- 9+ years of experience as a Sr Business Analyst and Project Management technical, analytical and best practice methodology (Agile) skills.
- Experience in providing monthly reporting to executives for forecasted opportunities and risks to the long - range business plan and presented mastered reporting and forecasting techniques as well as created a forecasting model in Excel.
- Experience in create new Power BI dashboards and reports to modernize business intelligence (BI).
- Experience in monitoring database used to track placements, facilitate optimization of revenue by monitoring daily reports.
- Experience in providing sales force profitability analyses; forecast returns by lot and owned daily sales report submission to executive leadership.
- Experience in delivering application lifecycle tracking tool, within modified project timelines and within budget.
- Worked as an EDI Business Analyst with significant experience in writing business and functional requirements and analyzing EDI solutions in a high volume environment
- Skill-set includes Business Analysis, Project Management and SDLC.
- Instrumental in identifying gaps, bringing matrix teams together to crosscheck review potential interdependencies and priorities.
Agile Practices, SQL, Cyber Security, Automated Testing, Gap Analysis, Documentation
- Provided support for FEP Next Gen Project moving from mainframe systems to B2B ITX so as to standardize the FCR to standard 837 claims
- Worked on Archival Error handling in the new system and global error handling
- Created stories in Jira for Batch summary,exception handling and load balancing
- Worked as a data analyst to create mapping documents for Trans Audit Tables,created routing logic flows for Pend/Denied claims and groomed the stories with the team
- Prepared and maintained technical documentation including flow charts, models, and procedures, user guides, scorecards and reporting to assist with the ongoing operation and maintenance of technology solutions.
- Created new stories for development and assisted testing team to create test cases
- Used SDLC processes and associated tools, analyzes current system targeted for replacement/enhancement to determine business and technical functions to be included in design.
- Worked on release planning with Scrum Master and made changes to the stories as changes occured
- Attended daily stand up meetings,planning meetings and retrospectives as per the schedule of the project
- Afte grooming the user stories,worked closely with developers and testers to answer questions and made changes to the work flow
- Functioned as a liaison between Production Technology, Account Management teams and business clients in gathering, defining and understanding client’s needs.
- Worked with different modules of Strataware-Smartcoder, Smartview, Pathways, Pricing
- Create new Power BI dashboards and reports to modernize business intelligence.
- Involved in data mapping from Coventry to Stratcare, applied business rules for the conversion processing.
- Created a list of new fields added moving forward with new client Liberty Mutual not in the Stratacare layout from different FSDs.
- Created Pathway Vocab rules t in Pathway module.
- Created Bill History Conversion FSD for Stratacare and Liberty Mutual.
- Investigated old bills and created new bills to understand the system in Strataware.
- Transformed the business requirements and solution into Project Charter, Client Requirements Document (CRD) Conceptual Design Document/Functional Specifications (FSD) and Software Change Request Documents.
- Collaborated with Supervisor, Subject Matter Experts, and Product Managers to find the best approaches to address the client’s requirements.
- Conducted or Participates in Joint Application Design sessions with Development and Quality Assurance Teams.
- Conducted the User Acceptance Test on assigned Projects/SCRs.
- Provided current market, economic and technical information and updates as well as external changes impacting trading activities to customers
- Ensured issues identified, tracked, reported on and resolved in a timely manner.
- Established priorities and foster strong relationship with the business.
- Provided a concise specification of customer’s project requests.
- Monitor database used to track placements.
- Facilitated optimization of revenue by monitoring daily reports.
- Provided sales force profitability analyses; forecasted returns by lot and owned daily sales report submission to executive leadership.
- Developed Procedures manual for tracking placements.
- Properly represented project status in the BI Project Tracker.
- Understood Fixed Income, Bonds and Bond Trading Cycle, Equities and Equity Trade Cycle, Derivatives (Options and Futures), Portfolio Management, Wealth Management, and Sales and Marketing.
- Improved monthly close process by creating custom Excel VBA macros and multiple excel templates
- Managed and resolved reported user concerns and defects in a timely manner.
- Maintained and updated status reports of open issues and communicate status of active projects.
- Managed business-facing communications.
- Facilitated priority-setting processes and ensured projects executed in order of business priorities.
- Developed report specifications and work with report developer to design reporting solutions.
- Engaged business users in testing and feedback.
- Troubleshot reporting issues and escalated to appropriate people as needed.
- Provided to end users on report context and purpose.
- Responsible for creating user stories in CMC Appirio Tool.
- Performed reverse engineering in Cognos reports and found the source code.
- Created new report types and reports in Salesforce after mapping source data from legacy systems to Salesforce.
- Involved in updating user stories after talking to different stakeholders within Sales, Marketing, and Enrollment etc.
- Worked closely with Tableau developers to create views and dashboards.
- Worked as a Business Analyst on Med D requirements for Eligibility migration from CMS and Independence Blue Cross to Highmark’s provider portal, and claims system implementation.
- Involved in gaining understanding of Med D Portal on Confidential side and building process flows.
- Involved in meetings with Independence Blue Cross, Highmark and Confidential stakeholders for B2B discussions and Eligibility testing files.
- Prepared requirements for charter and understanding the process of Med d flows related to Claims and Accumulator.
- Involved in preparing FTP document for file transfers.
- Worked with software developers to specify and implement improved reporting capabilities for Independence Confidential Med D web portal using the agile SDLC.
- Gathered requirements and created process flows for future Med D web portal after different JAD sessions with stakeholders.
- Managed and developed EDI specification, gap analysis and applications structures for data feeds and mappings for integration between various systems to follow ANSI X12 4010 formats including:
- 270/271: Eligibility/Benefit Inquiry and Information.
- 276/277: Claim Status Request and Response.
- 834: Benefit Enrollments.
- 835: Remittance Advice.
- 837: Claims and Encounter.
- 997: File Transmission Acknowledgement to meet and exceed HIPAA requirements set forth by the federal government.
- Worked on checking Eligibility files and updating the file with new coverage codes and assisting testing of Eligibility file.
- Identified gaps in daily extracts on both platforms by data mapping, Excel.
- Reviewed existing EDI mapping document and transformation rules and proposed new mapping and transformation rules
- Captured Data flow diagrams and formatting of the data flowing modeling through interfaces.
- Collaborated and participated with all interrelated teams including project management, development, QA, support,, technical, and infrastructure teams as appropriate.
- Worked as team JIRA administrator providing access, working assigned tickets, and teaming with project developers to test product requirements/bugs/new improvement.
- Created technical documents documenting JIRA project configurations.
- Prepare unified business process maps to show the common functionality in both the platforms.
- Participated in customer weekly JIRA progress updates.
- Served as a liaison between the internal/external business community and the IT organization using Agile methodology in order to provide technical solutions to meet user needs throughout the SDLC.
- Translated business requirements into functional specifications for the IT organization for NASCO large groups, managed changes to such specifications in SDLC.
- Responsible for managing the SDLC documentation on 4 concurrent projects.
- Acted as the primary EDI contact for suppliers, external customers, and internal business units.
- Used the HP ALM tool for putting the requirements and maintaining traceability.
- Gathered information about the organization’s work processes and information flows for NASCO & FACETS.
- Documented existing process in technical model format in order to evaluate and define new IT solutions and implementation processes in SDLC.
- Involved in /EDI transactions Analysis, Design, Implementation and Documentation.
- Created use-friendly documentation that clearly communicated the important, required EDI changes in order to ensure successful claim batch transmission.
- Assisted with building the EDI 837, 835, 270/271, 276/277, 278, 820 and 834 transactions processing flow from the vendor to the translator
- Used swim lane diagrams and context flow diagrams during gap analysis.
- Supported several simple to moderately complex business processes.
- Investigated and analyzed feasibility of low to moderately complex enhancements, automations and processes.
- Analyzed, defined and interpreted business needs and issues by gathering, analyzing, documenting and validating the Business area(s) and user(s) technical (functional/non-functional) requirements.
- Participated in the creation of complex PRD (Project Requirements Document) which includes defining Business, User, functional and non-functional requirements needed for approval by Business and for use by Design, Development and Testing teams.
- Participated in creation of Requirements Management Plan (RMP) for complex projects and created RMP for less complex projects, to define, organize and schedule requirements management and development activities.
- Participated in the tracking and management of open issues and assisted in planning for resolution for complex projects.
- Maintained communications with technical counterparts to adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.
- Led testing efforts by defining, developing and implementing practices and procedures for complete end user test plans.
- Ensured all user acceptance tests conducted and documented according to standards. Identified and documented system deficiencies and recommends solutions.
- Responsible for overall success of user acceptance testing, including results verification and release.
- Assured that all artifacts comply with corporate SDLC policies and guidelines.
- Worked closely with system analysts to help create Proof of Concepts (POCs) and alternative.
- Responsible for writing all documentation in clear and well-organized manner.
- Developed key project deliverables including requirements specifications, use cases, system test cases, and documentation and user manuals for projects of for low to moderately complex.
- Supported the production of Requirements Traceability Matrixes (RTM) and RTM gap analysis reports for complex enhancements, automations and implementations.
- Used project management techniques to establish roles and responsibilities, monitor project and request status and workload, and ensure deliverables of high quality, effectiveness and timeliness.
- Managed assigned enhancements, automations and implementations from concept through implementation.
- Developed requirements- functional and non-functional and established traceability matrices for NASCO & NMS Groups.
- Developed and utilized Impact Analysis, Gap Analysis, Level of Effort assessments, and SDLC methodologies.
- Used JAD sessions to interact with users (business domain) and with developers and testing personnel (technical domain) to create mapping documents.
- Performed data profiling using SQL for NASCO groups.
- Ensured all artifacts complied with corporate SDLC Policies and guidelines.
- Served as BSA Lead with hands-on activity developing and implementing SDLC methodology for all BSA projects focusing on Project Feasibility Analysis, Project Complexity Matrix and Project Lifecycle Timeline standards.
- Validated the HIPAA/EDI transactions, tested the claims processing and Adjudication (EDI837 & EDI 835
- Worked with team towards Procurement initiatives by collaborating with cross-functional teams to achieve enterprise process and policy compliance improvements.
- Worked with the business to help develop new methods of communication with its staff including Lotus Sometime and IBM Workplace Web Content Management.
- Prepared a Lotus notes based process flow to track migration status and automate administrative functions.
- Developed and manage procurement systems to meet business needs.
- Participated as a team member in the migration of Lotus Notes to Outlook including testing: data transfer and the internal and external GUIs.
- Performed Source to Target Mapping Documenting Business Rules/Use Cases for NASCO groups.
- Obtained knowledge of all NCPDP practices as related to routine releases as well as business and client -specific technology implementations.
- Worked with business and technical team members to identify/validate business rules.
- With help of Informatics developer, Generated Group History file from CAG lookup table after it get loaded from all three sources (i.e. CAG excel spread sheet, NMS and NASCO).
- Used Informatica, Generated Control file for Group History and Daily.
- Updated/added Small Groups from NMS and any changes done to CAG table sent to Prime as a daily feed.
- Pulled all the groups from CAG Look up table where delete indicator was not set to Yes and sent it to Prime.
- Used Informatica Power Center to extract the active and Inactive groups from the CAG lookup table for NMS & NASCO.
- Used Business logics to determine the respective attribute fields and generate the Target Fixed width PRIME file for group daily as well as for History for both NMS & NASCO.
- Worked closely with the QA team & assisted them to develop quality Test cases by referring the Use cases.
- Worked on defects, which sent by the testing team and resolved them in time with help of developers.
- Assisted the QA team to complete the performance testing of the integration project.
- Performed requirements Analysis & Design, RFP/ RFI creation using Rational Rose and Requisite Pro.
- Assisted with the Project Manager to define project milestones, schedules, monitoring progress and updating plans using MS Project.
- Defined systems work scope and objectives based on Business Requirements.
- Worked in different types of Projects such as CBR (Client Billing & Reporting) and Prior Authorization (Pricing & Drugs).
- Supported PMO by mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
- Delivered application lifecycle tracking tool, within modified project timelines and within budget.
- Responsible for understanding the use cases and business rules and make the appropriate changes to the data model.
- Used both Star Schema and Snowflake schema methodologies in building and designing the logical data model in both Type1 and Type2 Dimensional Models.
- Responded to RFP's, RFI's, and RFQ's in a prompt and professional manner by using Qvidian and other resources
- Worked with requirement gathering of QL & Rxclaim by interacting with the various SMEs of Confidential through interviews and prototyping.
- Supported procurement team in reducing the aging of inventory items received but not invoiced from outside vendors by improving management reports and highlighting vendors driving the aging problems.
- Checked the SharePoint Site to Access Monitoring and Reporting of SharePoint Sites.
- Monitored and analyzed SharePoint usage and activity.
- Created new conceptual, logical and physical data models, reviewed these models with application team, and modeling team.
- Monitored and analyzed SharePoint content and storage.
- Acted as Integral team member in the implementation project of NCPDP.
- Prepared documents in adherence to URAC standards and assist with URAC renewals.
- Responsible for creation of corporate compliance program related to Bank Secrecy Act and Anti-Money Laundering
- (BSA/AML) efforts, including new accounts and know your customer’s policies and procedures. Responsibilities included drafting 10 policy and procedure documents, streamlining and updating all aspects of Program, developing and teaching programs, and managing staff of one. Supported Chief Compliance Officer in all audit/examination matters, tracking, reporting, and maintaining all records relative to BSA/AML program.
- Implemented Actimize Anti-Money Laundering (AML) system to monitor suspicious transactions and enhance regulatory compliance.
- Interacted with Cash Management Division and Compliance Office to review the AML (Anti Money
- Laundering) requirements and provide Positive Pay service to reduce check fraud.
- Worked on establishment of the AML (anti-money laundering) program, including implementation of new AML software.
- Worked with SAS Anti-Money Laundering enterprise solution that facilitates the critical task of suspicious activity monitoring using a risk-based approach.
- Worked with Patriot act compliance and Import Export compliance business rules
- Worked with SMEs to automate OFAC scrub
- Assured that all Artifacts are in compliance with corporate AGILE Policies and guidelines.
- Interacted with the business users in knowing the business views and gathered the reporting requirements to design the universes and business objects.
- Expertise in Logical Modeling, Physical Modeling, Dimensional Modeling, Star and Snow-Flake schema
- Worked closely with the Enterprise Data Warehouse team and Business Intelligence Architecture team to understand repository objects that support the business requirement and process.
- Assisting programmatic review team with systemic wire transfer issues via payment and SWIFT subject matter expertise
- Designed data models, logical models, data dictionary, data mart, data warehouse data mining, conceptual and logical relational database, star schema, extended star schema, tables, columns, attributes, relationship (primary, foreign, composite keys), sorting, sequencing, stored procedures, triggers, search criteria and Prototypes.
- Designed the Dimensional Model of the Data Warehouse Confirmation of source data layouts and needs
- Extracted the data from SQL Server, Oracle, Files, and Access into Data warehouse.
- Designed Data Stage ETL jobs for extracting data from heterogeneous source systems