Experienced Leader with excellent client and project management skills. Action-oriented with strong ability to communicate effectively with technology, executive, and business audiences.
Proficiency in Microsoft Office Suite, MS Project Working knowledge of Access Knowledge of Micro Case 4.1, SPSS
Reports generation and analysis
Financial records and processing
Training and development
Project Leader05/2014 to CurrentIndependence Blue CrossPhiladelphia, PA
Manage multiple enterprise projects related to business transformation, and system implementation.
Lead various cross functional teams to work collaboratively in achieving project milestones.
Conduct regular internal team meetings for status updates, reporting and issues/risk management.
Conduct training and mentorship to other staff members on a daily, weekly and monthly basis.
Work closely with training staff to ensure all desk level procedures and documentation is updated and well maintained.
Responsible for gathering and understanding business requirements for internal and external projects.
Facilitate weekly project status meetings, in working with the technical team for system enhancements.
Develop and maintain project plans/timelines for direct and indirect business initiatives using specific project management tools, techniques and methodologies.
Coordinate working sessions with internal and cross-functional teams for release planning, testing strategy, and implementation.
Manage assigned tasks throughout project life cycle, including phases of planning, control, and execution.
Mitigate issues, assist with solutions, process improvement, and change management.
Support production releases, conduct business checkout as needed.
Responsible for the development and improve communication techniques, and leading effective work group sessions.
Proven track record for successful project completion and with time sensitive deadlines.
Provide leadership, direction and motivation to all team members while working in a fast-paced environment with time sensitive initiatives.
Maintain exceptional, professional relationships with all team members and business partners.
Manage vendor relationships and financial budgeting, resource planning and allocation.
Sr. QA Manager06/2013 to 05/2014Horizon Blue Cross Blue Shield of NJNewark, NJ
Implemented a new Quality measure under the umbrella of the 5-year project/product life cycle.
Created new user friendly training curriculum, desk level procedures, and tracking matrix for reporting and data analysis.
Led coaching and training sessions on benefit inventory models, application and structure.
Documented a detailed written process for Quality audit on benefit inventories.
Worked on barriers and process improvements for newly designed Quality audit matrix.
Mentored other team members to adapt to change processes by utilizing the benefit application, increase product, and market knowledge.
Facilitate meetings with internal customers and teams to ensure progress, and discuss status of the new process.
Strategized new concepts, formulate innovation by thinking outside the box, and conducting gap analysis, trending reports, and performing needs analysis.
Sr. Product Manager08/2010 to 06/2013Horizon Blue Cross Blue Shield of New JerseyNewark, NJ
Analyzed Health and Prescription Rx benefit data and structure within standard and non- standard business benefit coding working with all markets, small, midsize, and large, all products such as HMO, EPO, Medicare, PPO, Direct Access, Medicare, POS, Advantage EPO.
Implemented and design new Product/platform launch strategies, components, work flows and metrics.
Modeled benefit arrangement structures to meet the requirements of all State and Federal mandates.
Worked closely with other internal customers to gather necessary Health Care Reform and mandates to monitor compliance and regulatory changes.
Attended daily meetings, and web conferences with external vendors to assure quality and data integrity.
Managed the overall product portfolio and use of the customer community surveys and market research.
Ensured accuracy of data positioning within the Central Product Library and monitor defects within application.
Coached and Train all user community as a subject matter expert for integration and migration of benefit data analysis.
Provided demos to upper management and to Horizon business employees using CPL as the single source of truth for benefit information.
Coordinated workgroups and meetings to discuss potential risks and impact analysis for a specific product, design or project.
Offered support to Magellan Behavioral Health vendor to ensure adequate benefit administration and use of CPL.
Created and maintain benefit inventories to use as a base for data loading and error report management.
Changed base model as needed contingent upon results from remark analysis, error reports and tracking healthcare regulations.
Worked closely with cross-functional teams and other areas such as Underwriting, Coding, Sales, Contracts and Shared Services in regards to Profit and Loss margins.
Senior Trainer01/2008 to 07/2010Horizon Blue Cross Blue Shield of NJNewark, NJ
Lead trainer for claims business areas using Nasco, CMS claims experience.
Head trainer for benefit coding, claims processing, and billing.
Responsible for training delivery at enterprise sites and at remote vendor locations.
Collaborated with other Service Training & Development areas such as Instructional Design, Knowledge Management & Operations.
Assessed training Needs of clients to ensure compliance with Service Level Agreements ensuring productivity and quality goals are met.
Trained and assist in the design of material, become a subject matter expert for the following application such as CPL, Nasco EFDE, Problem Resolution Workshops and the Core Curriculum- Benefits, Claim Systems, Products.
Assisted other Directors with Mission Critical Projects such as Product Data Load, EEI4, and launching CPL.
Worked on Horizon University, compiling data reports for Director level training.
Conducted Web ex sessions for vendors and internal staff.
Attended meeting/conferences related to business initiave.
Participated in trainer certification for our vendor partners to conduct offsite training.
Implemented Compliance and Regulatory forums and training with directives based on the national board and MTM, Blue Experience Metrics.
Education and Training
Master of Arts: Social Work2002Rutgers University
Certification of Appreciation - Horizon BCBS of NJ for meeting deadlines and Customer Satisfaction -July 2013
PMI Certification- PMP in progress
Activities and Honors
Member, BCBS Association
Certificate of Successful Project Completion - Deadline driven
Customer Satisfaction Survey Master
Member Project Management Institute
Bilingual in English, Hindi, Working knowledge of Spanish
Management, Health, Benefits, billing, budgeting, change management, CMS, coaching, conferences, Contracts, clients, Customer Satisfaction, data analysis, Detail Oriented, direction, documentation, English, fast, financial, functional, Hindi, innovation, Instructional Design, inventory, Knowledge Management, leadership, Director, market research, market, meetings, Access, Microsoft Suite, MS Project, migration, needs analysis, enterprise, POS, positioning, Problem Resolution, processes, process improvement, Profit and Loss, Coding, progress, project management, project plans, Quality, reporting, risk management, Sales, Self -Starter, Service Level Agreements, Spanish, SPSS, strategy, surveys, Team Player, trainer, training delivery, Underwriting, Workshops, Healthcare Reform: People skills: great bedside manner, enthusiastic people person, advanced problem-solving, great organizational skills