- Over 20 years of experience in IT Industry with more than 15 years focused in Healthcare/Insurance segment spanning multiple roles like Business Analyst, Data Analyst, QA & Production Support Analyst etc.
- In the last 12 years have worked primarily as a IT Business Analyst supporting Data Warehouse systems in an healthcare environment supporting Financial, Business and Analytical needs/requirements.
- Have complete understanding of the SDLC lifecycle and been engaged in the different phases of the SDLC like High level design, development, deployment and post implementation activities in many of the projects/programs.
- Experienced working with distributed and global teams in multiple time zones. Experience working with both IT and Business stake holders effectively
Senior Business Analyst
- As a BA in UDW team supported Data Warehouse Operational Activities
- As part of UDW team, supported the critical PRDS monthly Eligibility process, and generation of PRDS/UDW Eligibility Reconciliation Reports, engaged in the analysis of reconciliation issues with respect to Eligibility etc.
- Handled UDW/PRDS Month End QA check out process with respect to various domains like membership, claims, etc, Healthcare data and supported the analysis for same for the issues identified as part of the QA process
- Supported and been part of different source system data feed issues like UCR Claims Highway, Rx Solutions pharmacy claims issues, etc with respect to UDW
- Handled and supported various issues/tickets with respect to PRDS UDW Data Migration activities during the design, development, and Operation tasks/activities
- Have also been part of PAPI Operations and Maintenance, Decommission and PAPI/UDW Migration activities.
- Has lead the effort and was responsible for generating the UDW Monthly Metrics Report for about 6 months
- Had started to learn the critical UDW data reconciliation process in different domains in UDW with respect to different source systems.
- UDW is Teradata based, was getting acquaintance of same.
- As BA in Confidential Data Store (PRDS) team supported Data Warehouse Operational Activities since mid of 2009 till end of 2016
- Developed very strong working relationship with various PRDS users and worked with them directly to support issues or queries or concerns.
- Over the years, have worked on several PRDS (PRDS is an Oracle RDBS) Service and Problem tickets with respect to multiple domains - member/membership, providers, benefits, claims, capitation data from different legacy source systems like ILIAD, RIMS, NICE, and lately Galaxy/UDW
- In the due course, have been part and led many of the root cause analysis (RCA) activities and created RCA documents with respect to critical issues
- Handled and resolved some of the critical issues like NICE and Galaxy member coverage overlapping issues, NICE Provider address issue, NICE Encounters claims issue, etc
- Supported the PRDS Security/Entitlement Reviews for more than two years
- Actively supported the documentation of the PRDS release notes for the PRDS Monthly Communications to Business Users
- Engaged in handling the PRDS Service Calls / Problem tickets management process and documenting/updating the problems/issues in the ticket log
- Supported many of the PRDS Decommission activities for 4 years
- Have supported in the creation, update/management of various PRDS Codesets used in some of the PRDS critical weekly/monthly production processes.
- Have satisfied the PRDS Business users critical needs and requirements in timely fashion and had good rapport and relationship with Business users and team members.
- On multiple times over the years, have lead/managed, supported, and worked on some of the PRDS critical month end/ year end operational issues and activities.
- For the issues worked upon, detailed analysis, documentation, different fix approach, post fix QA results, all the details have been documented with data examples, visio/data flow diagrams where appropriate, for critical issues in the Root Cause Analyis (RCA) documents, and also for other issues shared the details and communicated with team and Business for future reference.
- Responsible for creating requirement documentation (BRD)
- Responsible for creating data mapping documents & High level design documents and Functional specification documents
- Interfacing with key business stakeholders of RIMS and Galaxy team to understand and create a detail mapping documents with descriptions for the source and destination fields
- Handled and supported various issues/tickets with respect to Data Migration activities during the design, development, and Operation tasks/activities
- Extensively Supported the QA and Development team during the development, system testing and deployment phase of the projects
- Responsible for conducting User acceptance testing
Environment: Unix, Oracle 9i, Windows XP and Ascential DataStage 7.5
Business Analyst / Quality Analyst
- Extensively supported the System Integration Test - SIT activities for various application areas of MAPD ODS
- Accomplished the ODS validation tests for NICE Subscriber billing data, ECOR Capitation - Bid data, MMR- monthly membership report data from CMS, PPR - Plan Provider Report data successfully
- Performed the ODS SIT for NICE Member, NICE and Qiclink Member Month successfully
- Performed ODS SIT for Premium, Rx Claims, Member and OSA Off System Adjustments Summary applications successfully
- Involved in the design, development of PDE - Prescription Drug Event Contingency plan - monthly process for MAPD ODS
- Supporting the ETL development activities for PDE Estimate and Response and various applications code enhancements as per the changes in the business requirements.
- Involved in the SIT Load activities for various PDE and Member application areas
- Completed all the required documentation for SOX Audits for Capitation, Member, Member Month, Summary and PDE Applications
- Supporting the activities towards the Production Implementation for MAPD ODS
Environment: Unix, Oracle 9i, Windows XP and Ascential DataStage 7.5
- Extensively involved in the Analysis, Design and development of the Source System - NICE piece into the Common Medical Claim Layout (CMCL) of the ACP Project. The CMCL format data to be loaded into Financial Data Store (FDS), Integrated Financial Systems (IFS) and IBNP (Incurred but not paid) data models
- Worked closely with the NICE SME’s to understand the NICE source system and requirements
- Created the Extract to CMCL Data mapping document specific to the NICE source system
- Worked on the functional design piece of the project for disaster recovery, SOX & HIPPA regulatory requirements
- Performed the NICE load for SIT (System Integration testing) for 8 iterations of cycle1 - march data processing into FDS, IFS and IBNP datastores
- Created the documentation for all the completed activities.
Environment: Unix, Oracle 9i and Ascential DataStage 7.5
Business Analyst/ Developer
- Acquired in-depth knowledge of the Functionality, Infrastructure Integration, System Architecture, Project Planning and Business Systems Requirements of the Project by reviewing the Statement of work (SOW) of related Projects and various reference documents
- Participated in the analysis of Business Requirements and attended all Business Meetings related to RIMS Source System
- Extensively worked on the Gap Analysis for RIMS for subject areas Claims, Eligibility, Pharmacy and Providers
- Analyzed the Prescription Solutions data to address the changes for RX extracts from all source systems, NICE, ILIAD and RIMS for PAAX RX data model
- Extensively involved in the analysis of SDHP (Self Directed Health Plan) Claims data, Phase1 and 2, by going through the related documents, cross checking with SDHP and regular RIMS claims data mapping documents, ran the queries as part of analysis for SDHP implementation into PAAX data model
- Updated the Data Mapping Documents, Gap Analysis Documents related to RIMS and other systems
- Performed Peer Review of the Conceptual Design and Functional Requirements Document
- Assisted in completing the Functional Requirements Document for Rebuild1
- Worked on completing the Functional Requirements Document for the PAAX Enhancement Project for the Business to Sign off
- Helped in managing and updating the Action Items of the Project by constantly interacting with the Business and the Team to get the solutions and the Business rules finalized for the Business Requirements
Environment: Unix, Oracle 8i, Windows 2000 and Ascential DataStage 6.0