A result oriented Leader with broad experience in Healthcare and Manufacturing with a passion to deliver innovative and high quality solutions to achieve high business value and customer satisfaction.
+ Strong strategic visionary with a broad business perspective to set clear objectives balanced with analytical and technical skills to “drill-down” into details to resolve complex issues
+ Versatile Techno-Functional expertise in business operations management strategy, proven experience managing local, national and international cross-functional teams, driving project schedules and coordinating team activities to achieve short and long term corporate goals
+ Customer-centric with the ability to effectively build stakeholder agreement, initiate and drive synergistic engagements and partnerships across organizational and geographic boundaries
that accomplishes great results with direct reports, matrix teams, partners and vendors
+ Highly experienced in Vendor & SLA Management, Onshore-Offshore Model and Business Process Outsourcing
+ Skilled in all phases of the product life cycle-initial feasibility analysis,conceptual design, implementation, delivery, enhancement and sustainability.
+ Expertise in Solution design, Integration & Application Architecture Design, SOA, ESB, Data Architecture Design, Data Modeling & Analysis, ETL, Master Data Management, ICD-10, HIPAA, SOX.
+ Held senior management positions in several core industry sectors, managed teams with 50+ resources
+ Health care Projects – Healthcare Reform, Medicare & Federal compliance, HIPAA, PHI, Fraud control, Audit, Oregon Transparency Legislature etc.
+ Certified in EPIC Tapestry, AP Claims & Contracts and EPIC Reporting Workbench
+ Senior Leadership roles in Philanthropic Organizations and instrumental in implementing several Outreach projects in Healthcare and common causes
+ Strong believer in giving back to the Community, volunteer time and money on a weekly basis.
Specialties: Healthcare, Program Management/Manufacturing, Design and architecture
Managed a team of 20+ personnel across multiple sites as SME for Xcelys and Diamond Claims systems and interfaces for multiple regions across Kaiser.
•Successfully built the team from scratch and enhanced their domain and technical knowledge through continuous coaching and mentoring to deliver complex product releases.
•Performed root cause analysis and incorporated procedures that resulted in 50% issue reduction in the Claims platform and improved Claims auto adjudication rate to a stunning 95%, added to increasing savings on interest paid and reduction in manual work by business.
•Implemented several infrastructure improvements that have resulted in over 300% improvement in batch job performance and in business user on-line experience.
•SME for the claims platform across multiple regions, worked closely with other enterprise business units such as Common membership, KP Healthconnect, EPIC, Benefits, EDI, Macess and HealthTrans etc.
•Oversight of analysis/ development /implementation of several customized methodologies, efficient, cost effective solutions that supported client business processes, functional requirements and service level agreements.
•Worked closely with system testing and workflow integration testing teams to ensure issues identified are tracked and addressed in a timely manner.
•Oversight of multiple vendors and external groups to implement solutions, maintained excellent customer relationship by holding regular meetings and providing timely response/updates.
•Improved collaboration between teams by focusing on corporate goals and emphasizing on project priorities.
•Proficient with off-shore team management, cross trained several resources on the Claims platform.
•Managed Legacy systems migration, hardware migration, system upgrades, planned releases, Disaster Recovery and IT Governance, SOX remediation solutions for Claims systems.
•Design and development of of wrappers for the financial functioning including the General Ledger module interface for Diamond and Xcelys Claims systems.
•Developed short and long term performance analysis
•Implemented database performance optimization solutions for multiple interfaces.
•Developed process flows to effectively manage the team work.
•Documented functional and system requirements, work flows and system specifications working with IT cross-functional and/or cross divisional teams
• Design & development of wrappers for the Financial functioning including the General Ledger module
• Documented functional and system requirements, work flows and system specifications
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