Manasi Chauthai

Migration and new enrollment of 55k+ Florida HealthSun members to Medisys which involves HMO, DSNP, CSNP etc. plans.

• Preparing 'migration file layout' artifact which involves field mapping, additional field requirements for HealthSun to Medisys and downstream applications.
• Conducting series of brainstorming sessions with business and technical teams to gather requirements and document business rules for streamlining the migration process.

This is a yearly renewal/non-renewal process followed for MA/MAPD/PDP plans for 1.6M+ members.

• Created source to target mapping based on annual changes in plans (Individual and Group) to move the members' recent benefits to target combination based the move type.
• Continues updation of the source to target mapping deliverable based on ADHOC changes per business request and delivered to the development team.
• Prepared member moves calendar, prioritizing the group of members.
• Received several appreciations from the business, peers, and my leadership team for my valuable contributions.

Yearly, for Medicaid eligibility verification process, plan changes are required for different states based on mandated changes from CMS.

• Performed requirement gathering for YoY plan ID changes.
• Performed requirement understanding and data analysis for DSNP AID codes, prepared current translations and new cross walk translations mapping document for different states.
• Updated business rules related to DSNP (daily and monthly 270/271 changes) based on each state.
• Prepared functional requirements and wireframe document for UI enhancement DSNP individual/monthly queue for development team.
• Received several appreciations from the business, peers, and my leadership team for my valuable contributions.

For California state DSNP members, consuming 'Alternate Format Preference (AFS)' file into Medisys with new nine languages and format preferences, and generation of 60+ letters in new languages.

• Worked on preparing the functional requirement gathering and mapping document to load the AFS file to Medisys and trigger interfaces to downstream systems (GBD and EHub).
• Documented the letter translations requirements with business and coordinated the letter generations with downstream systems.
• Received several appreciations from the business, peers, and my leadership team.

Address Verification Tool (AVT) automates the address verification from TRCs and MMRs. This major system enhancement helped address to be tracked more efficiently utilizing queues, BEQ, and BOT process so the appropriate letters are sent to the members in timely manner and alert customer service about unconfirmed address.

• Gathered system design requirements for the complex process working with the business and defined the scope.
• Prepared multiple wireframes for UI screens, helped business and development teams visualize the screens during requirement gathering.
• Documented the functional requirements and business rules which was the base for tool development.
• Prepared a cross-functional diagram, which helped identify multiple business scenarios.
• Prepared functional scenario sheet for with 80+ TRC, MMR and Compass combinations, led minimal to no production defects.
• Queue numbers went down, members didn't get additional unnecessary letters, and reduced phone calls to customer service.
• Business had to manually handle only 11% of the records with all others being automated.
• Received several appreciations from the business, peers, and my leadership team for my valuable contributions.