- Over 11 plus years of work experience as Project manager, Business Analyst and Lead Quality Analyst on large and time boxed projects with strong domain knowledge in Health Care Provider and Payer, Commercial, and Investment Banking, and Travel & tours industries on their onsite and offshore projects.
- Having excellent knowledge and expertise on research, finding and project planning type of work for different healthcare organizations.
- Worked as a SME on Medicaid Management Information Systems (MMIS), Medicaid Information Technology Architecture (MITA) including Medicare, Medicaid, Medicare Advantage, MediGap, and also worked on MMIS Design, Development, and Implementation (DDI).
- Extensive experience in writing user stories, organizing technical review meeting, attending Story Grooming Session and facilitating to development and QA teams for more clarification and coding support. Also worked on MS Team Foundation Server (TFS) for accomplishment of project tasks.
- Extensive experience in writing test cases, handling testing activities, executing test activities, and writing test report. About 8+ years of work experience in managing, handling and executing test cases for different projects under the agile scrum software development methodology. Also having considerable amount of experience on waterfall methodology as well.
- Having work experience and expertise level knowledge on different claim adjudication systems e.g. Bluechip, FEP Express, FACETS, Magic, Coordinator Mouse, PREP, BlueSource, TSO, Availity, VDR, and also used Clarity PPM, Sharepoint 2013 and 2010, Lotusnotes, Webex, citrix, and NetMeeting for communication and information.
- Gained good experience on Configuration of QNXT followed by business rules around adjudicating claims, member eligibility verification, and authorizations. Worked on all three kinds of ( 837P - Healthcare Claim Professional, 837I - Healthcare Claim Institutional, and 837D Healthcare Claim Dental) membership, claim and contracts.
- Well known and having sound understanding and hands on experience on comprehensive health reform, Affordable Care Act (ACA) Obama Care, Life and Disability insurance, and medical claim policies and requirements including benefits, membership, enrollment and implementation. Also, worked on Special Needs Plans (SNPs/Snips) under the Medicare program to expand coordinated care for vulnerable seniors, insurers and managed care plans.
- Worked on different claim processing tools including Inter-Plan Teleprocessing Services (ITS), Health Reimbursement Arrangements (HRA), Flex Saving Arrangements (FSA), BlueCard Program, BlueExchange transactions, and Health Savings Account (HAS).
- Worked as a Business Process Analyst and provided support for diagnosing and improving business processes and increasing efficiency. Analyzed different tasks include analyzing past trends, monitoring workflow, making predictions, developing business process models, recommending enhancements and assisting the management in making decisions.
- Documented the Requirement Traceability Matrix for tracing the Test Cases and requirements and documented and assisted the QA Team with the Test Plan. Also worked on different types of testing in different environments e.g. UAT, UIT, and SIT testing including regression, parallel, load runner and many of other testing techniques.
- Worked on Defects management including analysis, retesting, verifying, and approving process. Used Rally and HP QC /ALM for testing purpose. Worked as a HP QC administrator as well.
- Extensive knowledge and working experience in Software Development Life cycle (SDLC), Project Life cycle, Business Process Modeling (BPM), Joint Application Development (JAD), Six Sigma and in Software Development Methodologies including Rational Unified Process (RUP), Waterfall, and Agile.
- Extensive knowledge in converting business requirements into UML diagrams using Rational Rose and MS Visio and also managing and tracking those requirements.
- Experience in process modeling using Use Cases, Sequence Diagrams, Collaboration diagrams, Activity Diagrams, Class Diagrams.
- Extensive experience in producing documents like Business Requirements Documents (BRD), Functional Requirement Specifications (FRS), Software Requirement Specifications (SRS), Creating Request for Proposals (RFP), creating Requirements Traceability Matrix (RTM).
Business Tools: Epic, Retalix, Proxis Store Manager Classic, TeleTracker Business Suite, Amadeus, Sabre, NotePad++, Adobe Acrobat, Business Explorer, Rally, Toad, Data Warehousing, WCM, Adobe CQ5, Lotus Notes, Availity, TFC, BlueChips, FEP Express, Kofax, SharePoint, Sabre GDS, amadeus.
Testing Tools: HP Quality Center/ALM, SoapUI, REST API, QTP/UFT, Load Runner, Rally, JIRA
SDLC Methodologies: Waterfall, Agile Scrum, RUP, Six Sigma
Claim Adjudication support Tools: BlueChip, FEP Express, Epic, VDR data System, BlueSource, Coordinator Mouse, ezclaim, ARC Memo Manager, PUTTY, WinSCP
Financial: SAP/FICO, Quick Books Pro, ARC Manager, MS Excel Financial, Double Entry Book Keeping System tools: General Ledger, Profit and Loss Account, Balance Sheet, Bank Reconciliation, Forecasting and Budgeting, Oracle ERP, ADP, Paychecks, ResortSuite, MemberPride.
Sr. Business Analyst
- Worked as a Scrum master and Sr. Business System Analyst for Integrated centralized Healthcare Calendar and the whole healthcare environment e.g. closest healthcare facilities and their activities, social organizations, sports, health and fitness, educational institutions, financial organizations, private and public community events, fun providing centers etc and other all social networks.
- Instructed and modeled core agile principles of collaboration, prioritization, team accountability and visibility; ensured consistent application of scrum methodologies across the enterprise. Also, organized and facilitated sprint planning, daily stand-up meetings, reviews, retrospectives, release planning, demos and other Scrum-related meetings.
- Lead and managed project activities, resources, human resources, and carried out other HR jobs e.g. supervision, evaluation, and reporting activities. Also organized daily stand-ups, managed scrum ceremonies, planned for next sprint, kept track of burn down and increased strength of team components and resolved issues.
- Handled all the activities of the SDLC of the project “Integrated Healthcare Calendar” for facilitating to stakeholders including developers, quality analysts, users and others to move forward aggressively.
- Built a system to Pro-Active Members and Passive Members to get involved with the project product (Integrated Healthcare Calendar) and made them aware of advantage of the product.
- Worked on Microservice-oriented architecture (SOA) architecture and MS TFS (Microsoft Team Foundation Server) to work on project development activities. Also worked on SOA Testing including creating test cases to executing test cases and dealing with the defect cycle.
- Documented process flows and developed requirements for functional improvements and enhancements.
- Keep batch tracking records for each and individual files that used for testing purpose. Also follow up with the Citibank for payment status.
- Worked as a SME on HL7, ICD 9 and 10, Medicare, Medicare Advantage, MediGap, MMIS, HIPAA, HIE, EDI Transactions, EHR and all other compliances to accommodate healthcare compliances to the healthcare centralized calendar.
- Followed the Agile Scrum SDLC Methodology and coordinated the project team for JAD and BRD Sessions through documentation to the development, testing and implementation phases.
- Prepared Functional Design Specifications (FRS) employing Use case scenarios, sequence diagrams, DFDs and class diagrams.
- Documented the Requirement Traceability Matrix for tracing the Test Cases and requirements.
- Documented and assisted the QA Team with the Test Plan. Also worked on different types of testing in different environments e.g. UAT, UIT, and SIT testing including regression, parallel, load runner and many of other testing techniques.
Hardware/Software: MS SharePoint, Cristal Report, VDR, Availity, Cognos, MSP, MSPP, JIRA, TFS, Confluence, CM Mouse, System Magic, SharePoint, MS Visio, XML, SQL, MS Project Professional, MS Project, Lotus Notes, WebEx, and Microsoft Office package.
Sr. Business Analyst
- Worked as a system integration BA for SynXis CRS to Olson, and SynXis CRS to Property Management System (PMS) along with different channel connects e.g. Voice Agent (VA), CRM, and other operating partners e.g. AVAYA, TREC and Ecommerce platforms.
- Worked on Financial Application Upgrading project including Oracle based Property Management System (OPMS) and Enterprise resource Planning (ERP) Financials and Human Capital Management (HCM) applications.
- Lead daily stand-ups and scrum ceremonies for two scrum teams. Work with product owners to groom the backlog and plan sprints. Track, escalate and remove impediments. Report at daily Scrum of Scrum meetings. Track burn down, issues and progress in Version One. Work with component teams to resolve issues.
- Assisted team with making appropriate commitments through story selection, sizing and task definition and participated proactively in developing and maintaining team standards, tools and best practices. Also, Facilitated as a Scrum Masters to its offshore teams in India.
- Organized and facilitated sprint planning, daily stand-up meetings, reviews, retrospectives, release planning, demos and other Scrum-related meetings.
- Taught the team to create clear and concise epics/stories, and defended stories in to the backlog meeting.
- Implemented ‘Planning Poker’ Scrum methodology to plan for product backlog by filling the wish list (numbers).
- Instructed and modeled core agile principles of collaboration, prioritization, team accountability and visibility; ensured consistent application of scrum methodologies across the enterprise.
- Implemented Issues Tracking in Version One to effectively track impediments against user stories.
- Resolved a complex infrastructure issue by creating and utilizing a professional network of Scrum Masters, Product Owners and Technical Leads within Sabre.
- Established the automated loyalty management systems for optimization of goodwill and revenue. For the purpose, established the loyalty driven automated pricing systems for Wyndham line of hotels where customized ‘Free Night Stay (FNS)’ and ‘Point and Cash Redemption (PAC)’ were established as of major Loyalty tools for its dynamic pricing.
- Worked on System Integration among SynXis CRS to Olson, and SynXis CRS to Property Management System (PMS) along with different channel connects e.g. Voice Agent (VA), CRM, and other operating partners e.g. AVAYA, TREC and Ecommerce platforms.
- Worked on functional flow of integrated application system including ERP Financial, Home Office and Vendors applications. Also, created change request and complete the change management cycle.
- Handed over project artifacts and sat with development and testing team to facilitate them.
- Attended one to one meetings, conference call meetings, client site meetings, and used other means of communication to gather project requirements.
- Having extensive experience on writing User Stories, attending ‘Technical Review’ session, defending user stories in ‘Grooming Session’, and participating the ‘Sprint Planning’ session.
- Conducted interviews, meetings and JAD sessions with project management, technology people, business people, users, advisors, and finance people during the Requirement Gathering process. Reviewed the Business Requirement Documents (BRD) with the cross functional team to analyze the High Level Requirements.
- Provided continue support to development and QA teams. Developed process flow depicting business activities, and performance metrics, also worked on utilization of COTS products, and also used TFS.
- Started working on High level requirement (HLR), and as directed by HLR Worked on requirements gathering using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, task and workflow analysis.
- Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology.
- Provided input (scope, goals, risks, constraints, timelines and interfaces) to PM for project planning and control.
- Involved in various business operations and helped the organization to achieve cost-effective services with increased quality, efficiency and satisfied customer service.
Hardware/Software: Altove XML SpyAPI, CA Rally, Sabre GDS, Amadeus, team SharePoint, TFS, Oracle Financials, ERP Tools, ADP, Paychecks, Control Center, XML, SOAP UI, SQL, Sabre Outlook, Primavera, Oracle SCM, Travel Spec Documents, VB Scripting, and Microsoft Office package.