SUMMARY

• 12+year Experience Business analysis,Business rules, Business case development, Business process improvement, Interface Design and proficient in Business Process Flows,Business Process Re - in engineering,Business Process Modeling & Management.
• 4+ years’ experience in implementing salesforce.com for the sales and support user groups based on the user requirements.
• 4+ years of experience in Report Design, Development, Analysis, Testing and implementation of various multi Complex secure reports from multiple database environments as Data analyst.
• 3+ years of experience in Benefit coding and Blue Exchange coding in Confidential Processing System.
• Experience in Salesforce Communities, Knowledge Articles, Content/Library, Sales & Service Cloud Features.
• Experience in different SDLC methodologies like Agile/Scrum, Waterfall, RUP and V Methodology.
• Highly proficient in writing User stories, creating Use Cases, BPMN 2.0, Swim Lanes, Use case diagrams, Decision Modelling, Workflow Diagrams, Sequence Diagrams, and Class Diagrams etc.
• Liaised withbusinessunits, stakeholders and technical teams.
• Providing functional and technical guidance ofSalesforceBest Practices for Implementation toBusinessProject Leadership.
• Ability to effectively translate Salesforce data into business understandable metrics using Reports (Matrix, Summary, and Tabular), Analytical Snapshots, and Dash Boards (Static and dynamic).
• Experience in SFDC administrative work like Approval and Tasks, Dashboards, Data Loader, Email Services, Escalation rules, Roles, Profile, Creating Users, Page Layouts, Reports, Validation Rules and Workflow Rules.
• Experience in using Data Loader for bulk import or export of data fromSalesforce.com Objects and data manipulation language for data migration.
• Experience with Validation Rules, Workflows, Approval Processes, Processes Builder, Field Updates and Email Generation per application requirements.
• Worked extensively on Accounts, Contacts, Leads, Opportunities, Products, Activities, other Standard Objects and Customized Objects for additional fields, Layouts, record types.
• Proficient in using Agile Scrum methodologies, performed roles of Product Owner, Scrum Master following sprint/standup sessions and used JIRA, CA Agile & Version One extensively to write Epics, User stories, analyzed the Iteration Burn Down charts and reviewed defects.
• Knowledge on the Salesforce Veeva Commercial Cloud and its functionalities.
• Actively worked as a Product Owner with Stakeholders & Agile teams to monitor and prioritize product backlog on an ongoing basis to meet release timelines and value to thebusiness.
• Emphasis on Elicitation of requirements through research, formal-informal sessions, JRP sessions and JAD sessions with SMEs (subject matter experts), Teams, Stakeholders and end users.
• Highly Proficient in SQL, RDBMS, Data Models, Data Mapping, Data Mining and Dashboards.
• Have good working knowledge in queryingSalesforce.com database using SOQL SOSL queries using Force.com Explorer.
• Performed GAP Analysis, extensively studied the as-is state of thebusinessmodel and generated to-be model, highlighting the specific benefits from the application.
• Extensive knowledge and experience in Software development life cycle (SDLC), Requirement Analysis and Software testing life cycle (STLC).
• Expert in Tracking and Managing Requirements using Requirement Traceability Matrix (RTM) to track bi-directional traceability across projects.
• Extensively worked with EDI transactions sets (270/271, 276/277, 835, 837, 276, 850, 824, 820, 810, 855, 856, 860, 997)& strong knowledge of Confidential & FACETS claims processing systems.
• Extensive working Knowledge of Business Intelligence tools like Business Objects 6.5 and Tableau 8.1, 8.2, 8.3.
• Experience in Designing, Creating and Reviewing Test Cases and scripts.
• Effective implementation of testing processes and devotion to testing Disciplines and knowledge on GUI features.
• Proficient in different types of testing such as System Testing, Integration testing, and UAT and Regression testing and familiar with various testing methodologies including End-to-End systems testing.
• Knowledge of automation testing and performance testing.
• Analytical, methodical and resourceful approach to Problem Solving, Root-Cause Analysis, Conflict Resolution, Negotiation Strategies and providing corrective actions to meetbusinessrequirements.
• Excellent Presentation skills with regards to communicating with bothbusinessand technical teams.
• Excellent communication skills and ability to quickly master new concepts and technologies and able to work under tough deadlines.
• Detail-oriented energetic team player, motivated with multi-tasking capabilities, problem solver, and hands-on leader with exceptional presentation and client/customer relation skills.
• In-depth understanding of the capabilities and constraints of the SFDC CRM application and its various licensing types, coupled with a good understanding around business processes.

TECHNICAL SKILLS

Business Skills: Business Definition Requirements, Business Process Analysis & Research, Use Case Modeling & Analysis, JAD/RAD Sessions, Requirements Gathering, and Gap Analysis

Methodologies: Agile Central, RUP, Defect Tracking, JAD, RAD, CMMI, ISO 9001, RUP, Six Sigma

SalesForce.com: Salesforce CRM, SOQL, Workflow & Approvals, Apex Data Loader, Dashboards, Reports, Custom Objects, Case, Management Automation, Workflows and Approvals, Process Builder, Assignment rules, Custom Settings and Custom Metadata, Apex Classes/Controllers, Apex Triggers, Visual Force Pages /Components, Apex Web Services.

Analysis & Case Tools: UML, Clear case, Clear Quest, Rational Rose, Requisite Pro, MS Visio, ER Diagrams, JIRA, DOORS, TFS

Work Flow Tools: MS Word, MS Excel, MS PowerPoint, MS Visio, MS Project, MS SharePoint

Reporting (BI) Tools: Business Objects, Tableau, Micro Strategy, PEGA Reports Assistant, Oracle Form& Reports, Crystal reports

Testing Tools: ALM, Quality Center, Clear Quest, SAOPUI, Test Manager, Quick Test Pro, Win Runner, Load Runner.

Languages: C++, VB, ASP, JAVA, HTML, DHTML, JAVA Script, VB Script, PL/SQL8.0, XML

Databases: Oracle, SQL Server, MS Access, DB2, ODBC

EDI Tools: Facets, Confidential, Edisim, Fecilidi, Claridi, Flexx, BXUI, OBN, PCF, Luminx, ProcerX, NetworX Pricer, McKesson ClaimxTen, McKesson Clear Claim Connect

PROFESSIONAL EXPERIENCE

Confidential, Middle River, Maryland

Sr Business Systems Analyst

Responsibilities:

• Design and develop the PRD,RTX, Requirement clarification tracker, test plan, system readiness and test strategies for the applications and executing them in Microsoft’s Team Foundation Server (TFS)
• DevelopBaltimore County Public School (BCPS) project standards, methods, and procedures to determine data quality using TFS.
• Assist the Product manager to determine the initial in scope / out of scope for all projects and assist in the preparation of project charter, test plans and test reports by using the Microsoft Visual studio Team foundation server tool.
• Work in Agile/Scrum/Kanban environment, partnered with business stakeholders and product Managers in defining agile requirements (Epics/Functions/Stories) using Microsoft Visual studio Team foundation server
• Created workflows for the discipline case management in salesforce service cloud
• Designed the email templates to be configured in process builder
• Participate and manage daily scrum meetings, sprint review to provide the feedback and make decisions to move the user stories to sprint backlog or product backlog.
• Support the Data Warehouse team in testing the data extracts by using Microsoft SQL server management studio, reports and dashboards in Cognos and Tableau to ensure the data quality before every release.
• Contribute to software process documentation to ensure technical accuracy, compliance to mitigate risks and to attain better project results by creating and maintaining the projects in TFS.
• Creating the Source to target mappings for the data migration and data flow diagrams between source and target
• Create and test several Data warehouse ETL Informatica Mappings to validate the business conditions
• Created new custom objects, assigned fields, designed page layouts, records types, custom tabs and components.
• Outlined the organization hierarchy and created profiles, roles accordingly in Salesforce; worked on visibility and security settings around them as required by the business.
• Designed different custom dashboards for various user groups based on their business functionalities and needs.
• Created and deployed several reports for different user profiles based on the need in the organization.
• Created validation rules to perform data validations depending on the requirement.

Confidential, Owings Mills, Maryland

Sr Business Analyst/Data Analyst/Salesforce Administrator

Responsibilities:

• As Business Analyst/Product Owner and SME used Interviews, JAD, and Focus Groups to Study the as is process across different departments in the organization like Claims, Enrollment, Self-Service, EIVR, and CFA to gather and propose the new requirements to build the MTM tool.
• Assist the Product manager to determine the initial in scope / out of scope for all projects and assist in the preparation of project charter worked in Agile/Scrum/Kanban environment, partnered with business stakeholders and product Managers in defining agile requirements (Epics/Functions/Stories)
• As a Product Owner responsible for Product backlogs, Release and Sprint backlogs are always prioritized for the Scrum team to deliver sprint to sprint.
• Supported automation testing performance testing teams by providing the toll functionality and critical requirements that needed to be tested.
• As Product Owner creates and maintains product backlog, prioritizes the PBI, iteration planning, and grooming of the user stories
• Created the Epics, Themes and Features in to user stories and determines the sprint backlog and sprint goal during the sprint planning session.
• Heavily participated in daily scrum meetings, sprint review to provide the feedback and make decisions to move the user stories to sprint backlog or product backlog.
• Develops and analyzes agile team performance reports (velocity and burndown charts) of the team members for the completed sprints for their velocity and provides notations of performance deviations and anomalies.
• Develops the Sprint review reports and represent the anomalies, observations, sprint progress, demos and developed the sprint retrospective reports.
• Participating in the analysis to recommend product enhancements or other appropriate actions to improve productivity for business and IT
• Collect, analyze, validate, and disseminate customer requirements and data required to successfully implement and manage MTM auditing flows
• Develops project plans that define scope, schedule, budget and business impact and risks. Executes plans and identifies issues or obstacles, gains alignment and brings to resolution
• Planned and conducted requirements elicitation meetings with the business to collect functional and non-functional requirements relating to client's Salesforce technology enhancement and initiatives.
• Conducted brainstorming sessions with the development team to actively involve them during the requirements stage level analysis.
• Worked towards preparation of requirements management plan, business and functional requirement documents.
• Created data flow diagrams and process flow diagrams to facilitate better system understanding.
• Assisted in designing and creation of training material and conducted internal training sessions for business users on Salesforce technology functionalities.
• Created new custom objects, assigned fields, designed page layouts, records types, custom tabs and components.
• Outlined the organization hierarchy and created profiles, roles accordingly in Salesforce; worked on visibility and security settings around them as required by the business.
• Designed different custom dashboards for various user groups based on their business functionalities and needs.
• Created and deployed several reports for different user profiles based on the need in the organization.
• Created validation rules to perform data validations depending on the requirement.
• Designed text HTML and custom HTML email templates for auto response to customers.
• Heavily used Salesforce service cloud for the MTM case tracking system and Group creation
• Implemented security and sharing rules at object, field, and record level for different users at different levels of organization. Also, created various profiles and configured the permissions based on the organizational hierarchy.
• Worked on Process Builder in Creating New Records, Post to Chatter, Email Alerts, Submit for Approvals, and Update Related Records.
• Effective employment of Apex Data Loader, Import Wizard and Data Manipulation Language for data migration and management in bulk.
• Extensively did the data analysis, root cause analysis to find the data related issues and process related issues and proposed the resolutions.
• Heavily compared the large set of data by quiring the Facets, Confidential and CFA data bases for the data anomalies.
• Worked with end users to perform unit, system, and regression testing and Developed documentation to detail the testing processes
• Provide analysis of current auditing and reporting practices
• Work with internal stakeholders to optimize services used to maximize performance and minimize cost
• Identified technical requirements and translatedtoadequate technical stories (e.g.: API creation, integrations, code refactoring, etc.)
• Collaborate with internal auditing teams and internal Service Business units to help define and support client’s growing global distribution business model to ensure scalability and efficiency
• Recommend changes to the current auditing system settings based on cost and transit analysis
• Participate in the QA process for system releases and coordinate production testing and launches
• Developed workflow, screen mock-ups, and conversion requirements for all transaction related activities
• Manage the Corporate initiative and Operational projects to meet internal and external customer requirements. Authorized to adjust work schedule as appropriate to meet the needs of the business
• Conduct Impact Analysis for all Change requirements and determine the impact of a change request on project scope, project timelines, and other projects/systems affected, project cost and present the findings to project stakeholders and Sr. Management.
• Act as an effective translator and facilitator between stakeholders, core team and business teams and communicate the requirements to the technical teams
• Submit MTM audit Memorandums to operations Management that outline the root cause of identified issues as well as provide recommendations for corrective actions, system and procedural modification and enhancements to improve service and quality.
• Responsible to collaborate with subject matter experts, architect, business users, data molders and other data analysts to create data mappings for the Confidential & FACETS implementation.
• Generating the timeliness reports for all modules in the MTM out from TRMS data base and performing the calculations to determine the exact timeliness for each unit.
• Generating the Production reports daily with the Bar chart visualization of the data flow across the MTM measures using Tableau.
• Generating the MTM ASU Sample Error Summary Reports for Semi-Annual with the graphical representation for the data visualizations across the months in related to the MTM measures and sending the EVP SBU Status and Discrepancy reports on Monthly basis.
• Generating the MTM Monthly SBU sample Discrepancy and Error summary report to show the waiting for response and agreed errors info and number of audits still pending across all MTM measures daily, which goes to VP’s Directors on daily basis.
• Running the jobs on DB2 database to generate the samples for the member, group, claim, Inquiry, MOS, CFD, BX, and Call/Corr, EVIR and HCBO by using the scripts.
• Generating the Claim waiting for response, Inquiry response, CFA, Group Root cause, Group Status discrepancy reports from the Business Objects 6.5 and Crystal reports.
• Handling the data warehousing and developing the design considerations for star schemas and its relationships for Audits and Claims in DB2 tables on biweekly basis.
• Generating the samples for measuring the internal departments by following the MTM standards from the DB2 by executing the jobs
• Responsible to write the Test cases and Test Scripts for the Service Procurement Re-launch project, MTM Log and MTM FACETS & FISERV projects.
• Tested heavily for the MSP member enrollment in SITB Facets for MSPP reports and tested Member and Provider log activity in Ebiz-CFD and MOS for MTM Log project.
• Participated in the high-level meetings for the integration of the Beeline system and the Clarity system to give SOW transparency for the Users.
• Tested heavily on Beeline UI for the dashboards and WOR and WR for CI DPE and DTD DPE templates and continues the testing for the CI & DTD Non DPE templates.
• Continuously working on the automation process of the reports that generate the timeliness and accuracy of each measure by unit wise.
• Perform follow-up activities related to audits/reviews, special projects, and other duties as assigned thus ensuring that corrective action have been appropriately taken.

Confidential - OHIO

BENEFIT FILE SYSTEM ANALYST/CODER

Responsibilities:

• Loading the data from the Benefit plan design in to BXUI of Confidential Processing System for 270/271.
• Analyzing the benefit plan designs of different kinds of groups like Genc, Non Genc, HMO, PPO, EPO, HAS, HDHP, HRA, HIA.
• Done the Blue Exchange coding of Benefit services in the NPS by reviewing the BPD of the Group for a particular PKG.
• Loading the Accums of the Group for the particular PKG for different benefit Services offered by the Group.
• Reviewed the plan design documents and analyzed the high-level requirements in PDM
• Created the benefit flow diagrams for the plans with associated to their group structures.
• Identifying the sections for the groups in the BXUI, and getting the benefit information of the plan from OBN
• Analyzing the Multiple results for the groups and copying & activating the sections and activating the whole Benefit PKG’s.
• Analyzing the Accums for their codes and definitions to load them in the appropriate services of the Groups.
• Participating in daily status meeting with the Group and with team leads.
• Preparing the group benefit status reports for their completion and activation.
• Loading the Copy, Coinsurance, OOP, Deductible, Benefit limit for IN-Network and Out - Network for services covered under that Group and Plan.
• Differentiating the benefit amounts by the place of service and Benefit limits.
• Accessing the plan Data bases through Lotus Notes & Citrix for the Benefit documentation and PKG’s which need to be coded in BXUI.
• Accessing the Nshare for the Confidential related documentation to upgrade the Knowledge on the system.
• Prepared the benefit grids and mapping the coinsurance, oop, deductible to in-network & out of network.
• Created, mentored and reviewed detailed use case specification documents in requisite pro and requisite web. Also, created and updated activity and use case model diagrams on rational rose.
• Identified Classes and created detailed use case realizations including sequence and activity diagrams on Rational Rose.
• Prepared UML diagrams for the Plan types with respect to their Groups and PKG’s.
• The technologies utilized on this project include Confidential, OBN, BX, MS Office Suite, Lotus Notes, Share point, Business Object 6.5, Crystal Reports etc.

Confidential, Jacksonville, FL

Business Analyst/ EDI Analyst

Responsibilities:

• Researched the Association License Requirement Manual and Business Product Launch documents to elicit the high-level requirements.
• Facilitated requirements sessions with business personals to understand and document the stakeholder requests.
• Developed questionnaire and conducted user survey for better requirement analysis.
• Created System Vision and Use Case Survey documents in close coordination with Rational Unified Process mentors and drove the approval process across project stakeholders through review meetings.
• Responsible for requirement gathering and analysis using RequisitePro and write requirement specification documents, business rules, and storyboards.
• Conducted GAP analysis between current system functionalities and the planned system expectations, created GAP Metrics.
• Worked closely with team leads to create detailed project sizing, artifact development timelines and man-hours assignments.
• Created, mentored and reviewed detailed use case specification documents in requisite pro and requisite web. Also, created and updated activity and use case model diagrams on rational rose.
• Identified Classes and created detailed use case realizations including sequence and activity diagrams on Rational Rose.
• Used Rational Clear Case to version controls various artifacts for multiple projects including dynamic views for rational rose.
• Entering the professional/institutional, dental claims and batch activation, dynamic reporting through eFDE
• Modify existing maps, Trading Partner configuration, Trading Partner setup to implement changes required for new trading partners.
• Validated the Memberships, Member Benefits and claims to make sure the implementation is done correctly or not through HRBK.
• Validated the claims and verified the member plan rules to make sure the adjudication system is using the plan rules correctly to process the claims.
• Tested the different modules in Confidential (Subscriber, Claims, Medical Plan, Billing, Provider, Utilization Management and Routing Rules)
• Performed BlueX &HIPAA analysis and assessment for the claims project following BlueX & HIPAA rules and regulations
• Conducted product validation activities including test planning, test development, issue/defect triage and test execution by performing a variety of tests on the NPS code to ensure claims process according to specifications or to determine cause of claim failure using EEC.
• Prepared and updated the CSR based on the approved requirements in the PDM of Confidential .
• Execute claims testing in the Model office test environment of Confidential Processing System (NPS).
• Responsible for monitoring the processing the claim input and response files, query input and response files which are transmitted using the ANSI X12/270/271 Entitlement query transaction set (version 4010AI)
• Wrote multiple Test Cases (Unit, System, Integration) for multiple transactions include 837I, 837P, 835, (both inbound and outbound) transactions

Confidential, VA

Business Analyst

Responsibilities:

• Knowledge on all application modules in the Confidential DSL and FiOS Software for and Home Customers and Business Customer Software installation.
• User Requirement gathering and documentation using Microsoft Word.
• Was a key liaison between US business team and Indian development team in translating high-level business requirements into technical requirements?
• Served as a liaison between the business and the IT team in order to help and facilitate the development of business, user and functional/non-functional requirements.
• Analyze, define and interpret business needs and issues by gathering, analyzing, documenting and validating the Business, user and technical (functional/non-functional) requirements.
• Participated in feasibility, risk assessment and cost benefit analysis in cooperation with business stakeholders
• Thorough understanding of how to interpret customer business needs and translate them into application and operational requirements.
• Working on developing new requirement document template for Blue Print Requirement Management tool.
• Focused on all levels of requirements - Business, User, Functional and Non-functional requirements and establishes a boundary around the possible solution set
• Ensured all artifacts complied with corporate SDLC Policies and guidelines.
• Created/Updated Requirements Management Plan (RMP) for the projects to define, organize and schedule requirements management and development activities.
• Worked as an Interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes.
• Wrote SQL queries to eliminate duplicate data from MS SQL Server 2000.
• Developed front-end functional specification documents based on reporting requirements
• Prepared detailed Test Plan by understanding the business logic & user requirements for Goal state document delivery project.

Confidential, Baton Rouge, LA

EDI Analyst

Responsibilities:

• Served as a liaison between the business and the IT team in order to help and facilitate the development of business, user and functional/non-functional requirements.
• Analyze, define and interpret business needs and issues by gathering, analyzing, documenting and validating the Business, user and technical (functional/non-functional) requirements.
• Participated in feasibility, risk assessment and cost benefit analysis in cooperation with business stakeholders
• Thorough understanding of how to interpret customer business needs and translate them into application and operational requirements.
• Focused on all levels of requirements - Business, User, Functional and Non-functional requirements and establishes a boundary around the possible solution set
• Lead the Peer review sessions for the PRDs approval/signoff from stakeholders that include Business, design and testing teams.
• Ensured all artifacts complied with corporate SDLC Policies and guidelines.
• Converted Business Requirements to the Functional Specification
• Gathered information about the organization’s work processes and information flows
• Performed Data mapping by moving the data from the Subscriber member database to Bus layout on the mainframe.
• Developed requirements through elicitation, analysis, specification and verification of business needs.
• Involved in implementing Change management, Change control in specific for effective results.
• Interacted with clients and other members of the development and QA teams to ensure delivery.
• Involved in writing Test plans, Test cases and responsible for executing the Test Scripts.
• Performed Smoke, Integration, functional, Regression, and system testing.
• Involved in testing HIPAA EDI Transactions and mainly focused on 835/837,997, 270/271 and 276/277,278,820,834 Transactions
• Performed BlueX &HIPAA analysis and assessment for the claims project following BlueX & HIPAA rules and regulations
• Used Quality Center for preparing the test plans and manual test scripts.
• Involved in creating Data Driven tests using Data Driver Wizard in QTP.
• Used Test Director for reporting the Bugs and performed regression testing after fixing the bugs.
• Involved in loading the flat files into Oracle Database and involved in writing Complex SQL Queries.
• Involved in writing Complex SQL Queries using TOAD to validate the loads for Caremark and DEA.
• Actively involved in QA reviews, WALKTHROUGH and audits during various Software Development Life cycle phases.