Summary
Overview
Work History
Education
Skills
Key Result Areas
Occupationalcontour
Languages
Othercredentials
Personal Information
Professional Snapshot
Certification
Timeline
Generic

Manju Sundararaman

Chennai

Summary

Ambitious and analytical Healthcare Business Consultant seeks top-level position with an esteemed organization to improve overall IT functional and non-functional capabilities

Business consultant with track record of driving strategic initiatives and delivering impactful solutions. Adept at analyzing business processes, identifying growth opportunities, and implementing effective strategies. Strong focus on team collaboration and achieving results, with flexible approach to dynamic business environments. Skilled in project management, data analysis, and stakeholder engagement. Known for reliability and adapting to changing needs.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Business Consultant – Product Owner

Acentra Health
04.2022 - Current
  • Product Overview: The objective of this product is to implement the MMIS product for one of the US States consisting of start to end of the healthcare payer cycle with respect to Medicaid
  • Responsibilities:
  • Identify and drive opportunities to enhance customer experience
  • Strategy or modifications required for the process based on decisions taken
  • Being a single point of contact to drive the Onshore calls in terms of getting the requirements and clarifications
  • Acting as the key liaison between the Customers and the IT stakeholders in terms of providing KT, explaining, and clarifying the requirements in detail through brain storming sessions, walkthroughs
  • Ensuring adherence to quality on the low-level design documents from the DSDD
  • Leading a quantifiable team of members and to mentor/manage them on various day-to-day activities
  • Providing walkthrough to the stakeholders such as Development team, QA team and the cross functional teams
  • Support Knowledge transfer at the time of process transition across all stakeholders
  • Oversee the accuracy of status reports for customers/ the managerial reports such as Health Check
  • Dashboard, Functional Summary, Iteration Closure Summary, Documentation Defect tracker across all the modules on a weekly/daily/ad-hoc basis across all the modules
  • Product : Medicaid Management Information Systems – Implementation
  • Client

Lead Business Analyst

CNSI
01.2021 - 03.2022
  • Product Overview: The objective of this product is to implement the MMIS product for one of the US States consisting of start to end of the healthcare payer cycle with respect to Medicaid
  • Responsibilities:
  • Preparing the low level design documents from the DSDD
  • Providing walkthrough to the stakeholders such as Development team, QA team and the cross functional teams
  • Being a single point of contact to drive the Onshore calls in terms of getting the requirements and clarifications
  • Acting as the key bridge between the Customers and the IT stakeholders in terms of providing KT, explaining and clarifying the requirements in detail
  • Preparing the managerial reports such as Health Check Dashboard, Functional Summary, Iteration
  • Closure Summary, Documentation Defect tracker across all the modules on a weekly/daily/ad-hoc basis across all the modules
  • Product : Audit Studio – Implementation
  • Client : US Based Healthcare Client

Consultant – Co-Product Owner

CNSI
10.2020 - 12.2020
  • Product Overview: The objective of this Product is to implement the MMIS product for one of the US States consisting of start to end of the healthcare payer cycle with respect to Medicaid
  • Responsibilities:
  • Revamping the Detailed Specification Design Documents as per the standards followed by the state
  • Being a single point of contact to drive the Onshore calls in terms of getting the requirements and clarifications
  • Acting as the key bridge between the Customers and the IT stakeholders in terms of providing KT, explaining and clarifying the requirements in detail
  • Preparing the Daily Status check report and sharing to Onshore
  • Leading a team of seven members and to mentor/manage them on various day-to-day activities
  • Product : Medicaid Management Information Systems – Implementation
  • Client : US Based Healthcare Client

Lead Business Analyst

08.2019 - 09.2020
  • Project Overview: The objective of this Product is to implement the MMIS product for one of the US States consisting of start to end of the healthcare payer cycle with respect to Medicaid
  • Responsibilities:
  • Preparing the design documents from the DSDD
  • Providing walkthrough to the stakeholders such as Development team, QA team and the cross functional teams
  • Being a single point of contact to drive the Onshore calls in terms of getting the requirements and clarifications
  • Acting as the key bridge between the Customers and the IT stakeholders in terms of providing KT, explaining and clarifying the requirements in detail
  • Preparing the managerial reports such as Health Check Dashboard, Functional Summary, Iteration
  • Closure Summary, Documentation Defect tracker across all the modules on a weekly/daily/ad-hoc basis across all the modules
  • Leading a team of four members and to mentor/manage them on various day-to-day activities
  • Product : RPA of certain Business Processes
  • Client : US Based Healthcare Client

Senior Business Analyst

01.2019 - 07.2019
  • Overview: The objective of this Product is to automate certain Business Processes using Robotic Process
  • Automation
  • Responsibilities:
  • Preparing the requirements workflow documentation of the Business Processes such as Claims
  • Processing Audit, Benefits Coding Audit, Enrollment Audit, in a detailed manner in order to deliver to the development team to initiate their work on the RPA for these Business Processes
  • Project : HMA Modernization
  • Client : US Based Healthcare Client

Senior Business Analyst

07.2018 - 01.2019
  • Product Overview: The Audit Tool (HMA) is an in-house product that supports audits within the Enterprise Health Solutions’ platform
  • The objectives of this modernization project is to deliver a flexible architecture to work in unison to allow easier integration of new functionality in future, Automation first approach in solution design to enable more cost-effective operational ownership, Deliver an enhanced user experience by developing User Experience Themes to drive productivity
  • Enablement of analytics and reporting to provide insight to increase operational efficiency
  • Responsibilities:
  • Understanding the core Business of the HMA application and analyzing the modernization parts
  • Designing Wireframes and Requirements documents for the modernization requirements considering the priorities
  • Acting as the key bridge between the Customers and the IT stakeholders in terms of providing KT, explaining and clarifying the requirements in detail
  • Project : Automated Business System Questionnaire Remediation
  • Client : US Based Healthcare Client

Business Analyst

12.2014 - 06.2018
  • Project Overview: Questionnaire Tool is a tool for configuring the questions to configure the Rating Method Code for each of the Products
  • This tool has to be remediated in order to remove the ambiguous/irrelevant questions and to reduce the number of questions
  • Responsibilities:
  • Analyzing the core functionality and reviewing the business impacts related to each of the questions
  • Scrutinizing the importance of each question and arriving at the right Business Impact
  • Sharing the final Use-Cases to the Development team and explaining the functionality in order for them to develop the functionality
  • Coordinating with Onshore counterparts and clients
  • Project : Unity Commercial
  • Client : US Based Healthcare

Techno-Functional Lead/Business Analyst

02.2012 - 11.2013
  • Project Overview: Unity is a third party Vendor product (from EDS, now it is taken over by HP)
  • It is a web based .NET application on MS SQL Server platform
  • Various Functional Enhancements and Upgrades have to be coordinated from time to time as per the Healthcare standards
  • Responsibilities:
  • Gathering the requirements during the Requirements phase
  • Writing the BRD as a part of requirements phase
  • Estimation for a given project (Enhancement/Development)
  • Coordination and Assignment of various tasks to the team members
  • Reviewing all the PDLC artifacts prepared by the team members such as Brief/BARR Assessment, Work
  • Order, Business Specification Document (BSD), Technical Specification Document (TSD), Solution
  • Document (SD), Coding, Unit Test Cases, Unit Test Logs, Requirements Traceability Matrix (RTM), Software
  • Release Notes (SRN)
  • Sharing the reviewed Deliverables to Onsite and getting the approvals within the stipulated timeline
  • Coordinating with QA team to explain the requirements as a part of any new/enhancement Project testing
  • Coordinating the Project planning and management activities in Cognizant2.0
  • Owned additional responsibility to contribute for innovative value adds to the team to effectively utilize the productivity on a day to day basis
  • Owned additional responsibility of being a SCM Coordinator of the project and was responsible for the
  • Process and delivery audits, metrics submission from time to time
  • Project : Customer Contact Center Modernization (CCCM)

Techno-Functional Analyst

05.2011 - 12.2012
  • Project Overview: The current MFLC program reimburses MHN on a cost plus model
  • The new MFLC program reimburses on a fixed price model
  • The new reimbursement model requires that MHN streamline activity and reduce MHN costs in order to profitably deliver MFLC services
  • One major component in achieving profitability under this model is the automation of its 5 unique process steps mentioned below
  • Fulfillment Pre-Assignment Activities During Assignment Post Assignment, and Others (Those activities that fall outside of the first four process steps
  • For example:
  • Network Development and on boarding, “Give an Hour Donations”, and CDRLs.)
  • Responsibilities:
  • Requirement Gathering and writing BRDs
  • Responsible for giving Knowledge transition sessions to the new joiners in the team
  • Preparation of Business Specification Documents and Technical Specification documents
  • Coding Stored procedures
  • Coordinating peers in framing queries efficiently
  • Reviewing the Stored procedures
  • Functional testing
  • Coordinating the Project planning and management activities in Cognizant2.0
  • Owned additional responsibility of being a SCM Coordinator of the project and was responsible for the
  • Process and delivery audits, metrics submission from time to time
  • Project : Claim sphere – Analytics Solutions
  • Client : US Based Healthcare Client

Business Analyst

01.2012 - 02.2012
  • CCCM is targeted to establish the next generation of customer contact center operations for Client’s Federal Services and
  • Commercial book of businesses contact center operations
  • This program provides the client, the ability for future growth by supporting Client's goals to establish best in class customer contact center operations through the utilization of Client’s ITG asset from Pega Systems Inc
  • (Pega) and this program is to build a reusable foundation for customer satisfaction, efficiencies in operations and a high quality of customer care delivery with utmost concern for privacy and security of customers
  • Responsibilities:
  • Requirement Analysis in Pharmacy Sliver
  • Preparation of Functional Specification Document
  • Coordinating the Project planning and management activities in Cognizant2.0
  • Owned additional responsibility of being a SCM Coordinator of the project and was responsible for the
  • Process and delivery audits, metrics submission from time to time
  • Project : Medi-Cal FileNet Modernization
  • Client : US Based Healthcare Client

Business System Analyst

09.2011 - 12.2011
  • Project Overview: The system architecture was previously constrained by low amounts of storage, requiring files to be deleted to make room for the next day's processing volumes and lacking sufficient ability for backing up to facilitate a quick restart of any task; Replacement of the existing workflow architecture and printing of routed claims, which are currently running in Visual Basic (VB) 6.0
  • By implementing this project, File Net application will be moved to a standardized environment where the application can provide more storage, flexibility and stability for continued business operations
  • Responsibilities:
  • Existing Source Code Analysis
  • Preparation of Process flow documents based on the existing work flow analysis
  • Responsible for sharing Knowledge transition sessions to the PEGA development team
  • Responsible for Clarifying the queries from development team on the existing workflow from time to time
  • Project, MFLC (Military Family Life Consultants) Pre-Award Program
  • Client : US Based Healthcare Client

Techno-Functional Analyst / Functional Testing Analyst

09.2009 - 04.2011
  • Overview: The initiative was to study business data and understand historical patterns with an eye for predicting and improving business performance in the future to arrive at an optimal or realistic decision based on existing data
  • Roles and Responsibilities:
  • Requirement Gathering and Analysis
  • Preparation of Business Specification Documents and Technical Mapping Specification Documents for
  • Phase 1, 1.1A, 1.1B
  • Giving Knowledge Transition on the Functionality to the Development team
  • Coding (Reporting Queries in Oracle)
  • Coordinating peers in framing queries efficiently
  • Testing of Key Performance Indicators of Phase 1, 1.1A, 1.1B
  • Played key role as a Techno-Functional Analyst
  • Project : MARS (Medical Authorizations and Referral System) Enhancement
  • Client : US Based Healthcare Client

Techno Functional Analyst

Healthcare
07.2009 - 09.2009
  • Overview: The primary purpose of the MARS Enhancement: System and Response Time project is to ensure ongoing system stability and improve response times to between 3 and 5 seconds
  • The MARS Enhancements: Stability and Response Time project seeks to mitigate this risk by implementing specific application enhancements to stabilize the
  • MARS production server and environment
  • Responsibilities:
  • A key member during requirements gathering
  • Preparation of BRD
  • Participation as a key member in various stakeholders’ calls
  • Contributed effective suggestions or techniques to the Technical solution team
  • Project : Billing System Control Tool
  • Client : US Based

Developer

04.2009 - 06.2009
  • A Graphical User Interface system is required for the client for the process of billing where the pharmacy claims under the workers compensation have to be managed to reject the claims, correct the claims and pay for the claims
  • This system is called the Billing System Control Tool
  • Responsibilities:
  • Involved in Coding and Unit Testing
  • Involved in reviewing the work done by the peers
  • Responsible for delivering the project deliverables
  • Project : FS Alert Configuration Tool
  • Client : US Based Healthcare Client

Techno Functional Analyst

02.2009 - 03.2009
  • Project Overview: In order to manage the Pharmacy utilization, client had a trigger tool to configure the alerts for the Nurse
  • Case Managers, Field Case Managers, Clients and other individuals involved in pharmacy utilization
  • This process involved a lot of manual involvement to modify or add the new alerts configuration
  • Hence there was a need to bring this configuration as a user friendly tool which can be used through intranet/internet and this tool is called the First Script Alert Configuration
  • Tool
  • Responsibilities:
  • Involved in Requirements gathering, Analysis, Coding and Unit Testing
  • Involved in reviewing the work done by the peers
  • Responsible for delivering the project deliverables
  • Project : MVP DEV migration

Techno Functional Analyst

10.2008 - 01.2009
  • Project Overview: Client maintained data across different databases like Facets, mvp_dev (Facets)
  • Maintaining & refreshing data across these databases is both complicated and time consuming
  • Also, having a unified data model across systems will reduce the effort in refreshing data from production environment to other environments
  • With regards to the same, Client would like to reuse the Facets database for all custom development thereby eliminating the mvp_dev database from all the environments namely Unit, ITS, Acceptance and Production
  • Responsibilities:
  • Involved in Requirements gathering, Analysis, Recommendation, Remediation(Coding) and Testing phases
  • Involved in creating a tool for migrating the data from one environment to another
  • Involved in reviewing the work done by the peers
  • Project : Facets Version Upgrade 4.31 to 4.51 and Remediation
  • Client :

Techno Functional Analyst

05.2008 - 09.2008
  • Project Overview: Client proposed to migrate from the current deployed version of Facets 4.31 to a higher version of Facets51
  • Client had several custom applications and processes, interacting with the Facets 4.31 core system
  • The Scope of this project is to make the impacted custom applications and processes to be compatible with Facets 4.51 after a thorough analysis both manually and by using the VC Analyzer tool
  • Responsibilities:
  • Involved in Requirements gathering, Analysis, Recommendation, Remediation(Coding) and Testing phases
  • Involved in reviewing the work done by the peers
  • Project : Underwriting Support Rate Modeler

Techno Functional Analyst

09.2007 - 04.2008
  • Overview: The Objective of the underwriting support Rate Modeler Application is to correct, improve, and streamline the sales and underwriting process for generating and delivering Medical Plan proposals
  • The secondary objective to the project is to create more input edits to control the type of data entering the system
  • The project involves in eliminating the use of Access Database, in designing a complete system that will generate reports and alternative plans, a specific business plan to resolve the errors within the existing system
  • Responsibilities:
  • Involved in the Requirements gathering, Analysis, Design, Coding and Unit Testing phases of the Rate
  • Modeler
  • Participated as a key member in the Status calls and Audio Conferencing with the Clients
  • Project : Automatic Group Load (AGL)

Developer

Healthcare
07.2007 - 08.2007
  • Project Overview: The current process at Medco is to take the product extract file and have employees manually enter each product record sent to Medco via Client's product extract
  • During open enrollment for the year 2007 Medco has identified that they will not be able to enter all Client's products in a timely fashion
  • As a result, Client will be implementing the Auto Group Load (AGL) process
  • This will speed up the processing of Client Rx benefit information so Medco will enter the required data in a timely fashion
  • Responsibilities:
  • Involved in the Coding and Unit Testing phases of the Product Build Module and AGL driver module
  • Project : National Networks Implementation
  • Client

Developer

03.2007 - 07.2007
  • National Networks Implementation is a project to address the development of the custom processes for the existing client system (a healthcare provider) to handle claim adjudication request from another partner client (a healthcare provider who is a partner of the client) for the client's Members and the priced response from the Partner since there is a strategic alliance between the client and the partner
  • Responsibilities:
  • Involved in the Analysis, Design, Coding and Unit Testing phases of the Claims Business Edit module
  • Involved in the Unit Testing phase of Claims Extraction Module
  • Working in the Analysis and Design phase of Automatic Provider Creation
  • Project : Claims Mass Re - Adjudication
  • Client : US Based Healthcare Client

Developer

Cognizant Technologies Solutions
12.2006 - 03.2007
  • Claims Mass Re – Adjudication is a Conversion project from Visual Basic 6.0 to C#.NET without changing the functionality of the existing system
  • Claims Mass Re-Adjudicator (CMA) is a GUI application developed in VB0 environment
  • It contains five different tabbed screens for the user to enter his/her selection criteria for selecting the appropriate claims for mass re-adjudication
  • The user is allowed to make his/her selection at the claim, line, group, provider and hospital level
  • The application is designed to be user friendly and provides easy navigability across screens
  • A list view is generated at the end of user selection
  • The final list of selected claims is taken up for the keyword file generation
  • Responsibilities:
  • Involved in the Override, Explanation of benefits, provider change modules
  • Involved in the Analysis, Design, Coding, Testing phases of the project

Education

Master of Science - Operations Research & Computer Applications

National Institute of Technology
01.2006

Bachelors - Mathematics

Seethalakshmi Ramaswamy College
01.2004

Skills

  • HealthCare
  • Facets
  • C#NET
  • VBNET
  • VB 60
  • JavaScript
  • CSS
  • Microsoft SQL Server 2005
  • Microsoft SQL Server 2008
  • Oracle 10
  • Sybase SQL
  • Visual Source Safe
  • Application Life Cycle Management (ALM)
  • Service Now
  • Microsoft Visio
  • Microsoft PowerPoint
  • JIRA
  • Presentation skills
  • Business analysis
  • Business planning
  • Staff mentoring
  • Performance improvement

Key Result Areas

  • Innovative ways for improving/ defining new processes to improve/substitute legacy systems
  • Overcome complex business challenges and make high-stakes decisions using experience-backed judgment, strong work ethic & irreproachable integrity
  • Conducting Analytical Research, studying data and utilizing information for taking critical business decisions
  • Leading, mentoring, motivating teams and managing conflicts while ensuring compliance to the laid guidelines
  • Imparting training to the team members and channel partners for enhancing their skill levels

Occupationalcontour

  • 04/01/22, Present, Acentra Health, Chennai, Tamil Nadu, Associate Functional Manager
  • 08/01/19, 03/31/22, Client Network Services Inc (CNSI), Chennai, Tamil Nadu, Lead - Business Analyst
  • 06/01/18, 08/31/19, HCL Technologies, Chennai, Tamil Nadu, Senior Business Analyst
  • 09/01/06, 06/30/18, Cognizant Technology Solutions, Chennai, Tamil Nadu, Senior Associate - Projects

Languages

English
Tamil
Hindi
Sanskrit

Othercredentials

  • Certified Scrum Product Owner (CSPO)
  • Professional, Academy of Healthcare Management (AHM 250)
  • Microsoft Certified Professional in C# Windows Application and SQL Server 2000

Personal Information

Date of Birth: 11/25/83

Professional Snapshot

Ambitious and analytical Healthcare Business Consultant seeks top-level position with an esteemed organization to improve overall IT functional and non-functional capabilities., 18+ years in Healthcare Domain with Business Analysis skills predominantly with the Payer Industry., Health Insurance Medicaid Management Information Systems, Claims Processing, Benefits Administration, Financials, Oracle Financials, Agile, Iterative and Waterfall models, Requirements Gathering, Project Management, Metrics management, Product Ownership & Management, Operations, Governance, Process/delivery audit activities, SQL procedures, efficient query designing

Certification

  • Certified Scrum Product Owner (CSPO®)
  • Professional, Academy for Healthcare Management (PAHM®) - AHM 250
  • Microsoft Certified Professional (MCP)

Timeline

Business Consultant – Product Owner

Acentra Health
04.2022 - Current

Lead Business Analyst

CNSI
01.2021 - 03.2022

Consultant – Co-Product Owner

CNSI
10.2020 - 12.2020

Lead Business Analyst

08.2019 - 09.2020

Senior Business Analyst

01.2019 - 07.2019

Senior Business Analyst

07.2018 - 01.2019

Business Analyst

12.2014 - 06.2018

Techno-Functional Lead/Business Analyst

02.2012 - 11.2013

Business Analyst

01.2012 - 02.2012

Business System Analyst

09.2011 - 12.2011

Techno-Functional Analyst

05.2011 - 12.2012

Techno-Functional Analyst / Functional Testing Analyst

09.2009 - 04.2011

Techno Functional Analyst

Healthcare
07.2009 - 09.2009

Developer

04.2009 - 06.2009

Techno Functional Analyst

02.2009 - 03.2009

Techno Functional Analyst

10.2008 - 01.2009

Techno Functional Analyst

05.2008 - 09.2008

Techno Functional Analyst

09.2007 - 04.2008

Developer

Healthcare
07.2007 - 08.2007

Developer

03.2007 - 07.2007

Developer

Cognizant Technologies Solutions
12.2006 - 03.2007

Master of Science - Operations Research & Computer Applications

National Institute of Technology

Bachelors - Mathematics

Seethalakshmi Ramaswamy College

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Manju Sundararaman