Ashutosh Pandey
Summary
Skilled Technical Project Manager with experience in leading complex IT projects and managing cross-functional teams. Demonstrated strengths include risk management, strategic planning, and process improvement. Known for delivering highquality results within budget constraints while fostering strong relationships with stakeholders.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Technical Project Manager
Carelon Global Solutions
07.2021 - Current
- Led and managed a team of 30+ individuals in PIAI area, It is an arrangement between Anthem and its clients to help in managing their claim dollars by finding and recovering any claims that were overpaid, and employing programs that help in preventing overpayments. This program generates close to 40 million dollars monthly billing through Anthem's Program Integrity Initiatives
- Executed simultaneous, successful migration of business infrastructure from on-premises to AWS cloud platform, enabling uninterrupted execution of monthly billing processes in PIAI program
- Demonstrated exceptional leadership capabilities in overseeing the integration of multiple Anthem claim recovery applications into a single platform. The resulting system greatly enhances efficiency for auditors, enabling them to swiftly identify potential claims for recovery
- Ensured seamless coordination between infrastructure and application teams resulting in favorable outcomes for Blue PI Marketplace (BPIM), the electronic network utilized by all BC/BS Home/Host plans. Spearheaded the team responsible for billing nearly $10 million monthly to Elevance and its clients
- Minimized data redundancy through the implementation of efficient measures, while ensuring thorough sanity checks in staging areas during data migration from on-prem to cloud
- Recognized opportunities for process improvements and applied relevant changes. Incorporated the ICEDQ validation tool into monthly and quarterly reports, achieving significant savings of 2 FTEs
- Drove innovation and process improvement through the implementation of more than 10 ideas, resulting a saving of over $4 million for year 2023-24
- Advised business stakeholders on the project's technical aspects, aiding the decision-making process. Assessed multiple cloud technologies to inform optimal migration strategy
- Spearheaded budget monitoring efforts and meticulously tracked project costs, safeguarding the financial success of projects by preventing potential revenue leakage
- Partnered with business and POs to analyze requirements for new features, facilitating brainstorming sessions with development teams resulting in improved customer service levels
- Collaborated with various teams to ensure the fulfillment of all delivery positions, while identifying and addressing any gaps in staffing
- Provided leadership and guidance to team members, ensuring that tasks were completed on time and to a high standard
Lead Consultant
Optum Global Solutions
07.2020 - 07.2021
- Coordinated with stakeholders, customers, vendors, and team members to ensure the successful merger of Health Scope Benefit, a TPA organization, to United Health Group's UMR business, which has an employee base of more than 800 associates
- Led and provided technical assistance in the onboarding of HSB users and migration of HSB data to UHG, while identifying gaps in processes and developing solutions to enhance accuracy of data migration tasks
- Utilized ETL tools such as SSIS and SAS for efficient extraction, transformation, and loading of large volumes of data from various sources into a single database
- Developed and maintained detailed project plans, ensuring successful delivery within budget, scope, and timelines
- Provided technical guidance and support on software development lifecycle processes, such as requirements gathering, design, coding, testing, and deployment
- Developed data mapping documents for the migration process between source and target systems
SENIOR BUSINESS ANALYST
Optum Global Solutions
08.2015 - 07.2020
- Collaborated with clients and stakeholders as a Developer/BA to identify data submission criteria for the state's APCD initiative, leveraging knowledge gained from the ICRC project
- Converted state's DSG into specific business requirement documents by understanding Datawarehouse structure and mapping fields
- Provided solutions and feed files for new state implementation, legislative updates, and collaborated with clients/states on guideline changes
- Conducted gap analysis between current state processes and desired future state processes
- Performed root cause analysis to determine underlying issues in complex problems
- Developed detailed project plans outlining tasks, deadlines and resources needed for successful implementation of projects.
IT BUSINESS ANALYST
Edifecs Technologies
08.2014 - 08.2015
- Contributed to the Premium Stabilization Reporting Project as a business analyst, handling tasks such as coordinating with multiple resources throughout the development lifecycle to ensure on-time project completion, executing plans to align with business goals and objectives for PSR (Premium Stabilization Reporting), contributing to business analysis by performing fit gap analysis, creating business architecture diagrams, and gathering business requirements, providing feedback on product designs based on industry best practices for usability standards, and providing guidance and mentorship to junior Business Analysts in order to ensure timely delivery of projects.
SOFTWARE ENGINEER
United Health Group
01.2011 - 08.2014
- Took responsibility as a Business Analyst in interacting with UPI Auditors and initiating projects through discussions with clients, SAS developers, Business Stakeholders, and Project Managers
- Resolving any business queries during development using expert domain knowledge, occasionally consulting the UPI auditor for clarification
- Played a key role in the Enterprise Decommission program by articulating roles & responsibilities
- Participated in regular meetings with stakeholders to discuss project progress, changes, challenges
- Designed databases to store application data using SQL Server or Oracle technologies
- Analyzed user requirements to develop software solutions and created technical specifications.
Education
Bachelor of Technology - Computer Science -
Hindustan Institute Of Technology, Uttar Pradesh Technical University
Skills
- Technical Project Management
- Strategic Planning
- Stakeholder Management
- Infrastructure and Application Collaboration
- Technical Decision-Making
- Budgeting and Cost Tracking
- Cloud Migration - AWS
- Hadoop Big Data Platform
- ETL Tools (SSIS, SAS)
- Systems Performance Analysis
- Gap Analysis
- Business Architecture
- System Architecture
- Agile Product Lifecycle Management
- HIPAA Compliance
Certification
- Certified SAFe Product Owner/Product Manager
- AHM 250
- AWS Certified Cloud Practitioner
- Certified Scrum Master
Accomplishments
- Achieved successful vendor transition and commenced project leadership remotely.
- Drove successful migration of business infrastructure from on-premises to AWS cloud platform, enabling uninterrupted execution of monthly billing processes.
- Assessed the technical and business value of more than 50 ideas as a jury member in a hackathon event.
- Managed a complex project with multiple stakeholders, ensuring all deliverables were met.
- Achieved successful transfer of a large user base, consisting of more than 800 individuals, from HSB organization to Optum's UMR business.
Languages
- English
- Hindi
References
Reference can be presented as and when requested.
Timeline
Technical Project Manager
Carelon Global Solutions
07.2021 - Current
Lead Consultant
Optum Global Solutions
07.2020 - 07.2021
SENIOR BUSINESS ANALYST
Optum Global Solutions
08.2015 - 07.2020
IT BUSINESS ANALYST
Edifecs Technologies
08.2014 - 08.2015
SOFTWARE ENGINEER
United Health Group
01.2011 - 08.2014
Bachelor of Technology - Computer Science -
Hindustan Institute Of Technology, Uttar Pradesh Technical University
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