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 healthcare Consulting/ Ba/ Qa Resume

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EXPERIENCE SUMMARY:

  • 9+ years of experience in diversified fields of IT and Healthcare Practices as Sr. Business Analyst/ Consultant and QA
  • Played multiple roles as business analyst on Business Process/ requirements projects and is well - versed in requirements elicitation and analysis, Pre sales activities and consulting
  • Successfully managed client (Payer, Providers and PBM) projects for new products and enhance existing products implementation to meet requirements with constantly changing norms and compliance and accessibility requirements
  • Experience with accessibility projects related to ADA guidelines (2010) and WCAG 2.0 compliance for UI
  • Understood the Client’s Requirements, Deepened Existing Relationships, Provided Customized services
  • Experience in identifying Business Process risks, risk analysis, providing baseline acceptance criteria and deliverables
  • Experience in Business Requirements elicitation, delivery, manage change requests and create/ update business processes
  • Expertise in requirement documentation using Use Cases, User Stories, Page Specs, Mapping Documents and Report Specs in Rational Requirements and other industry standards
  • Expertise in QA skills and have done Integration, UAT and Regression testing. Documented Test scenarios and Test Cases
  • Effective communication skills and record for coordination with business and IT
  • Expertise in Healthcare Insurance domain for Enrollment, Membership, Claims, HIPAA 5010, ACA, ICD-10, EMR/EHR
  • Thorough Understanding of Software Development Life Cycle (SDLC), involved in various phases like Requirements, Analysis/Design, Development and Testing
  • Worked on various project implementation methodologies including Waterfall, Iterative and Agile
  • Performed Business Development and Presales activities for new and existing clients in the different geographical area
  • Expertise in conducting domain training and workshops for employees

TECHNICAL SKILLS:

Languages: C, C++, SQL

Platforms / O.S: DOS, MS Windows 9x, 2000, XP

Data Bases: Microsoft Access, IBM DB2 7.1

Tools: Used: MS Office, MS Visio, IBM Rational Requisite Pro, Pega, Case 360, Clear Quest, JIRA

WORK EXPERIENCE:

Confidential, California

Healthcare Consulting/ BA/ QA

Responsibilities:

  • Gathered system requirements for the new Medicare application for the Cost products
  • Analyzed workflow changes for Agent and Members under Indexing and Membership processes in Pega
  • Updated letters and reports templates and rules to process printing requirements
  • Documented Business requirement in User Stories, Functional Specifications, Use Cases, Page Specs and Report Specs, Data mapping
  • Worked with Business SMEs and Solution Architects to finalize the requirements
  • Performed QA lead role, documented Test scenarios and Test Cases

Confidential, Minnesota

Healthcare Consulting/ BA/ QA

Responsibilities:

  • Studied ACA compliance requirements and understood the impacts on IFP and SG business
  • Analyzed new business processes and Pega/ Case 360 system changes for the Underwriting and Membership workflows
  • Created UI requirements for vendor website and ensured that UI pages are ADA and WCAG 2.0 compliant
  • Prepared User Stories, Use Cases, Page Specs and Report Specs, Data Mapping
  • Helped on test case preparations, defect tracking and resolved defects
  • Identifying ACA compliant changes and applying to the existing Customer/ Agent flows and Back end systems
  • Performed QA lead role, documented Test scenarios and Test Cases

Confidential

Healthcare Consulting/ BA/ QA

Responsibilities:

  • Prepared Business requirement document for benefits piece of Government and Commercial Claims Migration project
  • Discussed and coordinated business requirements and ETL activities with solution providers and business/ technical teams
  • Prepared Use Cases, File transfer specifications for ETL process and report specifications
  • Worked with Business SMEs and Solution Architects to finalize the requirements
  • Performed QA lead role, documented Test scenarios and Test Cases

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