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NewWave Telecom & Technologies Inc. is MBE certified and GSA IT 70 full-service Information Technology and Business Services firm and a leading implementer of business solutions using service-oriented technologies. NewWave specialize in providing end-to-end, mission-critical Information Technology (IT) solutions for healthcare, finance, telecommunications, government agencies and private sector clients.Project: Project scope included management and delivery of requirements on large, complex insurance reforms of Affordable Care Act (ACA) in addition to Gap analysis and assessment of US Virgin Islands’ health care systems to meet required technical standards and capabilities for implementing HIX according to the ACA 2010. USVI utilizes multiple software systems to support the intake and processing of authorization requests, The US Territories are also permitted, but not required, to establish an HIX and have limited access to the full range of federal HIX support services available to the states.

Southfield Mi

BCBSNC is a leader in delivering innovative health care products, services and information to help our customers improve their health and well-being. Their vision is to be a leader in improving the health care system in North Carolina. For over 75 years, BCBSNC has served North Carolina by offering health insurance at competitive prices and supporting community organizations, programs and events dedicated to promoting healthier livingProject: Large Groups Migration (LGM): The scope of the project is to: migrate large account (200 plus - risk/non-risk) with PPO, indemnity, MPOS, BlueChoice and CDH from a legacy system EAB to NASCO and FACETS. The project also focuses on to accommodate feeds and services such as: Paper vs. Automated Enrollment, COB, account receivable (AR), claims processing, and provider/customer/member services.

Washington

For more than 60 years, Kaiser Permanente has provided quality health care. Kaiser Permanente evolved from industrial health care programs for construction, shipyard, and steel mill workers for the Kaiser industrial companies during the late 1930s and 1940s. It was opened to public enrollment in October 1945. I worked on following two projects:Project-1: Kaiser Permanente, partner with NASCO, implemented a system BeneFACT that creates one single “source of record” repository for all benefit information and drastically reduces the need for the research, coding, maintenance and testing of benefits code by standardizing, modularizing, and automatically coding reusable benefit with desktop, browser and mobile based interfaces. This system will also provide benefit reporting and documentation and data interfaces to BlueExchange, MOS, CFD, OBN and ODS. Tools required for the creation and maintenance of benefit information on the NASCO platform are: Benefit Builder, Benefit Automator and Benefit Researcher. Project-2: The PBM team of Kaiser; manages Medicare Part D claims throughout the year. The PDM submits PDE (prescription drug event), with is a summary record that documents the final adjudication of a dispensing event to CMS. Dispensing even encompasses the process of submitting the drug prescription, submission of the claim for drug and finally dispensing drug after appropriate assessment of the adjudication. CMS uses these records to execute the payment provisions of Medicare Prescription Drug, improvement and modernization Act.

Southfield Mi

Founded in 1939, BlueCross BlueShield of Michigan (BCBSM) provides access to quality health care through affordability. Today, BCBSM has the largest network of health care providers in Michigan and over 6 million subscribersProject: The scope of the Project is to create the accumulation Rules in NASCO Processing System. The BlueExchange Provider Tool - Enhanced Eligibility Iteration 4 (EEI4) mandate requires BCBSM to respond to the provider request for eligibility information (HIPAA 270/271) at a detailed service level (55 service types) with static amount and accumulation amount. Accumulation Rules need to be created based on the analysis and research of database and code of existing claim process.

Chicago, Il

UTi is an international supply chain management services provider. It seeks to use its global network, proprietary information technology systems, relationship with transportation providers and expertise in outsourced logistics services to deliver competitive advantage to each of its clients’ supply chainsProject: The scope of this project was to reengineer the legacy application and develop a transactional application for logistics operations. This is a new development that aims to integrate existing eMpower system with the new Global Delivery Model (GDM) which helps to effectively control order processing, shipment tracking, inventory management and distribution

Chicago, Il

LaSalle Bank N.A. is the largest bank headquartered in Chicago with USD 72.9 billion in assets and USD 43.7 billion in deposits. It offers specialty services through its direct and indirect subsidiaries, including LaSalle Financial Services, Inc. LaSalle National Leasing Corporation and LaSalle Business Credit, LLC.Project: The scope of this project was to Develop an integrated Online Banking System that would allow customers to manage their multiple accounts online, transfer the available balance across the accounts and provide Electronic Bill Presentment and Payment (EBPP) services

Whitehouse Station, Nj

Merck & Co Inc. is a global research-driven pharmaceutical company. Established in 1891, Merck devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them. Merck also publishes unbiased health information as a not-for-profit serviceProject: The scope of the project was to address the problem that how the 24 hours/day Interactive Voice Response (IVR) can help Call Center better manage inbound calls, increase efficiency, and improve customer satisfaction by using the dynamic voice application.

Chicago, Il

Commerzbank is one of Germany's leading commercial banks. It deals in wholesale banking for corporate, institutional customers and banks in North America. The business includes corporate finance, trade finance, public finance, treasury and trading activities.Project: The purpose of the project was to define a mission critical reengineering of the Credit Appraisal System which conducts electronic approval to end-customers. The objective of this mission is to address the GAP analysis of the legacy system for improving its usability and portability.

Master In Business Administration, Management Information Systems And Services

Master In Computer Systems Technologies