SUMMARY

• Over fifteen years of IT experience in solution architecture, process architecture, business analysis, data analysis, design, implementation and software testing.
• Experience wif analyzing business needs, gathering requirements, planning, organizing, documenting, and testing software applications.
• Hands on implementing web, portal, web - services and enterprise applications using object oriented analysis and design (OOAD) methodology.
• Methodologies: experienced wif rational unified process (RUP), agile (Scrum) software development, waterfall methodology, six sigma standards and UML.
• Experience in participating JAD sessions for project definition, analyzing requirements,
• Documentation includes: Business process documentation, HLDD's and LLDD's.
• Experience in creating prototypes, wire frames and UIDD's. Developed use case diagrams, sequence diagrams, state diagrams and activity diagrams.
• Experience in business process definition, risk analysis, use case analysis and process flow diagrams.
• Strong analytical skills, evaluation and high degree of initiative. Coordinate all aspects of project planning, scheduling tasks, tracking, and monitoring risk analysis.
• Worked extensively wif dimensional modeling, data migration, data transformation, data loading, data modeling, Meta data model and performance tuning.
• Design and implement innovative data solutions for complex business problems.
• Experience working wif business and technology client representatives to identify functional and technical requirements. Translate complex functional, technical and business requirements into architectural designs.
• Experience in building overall solution blueprint, long term roadmap of BI platforms to measure TEMPeffectiveness of business processes
• Experience in providing cost TEMPeffective solutions dat meets client requirements and industry best practices.
• Clear and concise articulation, presentation, and documentation of technical opportunities, constraints, recommendations, and action items to both internal and external audiences.
• Extensive experience in data analysis, ETL techniques for loading high volumes of data and smooth structural flow of teh data. Experience in understanding database structures and write SQL/PLSQL.
• Experience in creating conceptual, logical and physical data models and determines teh most appropriate method to represent teh data for business consumption. dis includes all forms of physical representation of data, such as relational, dimensional, object, key-value (such as column families), and graph.
• Adept at writing data mapping documents, data transformation rules, maintaining data dictionary, data migration documents and interface requirements documents.
• Experience in gathering reporting requirements from teh business users for business intelligence, data warehouse application.
• Experience in writing test plans, test cases, generate test scripts and maintain reports for defect tracking.
• Experience in integration testing, system testing, user acceptance testing (UAT), functional testing/black box testing, grey box testing, regression testing, GUI testing, performance testing.

TECHNICAL SKILLS

Operating Systems: Windows, UNIX, Linux, Z/OS and AIX

Languages: SQL, PL/SQL, VB, C++, C#, Java, JavaScript, HTML and XML

Packages: Rational Rose, Requisite Pro, Clear Quest, me log J-Rules, Redmine, Parature and Jira

Databases: MS Access, Oracle 8i/9i, DB2, NETEZZA, Teradata and MS SQL Server.

Office tools: MS Office (Word, Excel, Power Point, Outlook), MS Visio, Lotus Notes, Microsoft Share Point, and MS Project.

Testing Tools: QTP, Rational Functional Tester, Rational Requisite Pro, Quality Center, ALM, Clear Quest and Bugzilla.

Reporting Tools: Crystal Reports, SSRS, Cognos, SAP Business Objects and SAS

Version Control: PVCS, SVN, CVS and Clear Case.

Payer Solutions: FACETS, NASCO, HealthRules Payor, HealthRules CareManager, HEALTHsuite, AMISYS and Epic HealthLink Tapestry

PROFESSIONAL EXPERIENCE

Confidential, Bloomsburg, PA

Data Management Consultant

Responsibilities:

• Analyze teh current GHP data structures and business needs w.r.t to FACETS configuration, work wif Enterprise architects to finalize teh data integration road map for FACETS data.
• Work wif product owners (Provider, Membership, COB, Letters & EOBs) in understanding teh detail FACETS configuration and their detail business requirements and transform data accordingly.
• Document teh Source to Target mapping rules from FACETS to ODS and ODS to DM ODS.
• Lead and coordinate ETL development team to build teh process to load data into respective target repository.
• Facilitate working sessions wif business and customer service teams to finalize teh business rules vs. Transformation rules.
• Work wif outbound Extract and Reporting teams to understand their need and make teh appropriate changes to teh repositories -Data model and transform data accordingly while following teh GHP standard change and release management standards.
• Provide test data as per teh test scenarios; coordinate wif business team to validate teh data once teh data is loaded into teh respective repository for approval.

Environment: SQL Server, Oracle, Informatica, FACETS, AMISYS, Operation Data store (ODS),Ms Visio, & Ms projects.

Confidential, Middleton, WI

Data Management Consultant-Process Architect

Responsibilities:

• Analyze teh current Gundersen & Quartz data structures and business needs, work wif Enterprise architects to finalize teh data integration road map.
• Design and document teh departmental data process flows, include teh IT applications, internal and external interfaces to fulfill teh existing business process requirements.
• Part of delivering multiple data projects by understanding teh business and technical requirements.
• Technical Transition Team: Gundresen business shall be migrated from their current Payor application (Amisys) to teh Quartz Payor application (Tapestry). Teh data team responsibility is to enhance teh current downstream process to accommodate Extract and reporting requirements.
• Responsible to analyze teh data need and design teh data process flows, perform Data profiling, Data quality check, GAP analysis, Impact analysis and publish results wif definite solution.
• Coordinate wif Data Modelling team to update teh Data warehouse atomic tables and provide teh Mapping rules to ETL development team to enhance teh current process.
• Responsible to analyze teh current outbound file feeds to external vendors and update teh Mapping documents to match teh future needs. Coordinate wif ETL development team to make teh developmental changes.
• External Vendor feeds includes HRA vendors, Medical Management vendor, EOB Print vendor, PBMs, Payment Processing vendor, Dental Vendors and HEDIS data to Verscend.
• Reports BO Universe: As part of teh Gunderson Integration project, able to Analyze teh current BO universes impacted wif EDW atomic changes and coordinated wif BO team to make teh necessary updates.
• Medicare Advantage (MA): For MA population, able to analyze teh Delta Dental claims and accumulator data.
• Document teh mapping rules from source to target for inbound and outbound feeds to teh vendor.
• Lead and coordinate development teams to build teh process accept inbound feed from teh vendor and load into teh repository.
• Lead and coordinate development teams to build teh process to extract teh data and transmit to teh vendor.

Environment: NETEZZA(EDW), SQL, Oracle, Informatica, SAP Business Objects, SAS, Epic HealthLink Tapestry, AMISYS, Ms Visio, & Ms projects.

Confidential, Philadelphia, PA

Data Management Consultant

Responsibilities:

• Responsible to design data process flow including teh new IT applications/solutions to fulfill teh existing business process requirements.
• Responsible for coordinating and initiating teh project activities. Generated detailed system requirements wif cost projections. Created and owned teh IT estimates, process documentation and traceability matrix.
• Responsible for facilitating JAD sessions wif Work stream leads, IT leads and Enterprise Architects to define teh scope for file feed extraction and report generation.
• Responsible for documenting Vision, Blueprints and Estimates (HLE) for data extraction, reporting and rationalization process.
• Able to manage multiple medium to moderate size Program releases.
• Works closely wif project teams and PM leadership to address IT tasks, risks and coordinate teh IT project deliverable.
• Extracts: Analyze teh existing inbound and outbound file feeds from external vendors and clients. Rationalize teh feeds and regenerate teh required file feeds in new platform. Feeds Includes Enrollment, Eligibility- Commercial/ Medicare advantage, Claims, accumulators, providers and finance data.
• Operational, Compliance and Client Reporting: Analyze teh current reports. Rationalize teh reports and regenerate teh required reports in new platform.
• Data Sourcing & Governance: Teh project management decision is to leverage existing IBC’s AEDW as future repository for inbound feeds, outbound feeds and reporting purpose. As part of teh sourcing effort teh data governance team was established to monitor teh data needs and comply wif standards.
• Medical Management: Analyze and document teh current medical management process, list all teh interfaces and feeds. Design teh future process, capture teh requirements and enhance teh existing processes.
• Membership and Enrollment reporting: Design an automated process to eliminate teh manual process for generating feeds and reports for internal and external purpose.
• Actuarial and underwriting: Design an automated process to eliminate teh manual process for generating reports.
• Responsible for initiating, planning, executing, controlling, and delivering.
• Performed requirement gathering & analysis by actively soliciting, analyzing business requirements and prepared technical Specification Document.
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify teh transformation rules wif respect to teh business logic.
• Engaged in a series of working sessions wif business and various internal /external technical teams to gather requirements for data transformation.

Environment: SQL (EDW), Teradata (AEDW), Access DB, SSIS, SSRS, MDX, UNIX, HealthRules, Medical Management, Aerial, HealthDialog, Magellan Health, Ms Visio, Ms projects.

Confidential, Ft Washington, PA

Implementation Analyst

Responsibilities:

• Participated in HEALTHsuite Mercato employee training and gained knowledge on technical and functional areas of teh product.
• Analyze GAPs identified during teh discovery phase wif John Hopkins Health Care to implement HEALTHsuite Mercato,
• John Hopkins Health Care is replacing their existing MC400 & IDX wif HEALTHsuite Mercato.
• Responsible for interacting wif business owners (John Hopkins Health Care) and product owners in identifying teh enhancement scope for provider credentialing and fee schedules.
• Able to analyze clients existing credentialing business process flow and incorporate teh functionality wif in Healthsuite application. Able to architect and document requirements for teh provider credentialing module.
• Work closely wif project manager to scope teh delivery timelines.
• Responsible to work wif configuration team to understand teh workflows. Documented Business Requirement/ Functional Specification Document (BR/FS).
• Gathered requirements to document business scenarios and responsible for creating use cases and wireframes.
• Act as lesion between client and product development. Able to prioritize teh requirements and document in detail.
• Able to master teh HEALTHsuite provider module to identify teh workaround for teh client to meet their business requirements.
• Engaged in a series of working sessions wif internal configuration and technical team to quantify in scope and out of scope items for teh enhancements.
• Walkthrough teh Business Requirements and Functional Specification wif client and get teh documents signed off.

Environment: Java, J2EE, COBOL, OLTP, SQL, DB2, Ms Visio, Redmine, Parature, HIPAA X12, WebSphere Partners Gateway (WPG), MC400, IDX and HEALTHSuite.

Confidential, Dresher, PA

Technical System Analyst- Data

Responsibilities:

• Able to work on multiple projects in analyzing teh business and technical requirements.
• Projects:
• Benefit Focus: Replace existing Group Insurance Enrollment system wif Benefit focus. Build process to send and receive feed to/from Benefit focus. Build process to, map and load data from/ to iMax into Enterprise Data Hub (EDH), load data from EDH to DW and BI region for analytical purpose.
• Voluntary Claims (Dell): Build process to send Enrollment feed and receive Claim feed from Dell for Voluntary Claims. Develop process to load data into DW and BI region for analytical purpose.
• Responsible for initiating, planning, executing, controlling, and delivering process modification projects.
• Responsible for interacting wif business owners in identifying teh scope of transforming data from source to target area.
• Able to provide teh work estimates to teh IT team, created and owned teh process documentation and traceability matrix.
• Performed requirement gathering & analysis by actively soliciting, analyzing business requirements and prepared teh Functional Specification Document (FSD).
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify teh transformation rules wif respect to teh business logic.
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of teh data.
• Engaged in a series of working sessions wif business and various internal /external technical teams to gather requirements for data transformation.
• Conducted Walkthrough sessions wif Business, development team and testing teams.
• Involved in conducting manual testing at various phases of teh project development.

Environment: DB2, Oracle, Informatica, Power center, Informatica Analyst, COGNOS, Tableau, XML, Web Services, ALM, GIDW, EDH, Benefit Focus, Enrollment Universe (Data Mart), SAS and Ms Visio.

Confidential, Newark, NJ

Sr. Business System/Data Analyst

Responsibilities:

• Responsible for initiating, planning, executing, controlling, and delivering process modification projects.
• Able to work on multiple projects in analyzing teh business and technical requirements.
• Able to manage multiple medium to moderate size Program releases.
• Projects:
• PBM: Replace Caremark wif Prime therapeutics for Rx Claims process in phase 1, Build process to pass Commercial and Medicare accumulator (History/Daily) feed from NASCO to Prime therapeutics. For Health Care Reform (HCR) mandate updated teh process in phase 2. In Phase 3 adjustments for Tier2 capitation was implemented.
• CDH Payment Processing: Replace My Health Bank wif Evolution 1, for HRA, HSA and FSA Plans. Build process to pass history, monthly and daily Eligibility/Claim feed from NASCO, NMS & Employers data to E1.
• ICD 10 mandate: Update QME logic for teh payment processing application.
• PG Audit: Build process for Performance Guarantee groups for BPM tool.
• Health Care Reform- SBC: Summary of benefits and Coverage generation for Individual, Small medium, Large and National groups.
• CPL Labor Funds: Benefit Mismatch report generation.
• CMS mandate Medicare Advantage Quarterly EOB: Build process to extract feed from EDW to generate Quarterly EOBs for Medicare advantage members.
• Responsible for interacting wif product owners in identifying teh scope of ICoE team in transforming data from source to target areas.
• Able to provide teh work estimates to teh product owners, created and owned teh process documentation and traceability matrix.
• Performed requirement gathering & analysis by actively soliciting, analyzing customer requirements and prepared teh Technical Requirement Document (TRD) and Technical Design Document (TDD).
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify teh transformation rules wif respect to teh business logic.
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of teh data.
• To transfer latest valid data to teh external vendors and internal processes able to analyze and create Gap documentation for Horizon’s EDW and MDM stores. Work wif respective teams to include/Update teh schemas.
• Engaged in a series of working sessions wif business and various internal /external technical teams to gather requirements for data transformation.
• Conducted Walkthrough sessions wif Business, development team and testing teams.
• Other documents designed are data mapping documents, updating layout files and business test cases.

Environment: DB2, Oracle, SQL Server, EDW, MDM, Informatica, Power center, IDE, IDQ, SSIS, OLTP, OLAP, XML, Web Services, SAS, Ms Visio, Share Point 2010, Siebel, TOAD, Thunderhead, Clear Quest, QTP, Quality Center, HIPAA, NASCO, NMS, E1(Evolution 1), ICD 10, CDH, HRA, HSA, FSA, Commercial and Medicare Accumulators, Prime and Caremark.

Confidential, Burlington, MA

Sr. Business System Analyst- Data Conversions

Responsibilities:

• Responsible for interacting wif customer (Independent Health, Buffalo, NY) to scope and deliver a wide range of technical services from a functional and design perspective.
• Support developments by clearly articulating teh customer’s business needs while continually verifying dat teh implementation approach and resulting technical developments meet teh needs.
• Engaged in a series of working sessions wif customers to gather requirements for systems integration. Work wif customer to facilitate large scale and complex data conversions.
• Acts as a customer advocate, working closely wif all stakeholders to understand and clearly articulate teh customer’s business needs and to verify dat teh implementation approach meets those needs.
• Created overview document for data conversion, data mapping documents, detailed instructions, specification documents, pre-requisites, sample files, loader formats and business test cases.
• Obtain understanding of customer's business model and intended use of HealthRules.
• For data conversions worked closely wif teh configuration analysts in setting up CTML polices for accounts, accumulator adjustment, authorizations, claims (converted), provider, membership (& subscription), premium billing and provider.
• Provision appropriate environments for staging, analysis, executing and testing conversions
• For every conversion entity (accounts, accumulator adjustment, authorizations, claims (converted), customer service, fee schedules, membership (& subscription), premium billing and provider) able to define and document business use cases wif customer.
• Advising customers on conversion data sourcing, mapping, transformation, and load technical developments
• Responsible for writing user stories to provide a definition of each requirement so dat teh developers can produce a reasonable estimate of teh effort to implement it. Able to update Microsoft share point portal wif teh updated project documentation.
• Responsible creating use cases, usage scenarios and traceability matrix.
• Using an iterative agile methodology could work side-by-side wif teh customer and teh developers to create teh technical developments throughout a series of rapid iteration deliverable.
• Engaged wif teh customer to demonstrate and test teh iterative work product while making sure along teh way dat teh developments meet their needs. Involved in conducting manual testing at various phases of conversion process.
• Able to advise customers on accessing teh correct web services, database schema's, conversion loaders and other technical components dat are part of teh HealthRules product.

Environment: DB2, Data warehouse, MDM, ERWIN, COBOL, OLTP, OLAP, XML, Web Services, Informatica, IDE, Rally, Cristal Reports, SQL, Ms Visio, Share Point 2010, Siebel, QTP, Quality Center, HP-Exstreme, HIPAA X12, Health Rules and Agile methodology.

Confidential, Kansas City, MO

Business Data Analyst

Responsibilities:

• Performed requirement gathering & analysis by actively soliciting, analyzing customer requirements and prepared teh requirements specification document for teh application.
• Involved in gathering reporting requirements from teh business users. Involved in building data warehouse application,
• Developed information cycle diagrams, data flow diagrams, in MsViso.
• Writing data mapping documents, data transformation rules and maintaining data dictionary, data migration and interface requirements documents. Able to update Microsoft share point portal wif teh updated project documentation.
• Created logical data modeling using tools like CA ERwin data modeler
• Able to analyze and Map source to target mappings using client Tool CDMA (Code and Data Mapping Application) to further develop enterprise data warehouse for Blue Cross Blue Shield.
• Applying Master Data Management (MDM) concepts for data alignment, maximizing analytics and business intelligence promoting corporate objectives and initiatives
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of teh data.
• Involved in data mapping of EDI transactions (834, 837 and 276), creating work flow and activity and use case diagrams.
• Involved in gathering reporting requirements from teh business users.
• Updated requirement documents as per business user feedback and changes, involved in generating test plans and test specifications as per business requirements
• Involved in conducting manual and automated testing at various phases of teh project development.
• Prepared test data for positive and negative test scenarios as per application specifications and application requirements and wrote test plans.
• Manually performed integration and build verification testing.
• Knowledge in relational database concepts like tables, primary and foreign keys, views and referential integrity. Proficient in teh data manipulation using SQL for teh retrieval of data from teh relational database.
• Responsible for defect tracking and reporting. Participated in teh bug review meetings.

Environment: DB2, CDMA, ERWIN, Data stage, Informatica, Cristal Reports, SQL, Data warehouse, Siebel, MsVisio, Documentum, Share Point 2010, HIPAA, Medicare Advantage, Medicaid, FACETS and Quality CenterPROJECT #3: Patient Keeper (Health Care)