Mr. Parth Jani
IT Project Manager at Molina Healthcare
Washington, Virginia, United States
About
Parth Jani is a seasoned and highly accomplished Healthcare IT professional with a strong portfolio in enterprise-level project management, business systems consulting, and technology-driven healthcare solutions. With a Master’s degree in IT Management and a decade-plus of real-world experience, Parth has earned a reputation for excellence in healthcare technology by consistently leading and delivering strategic, regulatory-compliant, and patient-centric projects across multiple healthcare domains. Parth’s career trajectory showcases a deep command over the Healthcare IT landscape, marked by substantial hands-on involvement in Medicaid and Medicare programs, Revenue Cycle Management (RCM), pharmacy benefits, Electronic Data Interchange (EDI), and enterprise-level integration using standards like HL7, FHIR, and OMOP CDM. He has operated in roles including Senior Project Manager, Product Owner, Business Systems Analyst, and Scrum Master, adapting to both leadership and hands-on technical environments with equal agility. One of Parth's major strengths lies in managing complex implementations across diverse systems and stakeholders. He has led large-scale initiatives for industry leaders such as Molina Healthcare, Florida Blue (BCBS FL), CareSource, Sentara Health Plans, and AmeriHealth. His expertise covers the full Software Development Life Cycle (SDLC), both in Agile and Waterfall environments, and includes requirements gathering, stakeholder management, sprint execution, backlog prioritization, and user acceptance testing. Parth has also played a vital role in supporting critical compliance projects like CMS Interoperability, Transparency in Coverage, the No Surprise Act, and ACA mandates, showcasing his detailed understanding of regulatory frameworks and payer-provider data ecosystems. He is highly proficient in tools and technologies used for business process improvement, data analysis, and healthcare informatics. These include Tableau, Power BI, Informatica, Microsoft SQL Server, SSIS, Azure DevOps, JIRA, Salesforce Service Cloud, SOAP UI, Postman, and more. His skillset extends to interface engine development using Rhapsody and experience with cloud integration, data migration, and API testing. Notably, he’s worked extensively with healthcare payer platforms like QNXT, FACETS, PEGA, and HealthEdge, implementing enhancements and configurations to streamline operations and improve auto-adjudication of claims. Parth has deep functional experience in Care Management, Utilization Management, Pharmacy Benefits Management (PBM), Digital Marketing Portals for member engagement, and Provider Data Management Systems. At Molina Healthcare and CareSource, he contributed significantly to the development and enhancement of care coordination portals, accumulators, and clinical vendor integrations. His role often involved translating regulatory and business requirements into scalable IT solutions, bridging gaps between business and technical teams, and facilitating organizational change management initiatives. As a certified Agile practitioner and experienced Scrum facilitator, Parth has led cross-functional teams through product backlog refinement, sprint planning, daily scrums, sprint reviews, and retrospectives. His leadership was crucial in transitioning teams from traditional Waterfall to Agile and SAFe frameworks, enabling better delivery cadence, responsiveness, and team productivity. He also played a critical role in developing training material, mentoring new hires, and building scalable knowledge repositories. Parth’s analytical mindset and communication skills are reflected in his ability to conduct SWOT analyses, lead Joint Application Development (JAD) sessions, and prepare functional and technical documentation such as Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), and Requirements Traceability Matrices (RTMs). He has worked with multiple stakeholders including state agencies, vendors, compliance units, and product teams to ensure timely delivery of high-quality, compliant solutions. What truly sets Parth apart is his ability to balance deep technical knowledge with strategic business insights. He is adept at evaluating system limitations and crafting customized solutions that align with enterprise goals while ensuring compliance with healthcare standards such as HIPAA, HL7, ICD-10, and more. His dedication to continuous improvement, automation, and innovation makes him a valuable asset in any healthcare technology initiative. In summary, Parth Jani is a versatile and forward-thinking IT leader with a rich blend of technical, analytical, and leadership skills. His comprehensive experience across health plans, regulatory programs, and enterprise-level implementations positions him as a thought leader and problem solver in the ever-evolving field of Healthcare Information Technology.
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Experience
Education
Bhartiya Shiksha Parishad (BSP)
B.Sc. in Computer Programming, Specific Applications
Passout Year: 2025
Certificates
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By : Scrum.org
Professional Scrum Master
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By : Scrum.org
Professional Scrum Product Owner (PSPO)
Scholar9 Profile ID
S9-022025-1309637
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