SUMMARY:

• Over 7 years of experience as a Systems Analyst/Business Analyst in Healthcare and Telecom Industry.
• Health Insurance Background - Specifically related to collecting requirements, documenting and representing the business, Use Cases, Business process improvements, etc.
• Experience with healthcare system and with prime focus on claims adjudication, provider, eligibility and prior authorization.
• Extensive experience with the SAS programming and in data step and with various SAS Procedures in Base SAS and SAS/Stat, including thorough knowledge of SAS Macro.
• Expert in developing Business and System Requirements, Design Documents, working with requirements traceability matrix
• Very good at writing documents like Business Cases, Vision and Scope Documents, Statements of Purpose and Requests for Proposals.
• Proficient in MS Office Excel (pivot tables, vlookups, hlookups, macro), Access, PowerPoint, Visio.
• Extensive experience in writing Use Cases and UML diagrams.
• Good understanding of Software Development Methodology including RUP and Agile methodologies. Facilitated many JAD sessions and Brain Storming sessions.
• Experienced in White Box/ Black Box Testing, User Acceptance Testing (UAT), Unit, Integration, Functional and Load testing.
• Assisted QA team in developing Test Scripts, Test Cases and Test Plans for the User Acceptance testing.
• Strong in developing test plans, test strategies, test cases, test data, test checklists, defect tracking & reporting, preparing test summary reports and conducting status meetings.
• Experience in conducting Backend testing by writing SQL queries and executing them.
• Ability to multi-task and work smoothly even under extreme pressure. Experienced in creating and enhancing Test Scripts in WinRunner, QTP.
• Familiar with Load and Stress testing. Experience in Software Quality Metrics
• Excellent experience managing the whole testing process using Mercury Interactive Test Management tool Mercury Quality Center.

TECHNICAL SKILLS:

Programming Languages: C, C++, C#, VC++, VB, VB.NET, C#.NET, ASP.NET, Java, SQL, PLSQL

Operating Systems: UNIX, Windows 95/98/NT/2000/XP, Linux.

Databases: MS-Access, MySQL, SQL Server, Oracle, Teradata, DB2, Sybase

Application Servers: IBM Websphere, ATG Dynamo, BEA WebLogic.

Internet: HTML, XML, VBScript, ASP, JavaScript, JSP, J2EE.

Automation Tools: MS Visio, Rational Rose, Rational ClearCase, Rational RequisitePro, Documentum

Bug Tracking Tools: Mercury TestDirector, Rational ClearQuest

Utility Tools: MS Office Suite, MS Project, TOAD, Adobe Photoshop

Reporting Tools: Crystal Reports, SQL Server Reports (SSRS)

Data warehousing Tools: Informatica, Business Objects, Cognos, Erwin

Testing Tools: Quick TestPro (QTP), TestDirector, WinRunner, LoadRunner

PROFESSIONAL EXPERIENCE:

Confidential, Washington, D.C.

Sr. Business Analyst

Responsibilities:

• Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams
• Consulted with healthcare third-party Administrator Company to develop conversion specifications for member, enrollment, and authorizations.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Claims. Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Involved in Service Oriented Architecture (SOA) of the claims processing system
• Worked on broad range of technologies, including business process tools such as Microsoft Project, Primavera, Promodel, MS Excel, MS Access, MS Visio, technical assessment tools, Micro Strategy Data Warehouse Data Modeling and Design
• Involved in Scrum development process and prepared Sprint burn down chart, product catalog and sprint backlog contain Business Requirements and supporting documents that contain the essential business elements and definitions as well as the tasks to be completed.
• Working with clients to better understand their needs and present solutions using structured SCRUM approach
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOD using UML
• Involved in all phases of software development life cycle in RUP framework.
• Used Rational Rose to model the process using UML to create behavioral and structural diagrams.
• Developed detailed Developer specification to reflect technical details of the business requirements
• Performed data analysis by using SQL queries using the DB Artisan tool
• Extensive experience in using collaborative tools like Mercury Quality Center to facilitate development across disparate teams
• Provided management support to the off-shore End to End Integration / Regression Test Team
• Prepared UAT Materials UAT Test Cases to include various steps involved for UAT and to have proper coverage of requirements

Environment: Windows 2000/XP, Microsoft Office SharePoint 2007, Cognos, Rational Requisite Pro, MS Office, SQL Server 2005, HTML, DB2, MS Project, MS FrontPage 2003, MS Access, MS Excel, Business Objects, EDI,TSO/ISPF,UML.

Confidential, PA

Business Analyst

Responsibilities:

• Involved in all phases of software development life cycle in RUP framework.
• Analyzed, documented, and managed all project requirements and changes to requirements throughout the software development lifecycle using Requisite Pro.
• Conducted user interviews, attended JAD (Joint Application Development) sessions, and documented analysis in requirement gathering.
• Identified the use cases from the gathered requirements and prepared a comprehensive Use Case Specifications document.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Verified and validated data model with changes to business information and rules.
• Developed UML Use Case model for the application using Rational Rose and assigned to prepare the detailed work flow diagram based on the proposed enhancement for the system.
• Extensively interacted with both user group and development team in coming up with structured charts, class and sequence diagrams.
• Created Use-Cases and Business Use-Case Model after accessing the status and scope of the project and understanding the business processes
• Integrated Requisite Pro with Clear Quest and Rose to provide all teams visibility and maintain tractability among requirements, use cases and change requests
• Managed all the requirements in Requisite Pro, making requirements available to all team members.
• Customized the test scripts using check points, synchronization and parameterization of data.
• Automation of test scripts was done using QTP for test re-usability of different online transaction modules.
• Set up test environment to facilitate Test Plan.
• Used automated test tools (Win Runner) to verify functionality, predict system performance and test scalability prior to deployment.
• Conversion of data from different database environments, while performing Back End Testing.
• Responsible for executing Volume Testing, Compliance Testing, Data Quality Testing.
• Responsible for status check at regular timeframe.

Environment: Rational Rose, Requisite Pro, Rational Clear Case, Feasibility Analysis, Risk Analysis and Gap Analysis, RUP, UML, SQL, MS-Office, MS Project, MS Visio

Confidential, PA

Sr. Business Analyst

Responsibilities:

• Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites.
• Performed the requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro.
• Documented the server farm requirements and requirements related to security within Share Point and using Windows Active Directory.
• Followed a systematic approach to eliciting, organizing, and documenting requirements of the system.
• Reviewed the Joint Requirement Documents (JRD) with the cross functional team to analyze the High Level Requirements.
• Used Query Analyzer, Execution Plan to optimize SQL Queries.
• Created the test data 837P, I, D and tested multiple fields for HIPAA validation and business edits.
• Involved in the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for processing of Claims.
• Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.
• Planned and documented procedures for data processing and prepared data flow diagrams for the application.
• Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology
• Analyzed trading partner specifications and created EDI mapping guidelines
• Documented the Traceability Matrix for tracing the Test Cases and requirements related to them.
• Developed Data Conversion Strategy for converting data from the existing site to the new site.
• Designed and developed project document templates based on SDLC methodology
• Prepared Demo on SharePoint for various Business to get new approvals like the Therapist and Nursing divisions.
• Involved in developing the test scenarios and test cases and helped in developing QA Test plans for Functional, Integration and Regression Testing.
• Designed workflows and allocated permissions within SharePoint.
• Performed Unit Testing and User Acceptance testing and documented detailed results.

Environment: Windows 2000/XP, Microsoft Office SharePoint 2007, Cognos, Rational Requisite Pro, MS Office, SQL Server, MS Project, MS FrontPage 2003, MS Access, EDI, Documentum 2.0.,UML.

Confidential, CT

Business Analyst

Responsibilities:

• Gathered, analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Performed Cost benefit, ROI and ROM studies
• Conducted user interviews and documented business and functional requirements.
• Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Created use case scenarios and documented work flow and business process using Rational Rose
• Involved in project management using MS Project
• Documented requirements, associated change requests with requirements and connected requirements with Use cases.
• Incorporated Rational Unified Process (RUP) to create Requirement Document Specifications using Visible Analyst.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
• Used Rational Clear case for version control
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• Served as conduit for managing system requirements between the business and the software development team.
• Queried database using SQL for backend testing
• Used Rational clear quest for defect management

Environment: Windows XP Professional, Oracle9i, MS Access 2000, MS Excel, RUP, Oracle, UML, Rational Rose, Requisite Pro, Clear Case 2002, Cognos, Rational Clear Quest 2002, MS Office suite, MS Visio 2003.