Kavitha Anantharaman
Buffalo,NY
Summary
HealthCare IT Project /Program Manager with 17 years of experience in managing complex, large-scale projects. Worked with five insurance plans and two provider organizations on technology projects involving Electronic Medical Records (EMRs), Claims, Encounters, Risk adjustment, Provider data, Wellness initiatives, Enrollments, and Market expansion. Worked extensively in both waterfall and agile methodologies. Organized, detail oriented and conscientious self-starter, able to strategize and prioritize effectively to accomplish multiple tasks.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Program Manager
McKesson
10.2022 - Current
- Experience as an Implementation Program Manager with proven record of successful delivery of a scorecard initiative - Experience running Data projects - Hands-on experience managing all stages of the SDLC lifecycle
- Experience with product selection lifecycle - Strong at delivering executive level project presentations
- Experience working with software vendor partners - Comfortable working with multiple teams, in-house and remote; strong team player
- Experience at communicating at all levels (team to executive) - Proven working experience in project management through all facets of project lifecycle - Proven track record to drive results and navigating challenges successfully - Collaborate with the Global Finance, S&P and other technology and business stakeholders to support the Enterprise Supplier Portal Project.
Senior IT Technical Project/Program Manager
Molina Healthcare
07.2020 - 10.2022
- Projects: Marketplace 2021, MyMolina Redesign Responsibilities: Coordinate internal resources and third parties/vendors for the flawless execution of projects, Offshore and Onshore resources with team size of 50-70 Managed an award-winning mega redesign project which led to growth in sales Ensured that multiple challenging complex squads like Member Portal, IVR, Enrollments Inbound and Outbound, Salesforce, Public Website within the Marketplace program are delivered successfully on-time, within scope simultaneously Assist in the definition of project scope and objectives, involving all relevant stakeholders and ensuring technical feasibility Worked on high visibility special projects within aggressive timelines like eight-week implementations Establish and maintain relationships with third parties/vendors to deliver competitive advantage for the client Problem solving skills; collaborated with 25 different cross functional teams to improve process efficiency by 150% through root cause analysis
Senior IT Technical Project Manager
Aspen Dental Management Inc.
07.2019 - 05.2020
- Projects: EPMS (Dental EMR) Backend Data Migration from AS400 to Google cloud-based environment Implementation of cloud storage solution for medical records and images Responsibilities: Facilitate, manage, lead Schedule, track and document minutes and Action Items for daily Entity Relationship Diagram Technical Calls
- Created and maintained Continuous Integration and Continuous Delivery (CI/CD) pipeline using most of the DevOps tools in agile methodology
- Discuss and document Foreign Key issues Data Migration Status Ensure that issues are logged and tracked on SmartSheet (tool for Collaboration and Work Management between Onsite and Offshore teams)
Project Manager
Independent Health
10.2016 - 06.2019
- Projects: HealthRules Upgrades, Cotiviti Prospective Claims Accuracy and Claims Recovery, Data Extract Projects, IRS Reporting, and Wellness Incentives, Medical Only Synchronization, Centivo Provider File Updates Responsibilities: Created project plan to track and monitor progress of the project and deliverables Provided status report updates every week to leadership, using SharePoint Led project kickoff meeting, to communicate project goals and objectives to stakeholders
- Documented and monitoring project risk using the RAID template
- Used Blueprint as a software, to document requirements
- Documented Requirements Specifications Document in an agile environment and used in built template
Senior Project Manager
Carefirst Blue Cross Blue Shield
10.2015 - 09.2016
- Projects: Student Health Plans: The Project entailed introducing two new student health plans, and implementing the portal to enable users to enroll, compare plans in a HIX environment and pay for the plan
- The students will also have a chat functionality to request live help when needed
- Responsibilities: Collaborated with senior management in the delivery of project strategy, goals, priorities and long term plans for the portal Led Steering Committee meetings to communicate timelines, risks and milestones
- Reported schedule, cost (for multimillion dollar budget) and risk status on Clarity every week
- Managed stakeholder expectations through various work streams
- Proactively addressed potential issues that may affect the system and worked with developers to resolve the matter Built solid client –vendor relationships by accurately understanding and addressing their needs in a timely manner Applied strong facilitation and negotiation skills to lead project meetings, achieve project results and manage vendor relationships Created Project Plan and tracked the progress of team activities Monitored project risks and scope creep to identify potential problems and proactively identify solutions
Project Manager/Senior Business Analyst
New York City Health and Hospital Corporation
09.2014 - 09.2015
- Projects: WebView Implementation - WebView is the interactive portal/user interface version of the IntelliSoft group of applications/ products that will allow existing and providers to complete applications and upload required documents, request privileges, electronically attest and sign their credentialing application and allow non providers to access the integrated Cactus database and search for providers and privileges through the internet and intranet
- Responsibilities: Composed Project Charter and received approval from the Project Sponsor and other Stakeholders for web implementation Identified risks by communicating and coaching with internal and external teams to finish the project successfully
- Managed project meetings and record keeping with project meeting minutes and action items
- Organized daily scrum meetings or standups, sprint planning and sprint review
- Developed a Stakeholder register and RACI chart Led the system User Acceptance Testing effort and coordinated issue resolution
Project Lead
Affinity Health Plan
04.2013 - 08.2013
- Projects: Medicare Expansion – Affinity currently operates in the five boroughs of New York City
- The expansion project was initiated to expand its operations in the five outer counties of Westchester, Rockland, Orange, Suffolk and Nassau
- This expanded coverage entailed inclusion of new providers, Provider credentialing (manual process), benefits and marketing materials
- Medicare Sales to Enrollment automation – The purpose of this project is to automate the enrollment data collection, eligibility validation and feed to Human Resources Administration
- To facilitate this, a database was created internally that supports an interactive enrollment application and is capable to data archival
- MLTC – The launch of this product was to help people remain in their homes as long as possible and delay use of nursing home and hospital care
- Responsibilities: Responsible for designing scope statement, project schedule, flow of project management and task management
- Applied strong facilitation skills to manage vendor relationships
- Prepared project requirements document and reengineered business processes
- Helped team members in designs, plan and coordination with work teams
- Developed process flow diagrams using Microsoft Visio
- Provided technical supervision to project team members by communicating with the client.
Lead Business Analyst/Project Manager
Emblem Health
05.2010 - 04.2013
- Projects: Medicare Renewals 2013, 2011 (Government Projects)- Every year Emblem Health submits a bid to CMS for the new plan year benefits
- In addition to the bid, CMS publishes the final Guidance of all the changes that the plan should adhere to, in-order to be compliant with CMS
- This project ensures that Claims, Benefits, Enrollment, Customer Service, Sales and Marketing, Vendors and Delegates and IT make the necessary changes to ensure compliance with CMS
- CMS Encounter Data System (Government Project) - CMS is transitioning their R.A.Ps process to leverage the HIPAA x12 ANSI formats for claims and to require submission of all Encounter data elements via the HIPAA version 5010 837-X Format
- In this process CMS mandates submission of all adjudicated, unfiltered claims and encounters from all sources including dental (on an 837I /P) as a condition of reimbursement
- Additionally, the new required fields, which follow the EDS submitable 5010 format, drastically increase the data for each transaction that is required to be sent for each claim
- Healthcare Reform (Affordable Care Act) – Emblem Health participated in the health insurance exchange program, by providing fee for service medical care
- Responsibilities: Assisted in creating Project Charter to formally initiate the project
- Monitored projects on an ongoing basis, evaluating progress and quality, managing issue resolution and taking corrective action as necessary
- Achieved a strong record of success in a dynamic environment
- Led UAT daily status calls and facilitated issue resolution within 24 hours, with documented agendas, minutes and action items
- Successfully led workgroup meetings to gather project updates from large cross-functional teams including, Claims, Finance, Enrollments etc.
Business Analyst/Senior Business Analyst
JSMN International Inc.
07.2000 - 04.2010
- Responsibilities: Managed all user requirements in RequisitePro, making requirements available to all team members Tested enrollments and billing functionality on the mainframe system Z/OS (IBM)
- Involved in Test Planning, coordination and implementing QA methodology
- Participated in weekly team meetings, where test status and defects were discussed
- Involved in maintaining, enhancing and troubleshooting of the application according to the needs of the customers
- Developed UAT testing documentation.
Education
MBA - Healthcare Management
Goldey Beacom College
01.2015
MS - Management, Technology Management
Stevens Institute of Technology
01.2006
Higher Diploma in Software Engineering -
Aptech
01.1999
MBA - Marketing
Pune University
01.1996
Bachelor of Science -
India
01.1994
Skills
- Project Management
- Life Cycle Management
- Team Development
- Quality Assurance
- Change Management
- Risk Analysis and Management
- Testing, Repair, and Troubleshooting
Technology Skills
Rational Requisite Pro, Mercury’s Test Director, Mercury Quality Center, Blue Print, Planview, MS Office, MS Project, MS SharePoint, Clarity PPM, JIRA, SnagIt, Smartsheet, PlanView, MS Teams, MS Visio
Certification
Certified Scrum Master
Professional Scrum Master I
Timeline
Program Manager
McKesson
10.2022 - Current
Senior IT Technical Project/Program Manager
Molina Healthcare
07.2020 - 10.2022
Senior IT Technical Project Manager
Aspen Dental Management Inc.
07.2019 - 05.2020
Project Manager
Independent Health
10.2016 - 06.2019
Senior Project Manager
Carefirst Blue Cross Blue Shield
10.2015 - 09.2016
Project Manager/Senior Business Analyst
New York City Health and Hospital Corporation
09.2014 - 09.2015
Project Lead
Affinity Health Plan
04.2013 - 08.2013
Lead Business Analyst/Project Manager
Emblem Health
05.2010 - 04.2013
Business Analyst/Senior Business Analyst
JSMN International Inc.
07.2000 - 04.2010
MBA - Healthcare Management
Goldey Beacom College
MS - Management, Technology Management
Stevens Institute of Technology
Higher Diploma in Software Engineering -
Aptech
MBA - Marketing
Pune University
Bachelor of Science -
India