Rishi Chandra

WORK HISTORY

EDUCATION

SKILLS

ABOUT RISHI CHANDRA

Expertise in Strategic Thought Leadership, Planning and Execution of business critical processes and functions. Led multiple complex projects from inception through execution and delivered successfully on time and under budget with substantial realized savings and commendable customer satisfaction scores.Subject matter expertise in healthcare domain especially payer segment as it relates to implementation of complex and demanding initiatives for compliance with Federal and State regulations. Worked on IT enablement of HIPAA EDI transaction set, Clinical data processing in HL7 format, implementation of HIPAA Privacy and Security rules, Blue Cross Inter Plan projects and automation of electronic medical record exchange. Assisted business areas in development of business case and coordinated initiation, execution, control, monitoring and timely delivery of Medicaid expansion project.Streamlined project estimation process, resource planning, budgeting/forecasting for EDI department resulting in efficient management of multiple projects completed per year.Directed efforts in standardization of clinical data receipt in HL7 format from Labs and associated analytics for Medicare CMS STAR and HEDIS ratings.Directed implemetation of Reporting capabilities for Inventory tracking and management, and workflow management tool for Inter Plan claim work processing.Core expertise in IT project implementation on both Legacy and Distributed platforms. President Circle member of BluePAC – Blue Cross Political Action CommitteeMember of BCBS Association Business/Technical workgroupsMember of CAQH (Committee for Affordable & Quality Health Care) workgroupCertified Project Management Professional (PMP)