CHECASTRO R

Worked in Membership data migration for large and small group of clients(Membership)

1) Worked on crosswalks (Legacy Vs new systems )

2) Stakeholders interactions about the changes.

3) Managing internal teams and supporting in mapping requirements.

Program Integrity and Aligned Incentives(ASO)

1) Functional Area(Fraud and Abuse of Services)

2) Working with Multiple Analytical team to Build the logic to Catch

fraud and Abuse cases from the Multiple Source of Data during

Adjudication process.

3) Create STTMs for Building logics and Business operations repotrs.

4) Interacting and coordinating with Internal team(Testing,Development,QA).

5) Interacting with Business Counterparts to getting requirements

Worked in Technofunctional team to migrate Membership data from Nasco National system to WGS System.

1) Creating business crosswalk

2) Creating Mapping and internal and external team stakeholders interactions

3) Working on Production rollout and post monitoring

Athenahealth is Publicly traded US-Based company that provides network-enabled services for healthcare in US.

• Migrate new healthcare entities from their existing systems(On Premises/cloud) to single instance,multi-tenant,secure,HIPAA Compliant Athena EHR cloud.
• Build Standard(HL7) between athenanet cloud EHR and third party systems such as Clinical Lab,Radiology/Imaging and Health information exchange(HIE).
• Building HL7 interface using various layer of Technical components like VPN,Webhost and SFTP.
• Working on Requirement scoping and drafting the technical Scoping documentation.
• Engaging External vendors and Client.
• Client user testing execution
• Worked closely with software development and testing team members to design and develop robust solutions to meet client requirements for functionality, scalability and performance.
• Documented business processes and analyzed procedures to align with changing business needs.

Exela is US based Health care company and which provides comprehensive solution for Health care industry sector through the Cloud based platforms and Configurable modules.

• Assigned tasks to associates, staffed projects and updated all involved parties to enhance optimal business flow.
• Synthesized current business intelligence data to produce reports and polished presentations, highlighting findings and recommending changes.
• Draft Business Requirement documentation(BRD) and Functional requirement documentation(FRD)
• Achieved 80% success in automation by analyzing claim operations, data and system issues to identify discrepancies for troubleshooting and corrective action.
• Worked closely with software development and testing team members to design and develop robust solutions to meet client requirements for functionality, scalability and performance.
• Managing Project delivery and Change Management.