AHMAD MOHIUDDIN

• Collaborate with the Product Management team and BCBS entities to drive enhancements for NASCO-owned applications, enhancing system functionality and delivering value-driven solutions that align with business objectives and customer needs
• Spearheaded product roadmaps and backlogs, driving cross-functional teams to define requirements, boosting team performance by 25%, and achieving timely, cost-efficient project completion
• Aligned IT solutions with business objectives by collaborating with stakeholders, streamlining claims processing through accurate updates of provider information and credentials
• Enhanced system performance and capacity by leveraging diagrams to refine business requirements and executing comprehensive test cases
• Optimized project deliverables by conducting thorough quality reviews, ensuring compliance, and reducing errors by 15%

• Led the resolution of issues within prior Cerner EMR system and facilitated the transition to HomeCare HomeBase EMR system for Hospice and Palliative Care, significantly increasing system reliability and operational efficiency
• Designed and implemented application solution integrations across Provider (Clinical Operations), Finance, HR, and Operations teams, enhancing cross-functional workflows and increasing data accessibility by 25%
• Revamped provider-patient documentation and scheduling applications by leveraging FHIR standards and ensuring interoperability, boosting documentation quality by 30% and streamlining operations
• Directed integration of new EMR system, seamlessly retiring legacy system with minimal downtime and automating HR processes, reducing manual effort by 30%
• Collaborated with cross-functional teams to analyze claims data and develop PowerBI dashboards, enhancing cost management, patient outcomes, and decision-making efficiency by 20%
• Orchestrated implementation of SAFe Agile Framework, leading sprint planning, product roadmaps, and UAT, increasing team productivity by 20% and resolving project concerns effectively
• Developed UAT test plans, led UAT for multiple projects, and proactively mitigated project-related issues, ensuring successful delivery for the Application Development Team

• Led the Group Portfolio team, focusing on enhancements to the IL HMO ASO Product Concept, driving strategic changes during the Planning and Analysis phases over multiple years
• Diagnosed pain points and designed solutions through customer discussions, developing process flow diagrams, mock-ups, UI design and wireframes to enhance stakeholder clarity and align current vs
• Future states
• Collaborated with cross-functional teams to create go-to-market strategies, analyze claims data, design training materials, driving results for large group employer plans and equipping teams with impactful tools
• Streamlined workflows by facilitating Agile adoption and transitioning teams from Waterfall methodology, optimizing processes by 25% and documenting Epics, User Stories, and test cases to enhance development and UAT
• Improved team productivity by 20% through effective backlog management, sprint planning, and the creation of comprehensive post-implementation training guides
• Designed product training materials and sales collateral, empowering teams to position and sell products effectively

• Served as the primary liaison between the Claims Quality Assurance (QA) team and Business Divisions, ensuring alignment and clear communication, which reduced testing cycle delays by 20%
• Provided actionable feedback on testing strategies and activities, expanding test coverage and accuracy by 15% and improving claims processing reliability
• Collaborated with cross-functional teams to streamline QA processes and boost productivity

• Successfully managed five projects within the Encompass team, including state contract updates for GA, CT, and NY, enhancements to policy and billing PDFs, and the automation of property inspection ordering
• Led project kick-offs and monitored progress through all phases of the software development life cycle, ensuring efficient resource allocation, achieving 95% on-time delivery, and enhancing operational effectiveness
• Coordinated the development and execution of project plans, defining scope, timelines, budgets, and staffing models to manage high-impact projects within budget constraints
• Engaged with stakeholders across business, financial, and technical teams to ensure alignment and seamless communication, driving a 20% increase in stakeholder satisfaction
• Reduced project-related issues by 15% through efficient resource management, budget control, and proactive risk mitigation strategies
• Cultivated strong partnerships with business units and vendors, utilizing technical and business expertise to deliver impactful solutions aligned with organizational goals

• Managed the timely integration of medical, lab, and pharmacy claims data into enterprise databases, ensuring the seamless execution of monthly HEDIS Data Refreshes
• Led the development of critical SSRS reports, including Provider Incentives and Missing Services Reports, as well as the Member Services Letter, improving reporting accuracy and operational proficiency
• Served as the Subject Matter Expert for all enterprise-wide data sources, increasing data integrity and fostering better collaboration across departments
• Established partnerships with lab and pharmaceutical vendors, enhancing member claims data integrity by 20% and ensuring seamless HEDIS data refreshes through efficient data management and dashboard updates
• Facilitated business meetings, conducted root cause analysis, and implemented solutions that reduced operational delays by 15% and improved process efficiency
• Extracted performance insights by analyzing claims data, ensuring compliance with ICD-10, CPT, and SNOMED standards while improving operational efficacy and reporting accuracy
• Translated business requirements into technical specifications, led integration testing and UAT, and leveraged SQL for data analysis and validation, delivering enhanced project outcomes

• Played a pivotal role in two enterprise-wide projects: the Master Data Management project replacing legacy applications for storing physician data, and the Migration of data from the Legacy Warehouse to the Enterprise Data Warehouse streamlining data management and accessibility
• Performed gap data analysis to ensure 100% data integrity during the migration from the legacy data warehouse to the Enterprise Data Warehouse, enhancing data access and reliability
• Directed UAT testing efforts, swiftly addressed user-reported problems, and partnered with developers to deliver timely resolutions
• Crafted comprehensive Data Dictionary documentation and process flow diagrams, enhancing clarity for Business User Groups and reducing query resolution time by 20%
• Implemented an application inventory system linked with product owners, cutting IT Support Center ticket resolution time by 25% and boosting operational efficiency

Served as a Business Analyst Specialist on the Enterprise Testing and Business Analysis Services team, contributing to key projects including ICD-10 Measurements & Analysis, Medical Loss Ratio Rebates, Affordable Care Act, and Montana Overall Dental. Led variance analysis between ICD-9 and ICD-10 on the ICD-10 Measurements & Analysis project, driving critical modifications for a successful deployment

• Led development of streamlined processes to enhance access to Foreign Exchange (FX) products within TS Finance. This initiative enabled enhanced revenue analysis and distribution across regions and business lines, driving operational competence and strategic decision-making

• Formulated platform for various Health and Life Insurance companies (clients of RSA Medical) to use in their underwriting processes. This initiative enhanced the automated underwriting process, improving effectiveness, accuracy, and service quality for clients.