SUMMARY:

• Over 9+ years of experience in Government and Health Insurance.
• 5+ years managing Business Intelligence projects
• Extensive experience working on WIC information system, conducting JAD sessions, high level interaction with section heads.
• Worked as scrum master on everyday tasks.
• Conducted Market & Technology research on WIC mobile App.
• Worked as SharePoint Business Analyst
• Preparing BRD, Functional & non - functional requirement documents.
• Participated in RFP process.
• Design requirements for traceability matrices.
• Analyze functional requirements and translate the requirements into written test plans and detailed test cases, for both front-end
• Understanding and mapping of the various ICD9/ICD10 Codes applicable for tracking of diseases for which diagnostic testing is done
• Knowledge and experience in implementation of HIPAA and NCPDP standards.
• Experience in preparing documentation which is in compliance with 21 CFR Part 11, Medicare Part D requirements, HIPAA ANSI X12 Transaction sets, and in accordance with NCPDP (National Council for Prescription Drug Programs) Standards.
• Worked as (in) a team with Account Management, Company Management to document requirements, process flows, wire frames, for corporate accounts/external clients.
• Application of Software Development Life Cycle (SDLC), with thorough understanding of various phases such as Requirements, Analysis/Design, Development, Testing and Implementation.\
• Extensive experience of EDI transactions (X12 - 837,835, 270/271, 276/277 & NCPDP - B1, B2, E1 and Medicaid Subrogation 3.0 for batch and real-time transactions.
• Proficient in creating Risk Analysis documents, Risk Management Plan, User Requirement Specification, Functional Requirement Specification and Business Process Flows.
• Proficient in using UML in behavioural, structural and architectural modelling - in creating Use Case, State, Activity, Class and Sequence diagrams using Rational Rose.
• Used Microsoft Visio and other Tools for Business Process Modelling and Data flow diagrams.
• Used ER w in 4.0 to capture data by creating Entity-Relationship and Use Case diagrams.
• Worked with Rational Suite of tools to create requirements documents (Requisite Pro), visual data models (Rose), manage and track defects (Clear Quest).
• Well versed in project management tool (MS Project) for status reporting, planning and resource allocation.
• Experience in conducting GAP analysis, User Acceptance Testing (UAT). SWOT analysis, Cost benefit analysis and ROI analysis.
• Successful as a team player to work in conjunction with other DBA’s, testers, developers and other team members in validation and testing complex scenarios and projects and in the maintenance of Quality Standards in Projects especially with Test Director.

TECHNICAL SKILLS:

• MS Visio
• MS Project
• Rational Product Suite
• Rational Rose
• RequisitePro
• ClearQuest
• Windows XP/2000/Me/98/95/3.1/NT
• SunOS
• MS-DOS
• Dream Weaver
• Adobe
• Pencil
• Photoshop
• Flash
• Business Objects
• XML
• UML
• HTML
• C++
• VB.NET
• ASP.NET
• Java
• Access
• Microsoft Word
• Power Point
• Excel
• Outlook
• PSP Studio
• HP QC
• Word Perfect
• Blueprint
• SharePoint-ECM
• TFS
• MTM

PROFESSIONAL EXPERIENCE:

Confidential, New York

Senior Business Analyst

• Working for the AVP of Dental Claims, candidate team members.
• Worked as SharePoint Admin and Analyst
• Document all processes/tasks conducted in the Dental Provider Maintenance team into a Process Manual.
• Using Process Manual, create training plan/syllabus for each process and/or job function in Dental Provider Maintenance team.
• Create process maps for all work streams handled by the Dental Provider Maintenance team including upstream tasks conducted by vendors Xerox and GOSC.
• Preparing Test Plan.
• Created Team SharePoint Site.
• Document all systems utilized by team and vendors in the performance of the handling any/all tasks
• Catalog all reports utilized by team, with examples and detailed usage applications..
• Project Scheduling
• Develop detailed work plans, schedules and status reports on the overall progress of a large scale project covers more than just Provider Maintenance.
• Provide support/coverage for management team in meetings by taking detailed notes on discussions.
• Provide support to project team members on project phases as needed.

Environment: MS Office Suite, MS Visio, MS Project, SharePoint, TFS, UCS, Tesia, Xerox SIR, Microsoft Test Manager(MTM), UML, .Net, MainFrame.

Confidential, Harrisburg PA

Senior Business Analyst

• Interview customers in order to understand identify and analyze their MPSC WIC business process objectives and requirements.
• Assessment Report on Existing MPSC Test Cases
• Worked along project Manager for Project schedule, using MS project
• Worked on Change management and Change estimates
• Working on MIS-EBT Interface and Data Mapping by Interviewing EBT Host Vendors
• Worked on setup of Vendor Peer Groups
• Review/Update Requirements for EBT Interfaces
• Prepare requirements specifications reports and other system documentation
• Prepare user documentation - process documents and training documents as needed for assisting in using the application
• Work with the client to assist in translating functional specifications into technical specifications
• Prepared and asset in preparing implementation plan, requirements plan, QA Plan, Training plan documents
• Lead others in the analysis and resolution of complex problems or events.
• Create and assist in executing test plans for projects
• Assist in identifying new or changed processes associated with this project
• Document process changes revisions and upgrades
• Worked as SharePoint Admin and Analyst
• Assist with and/or lead customer/CAI management presentations
• Assist with customer presentations on the project

Environment: MS Office Suite, MS Visio, MS Project, SharePoint, TFS, WIC Data System, Microsoft Test Manager(MTM), UML, .Net

Confidential, Albany NY

Expert Business Analyst

• Expertise with New York, Michigan & Florida WIC Test Systems
• Worked as eWIC Work Group lead and facilitated User Readiness Session
• Worked on UPC\PLU
• Conducted Market & Technology research on WIC mobile App
• Worked along project Manager for Project schedule, using MS project
• Worked on Oracle OBIEE Business Intelligent Requirements
• Analyzed and documented EBT Stand-besides Terminal, Vendor CertificationProcess
• Performed JAD Sessions by gathering both functional and nonfunctional requirements based on interactions with the stake holders and document analysis, represented them in Requirements Traceability Matrix (RTM)
• Performed Scope Meeting based on JAD sessions with department heads and stake holders and Documented in Gap/Impact Analysis Document for changes
• Interacted with department heads to finalize business requirements, functional requirements, technical requirements and also created Business process Flows.
• Participated in New York ITS bi-weekly Business Analysis & PMO forum
• Facilitated JRP (joint requirements planning) sessions between technical and Program teams for meeting requirements as well as solving problems on a daily basis
• Created all of the following project artifacts as need using MS Office and Visio Requirements Priority Matrix, Business Requirements Document, Gap Analysis Document, Functional Technical Specifications, Use Cases, Screen and Interface Design Document, scenarios document and others as identified
• Used SharePoint to improve the communication of project goals, enhance collaborative development, reduce project risk and increase the quality of application
• Created and maintained Narrative Use Cases (Business Use Cases, System Use Cases) and modelled Use Case Diagrams, Activity Diagrams, Data Flow Diagrams using MS Visio
• Working with matrix team structure, often facilitating multi-disciplinary teams, translating Business/program subject matter information into project artifacts
• Used SharePoint for daily scrum and Work Group Milestones
• Worked as Scrum Master
• Prepared and asset in preparing implementation plan, requirements plan, QA Plan, Training plan documents
• Worked as SharePoint Admin and Analyst
• Worked as Leader & Analyst for Different NYWIC Work Groups
• Worked on NYWIC External Portal
• Involved in RFP preparation process

Environment: MS Office Suite, MS Visio, MS Project, SharePoint, WIC Data System, HP QC, UML,.Net

Confidential, Sacramento California

Senior Business Analyst

• Tested applications and resolved complex problems throughout software development life cycle (SDLC), including preparing detailed program specifications
• Facilitated meetings with offshore; onshore, new and old vendor’s to coordinate seamless transition throughout the project lifecycle
• Worked on Oracle Obiee Reporting Requirements
• Verified claims response messages, accumulator values and % of member liability billing sent from PBM to PIMS
• Conducted thorough analysis on current software systems limitations on 5010 compliant data
• Involved in data mapping and identifying gaps between NCPDP 5.1 and NCPDP D.0 standards
• Engineered new workflows and designs for new 5010 transactions
• Identified gaps between 4010 and 5010 specifications
• Researched and evaluated technology solutions and present recommendations for improved system operations
• Maintained and updated technical documentation for software applications

Environment: Medicaid, HIPAA, NCPDP D.0/5.1, (B1, B2, P2, P3, P4) transactions, 270/271, NPI, DUR, Pharmacy lockin, Medicaid Subrogation, EOBs, Edits/Audits, Reject Codes, Prior Authorizations

Confidential,NY

Senior Business Analyst

• Understanding and assessment of the current ICD 9 codes used by the State
• Creation of a Gap/Impact Analysis Document for changes of the EDI Transactions
• Created NCPDP Transaction business rules and Segments Usage Matrix for this MCO organization
• Tracked Encounter files from the PBM (Pharmacy Benefit Manager) to verify the data content by transactional analysis
• Created a Flat File format to translator NCPDP transactions
• Created a Mapping Document for ICD9 Codes to ICD 10 Clinical Modifications and Procedural Codes.
• Created a Gap/Impact Analysis Document for the Prescription Drug Point of Sale System
• Created a Gap/Impact Analysis Document Operational Analysis Document for the Drug Utilization Review System, Drug Rebate Analysis and Management System and Medicaid Subrogation

Environment: MS Office Suite, NCPDP5.1 , MMIS, Subrogation transaction version 3.0, POS, GEMS, Document Analyzer, SharePoint

Confidential,Bloomington,MN

Business Analyst

• Performed Requirement Analysis by gathering both functional and non-functional requirements based on interactions with the process owners & stake holders and document analysis, represented them in Requirements Traceability Matrix (RTM)
• Interacted with department heads to finalize business requirements, functional requirements and technical requirements and also created Business process model
• Facilitated JRP sessions between technical and regulatory teams for meeting requirements as well as solving problems on a daily basis
• Involved in creation and reviewing of Functional Specifications and created a Functional Requirement Document
• Used Rational Requisite Pro to improve the communication of project goals, enhance collaborative development, reduce project risk and increase the quality of application before deployment
• Created and maintained Narrative Use Cases (Business Use Cases, System Use Cases) and modelled Use Case Diagrams, Activity Diagrams, Data Flow Diagrams using MS Visio
• Followed the adaptive RUP framework for the whole Project life cycle (PLC)
• Fine-tuned search engines and pulled data from different databases and migrated data back and forth using SQL.
• Worked on following applications Business Objects, Enterprise Architect, Toad, PlanView (project management), Microsoft Suite (Word, Excel, PowerPoint, Visio, Access, Project)
• Planview administrator; Responsible for end user training, report development, process documentation, and software administration.
• Employed Rational Clear Quest for effective Change Management (Requirements Creep) and bug tracking during the testing lifecycle.
• Involved in creation and execution of manual test cases in Mercury Test Director and automated Test Cases in QTP and analyzed the Test Results.
• Involved with the QA team to conceptualize, determine and develop test approaches and methods for unit testing, integration and functional testing, load and usability testing according to the application complexity and test requirements

Environment: Windows XP/2000, Oracle, PL/SQL, MS-Project, MS-Office Suite, MS Visio, Rational Requisite Pro, Clear Case, Clear Quest, Quick Test Pro (QTP)

Confidential, Sacramento,California

Business Analyst

• Collect, interpret, and distill customers system requirements into clear specifications and other product/application development artifacts using Rational Requisite Pro and MS Visio
• Conducted user interviews and documented business and functional requirements
• Provided creative solutions to better meet client needs by anticipating, investigating and analyzing specific problems related to systems, networks, providers, eligibility, billing and pharmacy
• Created specifications for EDI HL7 (A28, A31, ADT) and X12 (837/835) transactions that were transmitted between Claims Editor and Legacy Billing application and external Payers
• Developed DBMS queries, knowledge of HL7 and xml interface messaging
• Created and managed Project Templates, Use Case Project Templates, Requirement Types and Traceability Relationships in RequisitePro
• Gathered the system requirements & converted them into System Requirements Documents (SRD)
• Gathering requirements using Rational Requisite Pro and designing structure and behavioral diagrams such as class and activity diagrams using Use Cases and use case diagrams using Rational Rose.
• Worked in testing the Professional, Institutional Claims processing and adjudication and validate data with facets
• Completed the documentation of Claims Scenario’s for the source system

Environment: Windows XP Professional, Oracle, MS Access 2000, Oracle, UML, Rational Rose, Requisite Pro, WebSphere, Rational Clear Quest 2002, MS Office suite, MS Visio 2003