Madhanagopal Mani

Strategic Project Management professional offering over 21+ years of experience. 6+ years of work experience at Onsite (US) directly working with Health Care customers. 7+ Years of Contract Configuration & Pricing on different platforms like Amisys, DST Pricer, QNXT and FACETS across US Healthcare domain including Medicaid / Medicare line of business. 10+ Years of Experience in C#.NET, SQL Server Development and ETL Tools supporting for Production Support. Gained hands-on expertise in US HealthCare with understanding of Federal Laws (Mandates) of Insurance for various states. Pivotal as AMISYS, DST, QNXT Configuration Solution / Facets Configuration SME in projects by leading configuration design, system changes, and quality assurance testing.

Driving the Project Team for gathering and documenting requirements; developed & modified data, information, and functions for the Health Plan processes including claims processing, clinical editing utilization management and enrolment. Capability in communicating and influencing peers, directors, and executives; setting clear expectations and realistic goals; expert in the presentation of configuration ideas, status, solutions, and results. Proficient in grasping the big picture, conceptualizing, developing, implementing solutions, partnering closely with business leaders & stakeholders to achieve higher levels of efficiency & effectiveness.

A planner with skills in forecasting revenue/ operating plans / budgets and designing internal control systems for effective decision-making & operational effectiveness. Capabilities in delivering high quality services to customers thereby achieving high customer delight. Led the transition & transformation projects with assurance to budgets & ROI in dynamic and globally expanding MNC environment.

Senior Consultant - Infosys Ltd - Coimbatore

(2022-12 - 2026-01)

Configuration Analysis Senior Specialist - NTT Data Information Processing Services Pvt Ltd - Coimbatore

(2021-02 - 2022-11)

Working on US Healthcare Provider Contract & Pricing Configuration Process, Amisys, DST Pricer & Golden SQL to run the database queries.

• Handling a Team of Business Analysts & Senior Business Analysts
• Work Profile for Client is Business Analyst-Lead, taking care of Final Manager level approvals before deployment of configurations in Production environment
• Working on client deliverables and ensure to meet the required SLA
• Requirement gathering, Planning, testing UAT & Deployment are the different level phases for all user request
• Interacting with senior management of client during meeting and attending clients call to get their requirement and working on those
• Communicating with my Team on daily basis during DSR (Daily Status Report) Meeting
• Working on CR's reciving in Service Now ticketing tool
• Coordinating with Client directly for Approval related requests
• Connecting with End Clients in case of any additional information required on US Healthcare Provider Contracts amendments
• Ensuring to Meet the Client SLA's
• Working on request types related to Pay-Scale Shells, Fee Schedule, Change of Effective & End dates of Service Code rate update, rate update for Proceedure Code, HCPC's Code, Revenue Code, Modifiers, Place Of service Code
• Work involved End to End Testing

Senior Product Specialist - Cognizant Technology Solutions - Coimbatore

(2018-06 - 2021-12)

Senior Product Specialist - Cognizant Technology Solutions US Corporation - Virginia Beach

(2015-04 - 2018-05)

Facets Product Configuration Analyst in Providers, Claims and CRCT for analysis and configuration of Providers. This project includes configuration required for all the 10 Market place states.

• Led the Onsite Configuration Team and coordinated with the Offshore Team
• Worked on Implmentation of the Migrations project for Florida Simply for migrating the Providers from QNXT to Facets
• Mentored the team for delivering the automation solutions & enablers for making the configuration job easier, quicker, defect-free and with minimum manual efforts using MS Access & PL SQL scripts
• Coordinated with the Configuration State Leads for resolving the configuration issues and managing the work allocation
• Acted as a Senior Configuration Analyst for team management & training to the team members
• Managed the claims EDIT resolution, complex contracts configuration, prior authorization requirements for different quarters, restructured the Service Groups for Benefits and Contracts
• Participated in the complete recruitment cycle by establishing the Configuration Team at Onsite and Offshore

Senior Associate Projects - Cognizant Technology Solutions US Corporation - Hartford, Cleveland, St. Paul

(2011-09 - 2015-03)

Facets Product Reconciliation Project. The goal of the project is to move members from legacy MBEST mainframe system to Facets 4.81 to handle Part D business enrollment and billing. Modify other ancillary systems to use Facets as an enrollment source without any impact to business operations and customer service. Modify systems to accommodate business rules of both Universal American and CVS Caremark plans.

• Reconclie all enrollments received through Facets (enrollment and billing system) and Rxclaim (Claims system). Use CMS files FEF – full enrollment file, LISHIST – LIS history file, TRR – Transaction reply report, LEP file, MPWR file for confirmed members and BEQ files for pre-enrollment validation
• TCS Letters
• Exceeded the process deliverables as per customer SLAs
• Mentored the team for delivering the automation solutions & enablers for making the configuration job easier, quicker, defect-free and with minimum manual efforts using MS Access & PL SQL scripts
• Worked on the interfaces project for Systems Analyst to analyze the business requirements documents, discuss with client on the requirement clarifications and prepared the system use case and boundary specification documents
• Fixed defects and executed the change requests in the interfaces using various stages of Vendor Integration Testing, QA Testing and User Acceptance Testing

Associate Projects - Cognizant Technology Solutions India Pvt. Ltd. - Coimbatore

(2010-01 - 2011-08)

• Medicare/Medisys enhancement engagement involves providing application support & enhancements to Medisys application (Sr. Business enrolment suite) of WellPoint
• Managed a team of 5 members

Senior Software Engineer - Valtech India Technology Solutions Pvt Ltd - Bangalore

(2007-11 - 2009-12)

Software Engineer - Valtech India Technology Solutions Pvt Ltd - Bangalore

(2006-01 - 2007-10)

Associate Software Engineer - Valtech India Technology Solutions Pvt Ltd - Bangalore

(2004-11 - 2005-12)

B.Sc. - Computer Science - Bharathiayar University (1998)

MCA - Master of Computer Applications - Madurai Kamaraj University (2002)