SUMMARY

• 11 Years of experience in software development life cycle which includes Business/Systems Analysis, Technical Design and Development Lead, Testing, Support, Analytics.
• Possess vast knowledge on Trizetto Facets acquired by virtue of the various roles in different stages of my career as a Facets Systems Analyst, Solution Designer, Technical Lead, and Developer.
• Specialized in analyzing the US Healthcare related business requirements, designing and developing the optimum and cost - effective solution using Facets which involves developing and unit testing the technical components to implement the same.
• Experience in Analyzing the Business requirements and translating into Technical solution by writing System Use Case and Detailed Technical Design documents.
• Expert Knowledge in Facets Enrollment, Claims, Billing, Finance, Benefits Configuration, Accumulators, Provider and Broker Commission modules and possess good knowledge on the other Facets modules.
• Hands-on experience on HIPAA EDI (ANSI X12 5010) transactions 834, 837 I/P, 270, 271.
• Expert knowledge in writing SQL queries, PL/SQL procedures, efficient query designing, and Performance Tuning.
• Experience in working on a Data warehouse project for the largest healthcare payer which involves Extraction, Transformation and loading the data from various sources like Oracle, SQL Server, flat files, csv files etc. using Oracle SQL Loader, Oracle PL SQL programs and Unix Shell Scripting.
• Hands-on experience on Sybase, Unix shell scripting and ETL tools such as Informatica.
• Hands-on experience on Trizetto Membership Maintenance (MMS), Accumulator (ABI), Billing, Claim Adjudication (CLMU), Claim Payment (CKMM) core batches and good understanding of other batches like BLAF.
• Experience in working end to end in huge projects having complex business rules.
• Hands-on experience on Tidal Batch Scheduler.
• Expert Knowledge on Facets Data model. Working knowledge on Diamond.
• Exceptional ability to diagnose and solve system problems while working under pressure to meet aggressive deadlines in an environment with limited resources.
• Enthusiastic Team member and effectively interact with clients.

TECHNICAL SKILLS

Operating System: UNIX and Windows Operating System

Programming Languages: C, Java, Salesforce Apex, Visualforce.

Databases: Oracle - SQL, PL/SQL, Sybase, MS SQL Server, Salesforce SOQL, SOSL.

Scripting languages: Unix Shell Scripting

Tools: and Components: Informatica, Tidal Job Scheduler, Jira, ALM, Fisheye, Jenkins, SVN, Crystal Reports, MS Office, MS Visual Source Safe, PL/SQL Developer, Toad, Ultra Edit, WS FTP, MS Visio, Eclipse

Data Model: Facets 5.5

PROFESSIONAL EXPERIENCE

Confidentia, Fremont, CA

Technologies: Facets 5.5, Oracle - SQL, PL/SQL, Unix Shell Scripting

Responsibilities:

• Participate in business requirements and functional requirements gathering, which involves a review of existing systems configurations and operating methods as well as understanding evolving business needs. Perform system analysis and capture functional business requirements in the Functional Specification design (FSD) documents for new and change request for the custom interfaces on Facets™. Provide support for business and functional acceptance testing which involves ensuring technical specifications meet business requirements.
• Design, Develop and Support of custom interfaces that feeds data into and/or extracts data from FacetsTM to implement the business requirement. Design and Development includes activities like developing and presenting Proof of Concept to architecture teams and technical leads, develop and maintain database objects like Stored procedures, Functions, packages etc, prepare field mapping, evaluate dependencies, work on data model changes, work with cross functional teams, create detailed flow diagrams, participate in design and code review meetings, Support includes activities like Triage, Investigate and fix defects and provide support to quality assurance teams, Defect Tracking and Perform Root-Cause Analysis on production defects, work with release manager to deploy code to higher environments including production.
• Write unit test cases covering all functional, technical and end to end scenarios for the custom interface developed on FacetsTM., prepare data quality checklists, create test data, prepare test environment to perform unit testing, execute the test cases and defect tracking.

Confidential, San Francisco, CA

Tools: Facets 5.5, Oracle - SQL, PL/SQL, Netezza, Unix Shell Scripting, Informatica, Tidal Schedular, Jira, ALM, SVN, MS Visio.

Responsibilities:

• Participate in Joint Application Design (JAD) meetings and meet Business Users to discuss on the user expectations, understand requirements, elicit feedback and refine solution through demonstrations.
• Perform system analysis and capture functional business requirements in the system use case and boundary specifications documents for new and change request for the health care custom interfaces on Facets™ such as Member Enrollment, ID Cards, Welcome/Delinquency/Termination letters, Generating Bills, Claims Processing, Renewals, Finance /GL, System Configuration and various custom interfaces developed to improve business process and changing government regulations etc.
• Define requirement for data, workflow, logical processes, hardware and operating system environments, interfaces with other systems, internal and external checks and control, system inputs and outputs.
• Present the approach paper, prepare system technical design based on functional and system knowledge on Facets™ system data model and data level field mapping.
• Flow charts of existing and “To Be” processes by applying extensive knowledge and understanding of capabilities and limitations of Facets™.
• Develop structured diagrams for the use cases, sequence flows, and cross functional relationship within modules. Prepares flowcharts and diagrams to illustrate sequence of steps program must follow and to describe input, output, and logical operations involved.
• Derive Proof of Concepts on functionalities achieved by using Facets™ modules such as claims, membership, provider etc. and present to client.
• Lead the Confidential design and development team assigned to the project and ensure quality and timely delivery. Participate in Design and Code peer reviews and provide suggestions and reporting the project status to project managers.
• Programming and automation of Inbound and outbound interfaces on proprietary healthcare core administrative platform Facets™. Work on data model changes to create or modify oracle tables structure, sequence, Views etc. Develop oracle PLSQL database objects such as packages, triggers, procedure, functions, collections, materialized views for data extraction and load process to ensure that data is properly loaded and extracted in and out of Facets systems.
• Triage issues by coordinating cross functional teams on non-production environment. Facets™ Upgrade activities for custom oracle components.
• Investigate data quality issues and implement appropriate solutions. Involve in data migration/conversation activities using SQL*Loader.
• Develop detailed systems operations designs. Resolve problems of intent, inaccuracy, or feasibility of application processing. Write instructions to guide operating personnel during production runs. Analyzes, reviews, and rewrites programs to increase operating efficiency or to adapt program to new requirements.
• Write manual for users to describe installation and operating procedures. Assists users to solve operating problems. Recreates steps taken by user to locate source of problem and rewrites program to correct errors. Conduct technical design meeting prepare support plan for run team, and coordinate with the vendors/business to solve the issues by testing the process.
• Coordination with cross functional development teams such as Tidal team, DBA, Data Services teams for developing the interface and address their clarifications.
• Performance tuning of queries for minimizing the execution time and work with PACE team to improve the query performance.
• Conduct design review sessions with Business, Leads, QA and other stake holders and obtain sign off.
• Responsible for end to end implementation of the requirements right from the requirement gathering to production deployment of the code.
• Extending support to the QA team in answering their clarifications/observations and fixing defects.

Technologies: Facets 4.71, Diamond, Crystal Reports, Sybase, Oracle

Responsibilities:

• To understand the business requirements by doing a complete analysis of the diamond reports and facets data model for migration of the existing code from diamond to Facets 4.71.
• Analyzing Oracle 9i code for migration to Sybase 15.0
• To design and develop Stored Procedures, Crystal reports using Sybase 15.0
• To develop test cases for the enhancement and perform extensive Unit and Assembly Testing.
• To review the code and design documents to ensure that they adhere to the standards