied methodology: Agile (scrum) - product backlog, sprint backlog, epic, user stories and acceptance criteria.
Experienced and Executed the Commercial Health plans Benefit and Cost share mapping across different States and market segments, abiding the CDC and HHS Governance.
Mentored teams and streamlined the Elicitation Techniques through evolution of delivery cycles, establishing documentation framework to support agile methodology implementations.
Accomplished Good Understanding and Knowledge on the End-to-End Workflows of US Healthcare PSS Module/ systems.
Used and Implemented HEDIS (Healthcare Effectiveness Data and Information Set) as a part of measuring the quality of Health Plans.
Liaised with key stakeholders and system integration partners.
Facilitated the Product backlog refinement meeting and got the teams to estimate the Work based Effort for the user stories in their respective product backlogs in JIRA.
Mapped current business and operational processes and offered recommendations for improvement.
Managed team performance by implementing measurable metrics to track delivery of supporting requirement artefacts.
Assisted development team to translate the User Stories into technical responses.
Walked the Product owners through with the Sprint Demo and got a sign off on the Business Checkout Document for all the CR’s and helped the scrum master to close the sprint.
Created and Maintained the Business checkout document for all the CR’s that are planned for the monthly release and Facilitated the UAT on the release day and get a final sign off for all the changes that went live.
Conditioned the performance of the application from various dimensions.
Worked closely with Key business leaders/Stakeholders to understand change management implications across multiple business units within OCM and Managed the cycle.
Collaborated with project team members to ensure alignment with key cross functional project activities.
Designed, developed, and implemented a stakeholder management strategy to drive engagement, awareness, and preparedness of/for the project.
Designed, developed, and implemented a multi-level, two-way communication strategy. Partnered with UA Corporate Communications to validate and execute the OCM plan.
Skills:
Scrum ban, JIRA, Agile, SDLC, UAT, Rational Team Concert, XML, SoapUI, ServiceNow, JSON, SQL, RDBMS, JAVA.
Accenture Solutions Pvt Ltd
Business& Integration Arch Sr Analyst/Scrum Master
Oct 2015 - Mar 2017
Client/Project: Highmark- Pittsburgh, PA
Role Description
I was into the Maintenance and Support Project and as a part of it I supported all the applications of the US Health Care Payer/Provider operations Domain.
Responsibilities:
Gathered Requirements and documented the proposed Solution for all the defects and Enhancements for the applications as per the CAQH Regulation, that I Supported.
Facilitated Brainstorming sessions with the stakeholders to make sure everyone is in sync with the business requirement processes.
Experienced in ANSI X12 EDI as per the HIPAA Compliance specially to do with Provider,837i- Institutional & 837p- Professional claims Data.
Gained in depth knowledge in the Healthcare Providers Claims Processing stages such as:
Claims Adjudication
Explanation of Benefits (EOBs)
Claims Settlement
Executed analysis of risks and identified risk mitigation strategies.
Streamlined Scrum ban technique to support Agile methodology implementations.
Interacted with customers/External Stakeholders to understand business needs and translate them into Business requirements and identified/defined the project scope.
Supported leadership team with reporting, analysis, and business presentations to inform divisional strategies.
Managed team performance by implementing measurable metrics to track delivery of supporting requirement artefacts.
Accomplished experience through whole SDLC from requirement analysis.
Assisted development team to translate requirements into technical specifications.
Performed the testing on the RWD to do with provider on the Mainframe Application.
Walked the clients through with the proposed solution and got a sign off on the proposed solution.
Created and Maintained the Test plan documents and performed Testing on the solution.
Conducted User Acceptance Testing (UAT) sessions with business users and prepared documents for enhancements.
Mapped current business and operational processes and offered recommendations for improvement.
Conditioned the performance of the application from various dimensions.
Skills:
SDLC, UAT, Scrum, Test Plans, BRD, FRD, mainframe, HP Service Manager, Clear Quest. Rational RequisitePro, Java, Mainframe, ServiceNow.
Cybermate Infotek LTD
Principal Business Analyst
Jan 2014 - Oct 2015
Client/Project: Anthem- Mason, OH
Role Description
I am into ABCC Module which deals in creation of the members, generating the invoices, adjusting the members, making payments and credit control activities like lapsing the members, generating the dunning reports, and executing the dunning cycles.
Responsibilities:
Gathered Requirements and documented the proposed additional extension to the existing HIPAA application.
In Depth understanding and Hands on Knowledge on Member Eligibility and Handling the Data of Eligibility, Coverage or Benefit Inquiry Transaction Set (270) & Eligibility, Coverage or Benefit Inquiry Information Set (271).
Facilitated Joint Application Development (JAD) sessions with the Management and HIPAA team to make sure everyone is in sync with the business requirement processes.
Used Balsamiq to create wireframes for detailed understanding.
Excellent leadership, communication (written and oral) and interpersonal skills
Proven ability to work creatively and analytically in a problem-solving environment.
Proven success in contributing to a team-oriented environment.
Hybrid Agile software development methodology
Accomplished experience with Web-based software applications
Demonstrated project management skills.
Created and Maintained the Requirement Traceability Matrix (RTM).
Worked on modules such as payer, eligibility under claims processing system.
Conducted User Acceptance Testing (UAT) sessions with business users and prepared Business checkout Document.
Created the ‘Business Glossary’ to facilitate efficient understanding of the Business process amongst the other teams.
Skills:
MS Word, MS Excel, JAD session facilitation, HIPPA, RTM, SDLC, UAT, Business Requirements, Bugzilla.
Cybermate Infotek LTD
Sr Business Analyst
Mar 2009 - Dec 2013
Client/Project: APSRTC- Hyderabad, India
Role Description
Responsible for working on Online Hospital Management service is focused on to provide swift treatment to the current and retired employees and their families of the ASPRTC .OHMS helps different departments to manage their data and Communication between the employees to provide the best services to patients .Application has different modules Front Office Module, Medical Officer’s module, pharmacy module, Lab module and Financial modules they integrate and communicates with all the modules and gives consolidated data reports.
Responsibilities:
Gathered Requirements and documented the proposed solution using elicitation techniques.
Facilitated Joint Application Development (JAD) sessions with the Management, Mainframe
Used MS Visio to create Use Cases and used Balsamiq and created mockups and understanding document for client’s understanding.
Accomplished experience through whole SDLC from requirement analysis till deployment.
Assisted development team to translate requirements into technical specifications.
Analyzed mandatory and the situational fields and compared with the user manuals.
Created and Maintained the Requirement Traceability Matrix (RTM).
Created Test Plans, developed and executed test cases and scenarios, worked with users to develop specific acceptance criteria, and prepared test exhibits.
Conducted User Acceptance Testing (UAT) sessions with business users and prepared documents for enhancements.
Conditioned the performance of the application from various dimensions.
Helped create the ‘Business Glossary’ to facilitate efficient understanding of the Business process amongst the other teams.
Skills:
JAD, SDLC, UAT, RTM, Testing strategy / Test plan, Bugzilla, MS Word, MS Excel.
Supple Consulting LTD
Business Analyst
Mar 2007 - Feb 2009
Client/Project: Cardiff University- Cardiff, UK
Role Description
Responsible for Student Publication, which is an online education system, where the students who are registered can either read the notes of their desire by using the search engine or can publish their notes, so that their notes are useful to the other students. Students who are not registered also can use the notes of their desired but can only post notes when they are registered. Registration has two sections. Fully registered, who uses his university email id, and General users, who use other email id for the access.
Responsibilities:
Gathered Requirements and documented the proposed solution using elicitation techniques.
Used MS Visio to create Use Cases and used Balsamiq and created mockups and understanding document for client’s understanding.
Assisted development team to translate requirements into technical specifications.
Responsible for sending Daily & Weekly Status Reports to Project Manager.
Created the Test Cases, execute them and maintain, capture the test results.
Skills:
MS VISIO, Elicitation and Facilitation, Balsamiq Mockups, Status Reporting, QA, MS Excel, MS Word, JAVA.
EDUCATION
International Management & International Marketing, MBA, University of Wales Institute Cardiff (UK), 2007
Bachelor of Commerce (BCom Computers), Bachelor, Madurai Kamaraj University (IND), 2003
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