SUMMARY:

• 7+ years of IT experience with expertise in Business Analysis.
• Extensive experience with Healthcare/Medicaid processing as well as the Claims/Billing.
• Extensive success in translating business requirements and user expectations into detailed specifications employing Unified Modeling Language (UML)
• Strong business analysis skills and an understanding of the software development life cycle (SDLC) utilizing Rational Unified Process (RUP)
• Experience designing and developing SQL statements and queries for Oracle Sybase and SQL Server database.
• Strong knowledge of the Software Development Life Cycle methodologies like Agile and Waterfall models.
• Involved in requirement analysis workshops with key stakeholders and created Business requirements document (BRD).
• Worked in the ETL Procedures and processes.
• Reconciled disparate master data from distributed systems and synchronized this reliable data with analytical and operational systems using master data management (MDM) solution Siperian MDM Hub.
• Involved in creating automated Test Scripts representing various Transactions, Documenting the Load Testing Process and Methodology.
• Created meaningful reports for analysis and integrated the Performance Testing in the SDLC.
• Implemented a mechanism to in corporate business - required data that is not in the core Facets system.
• Create Business Requirement (BRD), Functional Requirement (FRD), Use Case Documents, rules, and workflows.
• Experience in writing SQL queries and optimizing the queries in Sybase, Oracle and SQL Server 2000.
• Extensive experience in Business Requirements gathering and writing skills with expertise in developing and documenting Business Requirement document (BRD), Functional Requirement Document (FRD), Software Requirement Specification (SRS) across the deliverables of a project.
• Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence)
• Facilitated User Acceptance Testing (UAT) with the stakeholders and the business users as well as trained users to use the system configured.
• Analytical, methodical and resourceful approach to problem solving, identifying root causes and corrective actions to meet short and long-term business, financial and system requirements
• Excellent verbal/written communication skills and strong analytical abilities and can perform well both independently and as a team player
• Expertise in Logical Modeling, Physical Modeling, Dimensional Modeling, Star and Snow-Flake schema

TECHNICAL SKILLS:

• OOAD (OOA/OOD)
• RUP
• UML
• SDLC
• Waterfall
• QA
• Business Requirements Document (BRD). WAP
• CVS
• TEAMMATE
• MS Access
• SQL Server
• My SQL
• PL/SQL
• Oracle DBA
• DB2. Java
• SOA
• SQL scripting
• Windows basic UNIX
• HTML basic DHTML basic XML
• MS Office Suite-Excel Macros
• Project
• Visio
• Adobe Photoshop
• Flash
• Rational- Rational Rose
• Rational XDE
• DOORS
• Mainframe
• Cobol
• RequisitePro
• CaliberRM
• Crystal Reports various NIKU products
• C
• C++
• SharePoint
• Docushare
• BASIC
• Intermediate level-Visual Basic policy forms

WORK EXPERIENCE:

Sr. Business Analyst

Confidential, Kalamazoo, MI

Responsibilities:

• Produced functional and technical specifications for utilization of Business Objects against Facets, Regence specific and alternate data sources.
• Created and managed functional and technical specifications related to extension and enhancements to the Facets 4.2X environment and standalone applications that utilized Facets data to support a major migration effort from multiple legacy and legacy Facets systems
• Analyzed and gathered business requirements or web-based front-end with mainframe back-end.
• Worked on the existing mainframe system to understand the code written in COBOL, documented the system requirements from the COBOL code and came up with Use Cases from the analysis.
• Performed gap assessment between the HIPAA 4010 transaction and the new HIPAA 5010 mandated requirements.
• Worked on tools viz., MS SQL Server Management Studio, HIPAA regulations for data exchange and security and JIRA to maintain Deployment services, Monitoring and Testing plans and to obtain Continuous feedback.
• Managed the planning and test process for Medicare Part D Pharmacy Claims (PBM) and NCPDP code sets.
• Responsible for extensive medical research of healthcare regulations required to create guidelines for Medicare, Medicaid, and commercial payers
• Created the Requirement Traceability Matrix for use cases with use case drawings, diagrams and test criteria to assist the testing team in understanding the requirement testing parameters.
• Developed and managed project teams in accordance with standards and processes, tracked work plans, issues, risks, dependencies, staffing needs, deliverables and milestones; teams delivered results to corporate standards and exceeded stakeholder requirements.
• Involved in developing the logical and physical data models to support the Data Marts and the Data Warehouse
• Involved in gathering and preparing the requirements documents for replacing the existing commercial lines of businesses from legacy to web-based system
• Establish documentation for agile methodology for implementation with a very water-fall-centric development team.
• Worked on business and data analysis, prepared functional specifications and defined logical data model.
• Communicated CRM progress and incremental successes to management on a regular basis.
• Provided configuration expertise for global configuration strategy and development and worked with multiple conversion and implementation teams.
• Managed several different teams of configuration analysts responsible for system configuration, including product design and loading, benefit conversions and reporting.
• Participated in the actually build of Medicare Advantage plan which included Billing, Capitation, Utilization Management, Customer Service and Claims Adjudication.
• Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Visio.
• Built business requirements into the Medicare Advantage requirements database and created the Project requirements Document for the three functional areas.
• Reviewed the Joint Requirement Documents with the cross functional team to analyze the high-level requirements.
• Utilized SQL queries to extract data from different databases including testing and production for data validation and data analysis; participated in testing software by conducting User Acceptance Testing.
• Prepared presentation slides in MS Project, which was extensively used in different JAD sessions and to track progress
• Facilitated preliminary sessions with the client SMEs for the upcoming 5010 transaction sets on Claims and Payment.

Environment: Windows, Microsoft Office SharePoint, Rational Requisite, MS Office, Mainframe, Cobol, Java, SOA, SQL Server, Agile, MS Project, MS FrontPage, MS Access, EDI and Documentum.

Business Analyst

Confidential, Austin, TX

Responsibilities:

• Gathered legacy system requirements by shadowing Customer Service Representatives (CSRs), Customer Relationship Representatives (CRRs), preparing questionnaires, to identify limitations in the current system and GAPS in the proposed system.
• Created Functional requirement document (FRD), System Requirement Documents (SRD) and Test Cases and implemented test scripts.
• Involved In developing report creation modules in COBOL and COBOL/DB2
• Scheduled and successfully implemented mainframe jobs in production, Identify Member, Provider, Coverage, Medicare, and Medicaid
• Produced functional and technical specifications for utilization of Business Objects against Facets, Regence specific and alternate data sources.
• Responsible for preparing BRD (Business Requirement Document), FSD (Functional Specification Document)
• Utilized Agile/ SCRUM and PMI methodologies to monitor, steer and develop project objectives.
• Worked closely with the Enterprise Data Warehouse team and Business Intelligence Architecture team to understand repository objects that support the business requirement and process.
• Execute Test Plan (execute test cases- system and UAT) on integrating SOA interfaces with JD Edwards.
• Prepared logical data model in the form of Business Context diagram to include various entities and attributes in order to facilitate the design of Data model in the form of ER Diagrams.
• Studied current information structures and data models of the current databases to better understand the design of target data source.
• Develop and maintain sales reporting using in MS Excel queries, SQL in Teradata, and MS Access.
• Produce performance reports and implement changes for improved reporting.
• Interface with internal customers.
• Provide ad-hoc reporting and analysis from data sources including PeopleSoft (SET) and Teradata.
• Performed custom data conversions and developed custom software for risk management applications including general claims, vehicle accident and administrative tracking. Performed all data field mappings.
• Used Rational Rose to model the process using UML to create behavioral and structural diagrams.
• Used Rational Clear Quest to track required changes and Rational Clear Case to maintain different versions of the project documentation.
• Identified/documented data sources and transformation rules required to populate and maintain data warehouse content.
• Prepared Test Cases based on base-lined Requirements Document, prepared Requirements Traceability Matrix and provided Performance Testing Requirements.
• Worked very closely with the Test team to Test all iterations during the Testing Phase and documented all the defects.

Environment: Windows, HL7, Microsoft Office SharePoint, Congo's, Agile, Rational Requisite Pro, MS Office, SQL Server, Cobol, DB2, JAVA, SOA, J2EE, MS Project, MS FrontPage, MS Access, EDI

Business Analyst

Confidential, Philadelphia, PA

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Performed Requirement Analysis and developed UML Use Cases, Activity Diagrams using Rational Rose to understand the requirements.
• Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions.
• Worked as a team and responsible for developing on-demand Medicaid Management System reports.
• Used the Agile methodology to build the different phases of Software development life cycle. (SDLC)
• Analyzed the existing claims process and specific business rule logic will be applied in the requirement model.
• Proven experience in requirements gathering, functional design and all facets of system testing Analytical day to day support for Enrolment and Billing system enhancements.
• Involved in creating business processes and modelling diagrams using Rational Unified Process (RUP). Worked as a Data analyst.

Business Analyst

Confidential, Washington, DC

Responsibilities:

• Involved in development phase meetings for Business Analysis and Requirements Gathering.
• Coordinated various kinds of User Acceptance Testing (UAT) including regression testing, system testing, integration testing, functional testing, alpha & beta testing.
• Built business requirements into the Medicare Advantage (MA) requirements database and created the Project Requirements Document for the three functional areas.
• Involved in the Oracle Data Integrator ODI as the ETL tool and OBIEE for the reporting. Proficient in ETL using ODI and OBIEE.
• Responsible for integrating with Facets.
• Designing test scripts for testing of Claims in Development, Integration and production environment.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Developed & executed several Optimized queries in SQL on this data.
• Created Graphical representation of reports such as Bar charts, Pie charts etc. as per the End user requirements using Business Objects and Crystal reports.
• Analyzed Business Requirements performed gap analysis and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
• Responsible to import the data from Crystal reports by using Business Objects Live office into Microsoft Excel and Word.
• Conducted user interviews, gathered requirements, analyzed the requirements by using Rational Rose, Visio and Requisite pro - RUP
• Prepared Business Requirement Documents (BRD's) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Analyzed the given source Dimensions and target Fact table structures to develop Surrogate Key tables referencing required dimensions.

Environment: RUP, UML, SDLC, UAT, Use Case, Rational Test Manager, XML Spy, Data Stage, Rational Requisite Pro, Rational Clear Case, Clear Quest, Rational Rose, Visio, Agile, DB2/UDB Universal Database Oracle, MS SQL Server, HTML, XML, UNIX, Windows NT, Sybase.

Business Analyst

Confidential, Houston, TX

Responsibilities:

• Gathered User and Business Requirements through Surveys, Prototyping and Observing From Portfolio Managers and UI (User Interface)
• Analyzed and Prioritized User and Business Requirements as System Requirements That Must Be Included While Developing the Software.
• Responsible For Installing, Configuring, Upgrading And Maintaining A Scalable And High Performing Solution.
• Prepared and maintain Business Rules Spreadsheets (BRS) identifying Rules, Triggers and corresponding data fields from Legacy to target CRM application.
• Worked in mainframe environment and used SQL to query various reporting databases
• Involved In Inception Phase And Prepared Logical Data Models That Contains Set Of Diagrams And BRD (Business Requirement Documents) Supporting Documents Containing The Essential Business Elements, Detail Definitions, And Descriptions Of The Relationships Between The Actors To Analyze And Document Business Data Requirements.
• Planned And Defined System Requirements To Use Case, Use Case Scenario And Use Case Narrative Using The UML (Unified Modeling Language) Methodologies.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Created Use Case Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Visio.
• Having Good Knowledge on Development on SDLC Methodology.
• Involved in scheduled Meetings with Developers, System Analysts (SA) and Testers to Collaborate Resource Allocation and Project Completion Using MS Project.
• Created Mock-Up Forms In MS Access For Better Visualization And Understanding Of The Software Solution.

Environment: J2EE Technology, Test Director, Windows Advanced Server, DB2, XML, Toad, UNIX / Oracle Platform, Cognos, mainframe, MS Visio, RUP, Rational RequisitePro.