SUMMARY

• Over 7+ years of IT and Management experience in Software Development Life Cycle (SDLC) and Project Life Cycle working as Business Analyst.
• Experience with Health care and Finance sector.
• Experienced in interviewing business users and customers, providing recommendations to resolve issues for various business/technical groups and defining strategic solutions to business problems in a multiple project environment.
• Efficient in MS Project for planning and status reporting.
• Experience in developing functional specs through JAD sessions and user interviews.
• Experience with Object Oriented Analysis and Design (OOAD) using UML, Rational Unified Process (RUP), Agile/Extreme Programming, the Waterfall life cycle, Rational Suite (Rational Rose, Rational Requisite Pro, Rational ClearCase, Rational ClearQuest).
• Strong in developing Use Case Diagrams and creating Use Case Specification document (USD).
• Expertise in managing multiple projects and teams with an excellent track record.
• Strong experience in documenting existing process, analyzing business requirements, working with requirements traceability matrix, re - engineering business processes and designing.
• Experience with 21CFR Part II code of federal regulation, which deals with electronic records and electronic signatures along with HIPAA compliances.
• Experience with claims process and adjudication in the Medicare, Medicaid and Private Insurance Sectors.
• Experience in business requirements gathering and writing, EDI. Versed on HIPAA regulations and requirements. Experienced in HIPAA Transactions 270/271, 278, 837, 835, 834, 820, 276/277.
• Experience in configuration of claims adjudication systems, i.e., MMIS, Amisys, Facets.
• Experience in Quality Assurance of client server and web-based systems with focus on Healthcare (HIPPA).
• Have Incorporated Zachman framework to make Real-time information to make decision. Also used Zachman for New and evolving regulatory requirements. Zachman frameworks are used for Intra and inter company business models and processes.
• Comprehensive experience in business analysis, gap analysis, cost/benefit analysis, testing, development of business requirements specifications, and project planning working with project managers and business sponsors.
• Actively involved in developing, executing and managing User Acceptance Testing (UAT).
• Used Agile methodology and Extreme Programming concepts of system development and fully coordinated the sprint activities.
• Production support for Cognos and Crystal Reports.
• Experience with Peoplesoft EPM.
• Experience with dimensional modeling using ETL tools like Informatica/PL/SQL.
• Experience with analyzing the requirements of datamart. Worked with business users to understand their reporting requirements, worked with Reporting team to develop report prototypes, demonstrated report prototypes to the business users, came up with FRDs for the datamarts.
• Coordinated with data architects and ETL team to understand/drill down on the datamart requirements. Came up with the plan to roll out datamart development efforts in different phases, coordinated efforts to analyze the datamart requirements between teams responsible for various source systems, scoped out the work required on behalf of different teams to adhere to the interface documents to provide data to the data-marts.
• Lead the testing efforts of the datamarts in development, coordinated moving/setting up of processes in dev/qa/production. Worked with QA team and UAT team to go over the various test scenarios for different types of loads in the datamarts.
• Documented the evaluation test cases/test results/feasibility study of various ETL tools like DataStage/Informatica/AbInitio.
• Documented the evaluation of various reporting tools like Cognos/Business Objects, made recommendations about the product depending on the reporting requirements.
• Worked with the reporting team to understand the capabilities of Cognos ReportNet and PowerPlay. Demonstrated these capabilities to the business users, conducted one-on-one and group sessions to educate the business users on various reporting capabilities of Cognos. Worked with vendor teams like Informatica/Cognos to resolve various issues with being faced by development teams.
• Used sqls to test various reports and ETL load jobs in development, QA and production.
• Wrote BRD, FRD, use cases, test scenarios, test cases for testing the functional and non-functional aspects of both ETL jobs and Reporting jobs.
• Proven skills in the areas of Enterprise Content Management using Siebel CRM and Business Process Management (experience with IBM Process Modeler).
• Good knowledge of RDBMS and SQL with experience in Data analysis and reporting.

TECHNICAL SKILLS

Process/Modeling Tool: (SDLC) Software Development Life Cycle, Agile, Extreme Programming, MS Visio, MS Project, Rational Rose, Rational RequisitePro, ClearCase, ClearQuest, TestDirector, WinRunner, Load Runner, HP Quality Center, File-Aid, TSO.

Methodology: OOAD, UML, RUP, Business Modeling and Data Modeling.

Databases: MS Access, SQL server 2000, Oracle 9i/10g, DB2, COLD Repository.

Languages: SQL, COBOL and HTML

Operating Systems: WINDOWS 2007/2000/NT 4.0/XP, Vista.

Office Tools: MS Office 2007/2003/2000, Word, Excel, PowerPoint, Visio, Outlook.

Project Management: MS Project 2007/2003/2000 .

PROFESSIONAL EXPERIENCE

Confidential, Louisville, KY

Senior Business Analyst/Data Analyst

Responsibilities:

• As a Business Analyst, lead interviews and meetings with business associates to gather business requirements for Client Billing, Claims Processing applications.
• Analyzed client communication processes for the Pharmacy Benefit Management Business Unit using Six Sigma process improvement methodology resulting in optimized process performance and cost savings.
• Conducted research on claims, provider relations and enrollment issues to identify root cause.
• Designed Microsoft Access database for capturing and reporting of provider and billing data and developed SQL queries for successful monthly reconciliation of billing files.
• Gathered reporting requirements / specifications for report design in SSRS and performed data reconciliation.
• Responsibilities included assessment of current business processes for the as-is and recommendations for the to-be presented in gap analysis deliverable.
• Involved in the implementation of HIPAA 5010 that required changes to the software, systems, and procedures for billing Medicare and other payers.
• Strong understanding on the Structure of transaction sets (i.e.; Loops, Segments and Data elements)
• Member in interviews (JADs) and meetings to engage business associates/Subject Matter Experts, in business planning, business analysis, and business requirements definitions.
• Responsible for 278, 835, 837 transactions.
• Involved in the conversion of ANSI 837/275 data and images to formats that can be loaded into their claims systems.
• Responsible for mapping documents, test cases, test scenarios, test plan, unit testing, system testing, system integration testing, remediation and configuration of system for HIPAA compliancy.
• Involved Subject Matter Experts in requirements planning/gathering sessions.
• Used Unified Modeling Language (UML) methodologies to design Use Case Diagrams, Activity Diagrams, and Sequence Diagrams.
• Worked closely with the development team to clarify and ensure adherence to business requirements.
• Effectively tracked and managed changes in requirements and scope of project.
• Communication with clients, upper management, other technology specialists, and vendors.
• Re-Engineered AS-IS Business Process in the Relocation Business to build detailed maps for future business processes.
• Prepared Functional Requirement Specification and Business Use Cases.
• Managed Traceability matrix to trace Business Requirements, Functional Requirements and Use Cases.
• Created and overseen the test plan and UATPs (User Acceptance Test Procedures).
• Identified opportunities for business process improvement and initiated efforts to make improvements and problem resolution.

Environment: Requirements Analysis, UML, Agile Methodology, SQL Server 2005 ( SSIS, SSAS and SSRS), Use Case Analysis, MS Visio, Rational RequisitePro, VB, C#, XML, Business Objects, Oracle 10g, Windows XP, MS-Office, Toad, SQL Developer, TeamTrack

Confidential

Business Systems Analyst

Responsibilities:

• Delivered solutions and closed problems in the Problem Queue assigned by running the tests in CLAREDI, HIPAADESK and other applicable Clearing Houses that act as vendors for Confidential ’s EPM clients by analyzing the test results.
• Organized and conducted extensive JAD sessions with users to identify and understand requirements.
• Responsible for doing the gap analysis for the interfacing system.
• Documented the Business Application Requirement Specification (BARR) and the Business Specification Document (BSD).
• Coordinated with the different teams distributed at different geographic locations for various releases.
• Identified Actors, Activities, Artifacts and Workflows and developed use case diagrams using Rational Rose.
• Wrote Use Cases, prepared use case diagrams (using Rational Rose) and followed Rational Unified Process at every stage of the process.
• Followed Scrum development process using agile methodology. Coordinated monthly Sprint planning meetings. During the sprint period, held small daily meetings to ensure the monthly deliverables. Got user feedback at every step of the development process.
• Coordinated with Reporting team for developing report prototypes in Cognos8(Report Studio, PowerPlay), dash-boards, etc.
• Resolved/tracked production issues with Reports in Cognos.
• Coordinated with the ETL team to come up with processes for ETL involving Oracle/Sybase/Informatica.
• Created the test plan and test scripts in the Quality Center.
• Reviewed Test Strategy and Test Plans to ensure that they reflect and include all functional, Performance, Usability and Security requirements.
• Participated in Automated regression and Non-Functional test plans.
• Assisted informational needs in mapping of Test Cases.
• Maintained Test Matrix with the test results obtained.
• Clarified QA team issues and reviewed test plans and test scripts developed by development team and QA team to make sure all requirements have been covered in scripts and tested properly.
• As a point person need to train and guide the testing team during test script preparation.
• Involved in identifying the base testing efforts on a prioritized feature schedule.
• Came up with methods to reduce risks of releasing new upgrades to the system in production by doing a controlled release of new features (upgrades).
• Reviewed Performance/Stress testing results done by analyzing Task distribution diagram, Transaction Profile and User profile, creating virtual users and analyzing different reports.
• Effectively communicated user acceptance test results between users and development team and provided recommendations for change control requests (CCR)

Environment: Lotus notes, Requisite Pro, Rational Rose, Peoplesoft EPM, ClearCase, HP Quality Center, Oracle 9i, Cognos8, Cystal Reports, Informatica 6.1/7.1

Confidential

Business Systems Analyst

Responsibilities:

• Helped create Level I and Level II specifications including VISIO data and program flow charts utilizing Gentran Translator’s capabilities and limitations. These techno-commercial documents were presented to the Confidential for their approval for claims (837I/837P/837D), Service Review Request and Response or Prior Authorizations (278), Eligibility Verifications (270/271) and Claim Status Request/Notification (276/277). Outbound batch transactions included Claim Payment Advice (835)
• Researched the then current application, various compliance issues, providing insights to the architecture group, Security group, and resource management group for effective budgeting, bridging with the Translator vendor’s technical group and converting these semantics to the eMedNY application.
• Helped alleviate the problem of insufficient test data, inaccurate test files by creating large and complex, compliant and non-compliant test files with positive and negative test conditions. Helped achieve conformance by doing unit testing, system testing, regression testing, volume testing, end-to-end testing, user acceptance testing (UAT), Trading Partner enablement by first promulgating test cases and test scenarios and creating a test result documentation methodology that supports a stringent pedantic testing but also eventually supports a realistic production environment.
• Create customized Implementation Guides using the SpecBuilder 5.1 module of EDIFECS software for 837 Professional, 837 Institutional, 837 Dental, 835 Remittance Advice, 276/277 Claim Status/Response transactions /271 and all NCPDP transactions like B1, B2, B3, B4, E1, P1, P2, P3, P4
• Involved in Validating the System in Accordance with 21CFR Part 11
• Created use case narratives to record Subscription business rules.
• Analyzed the business rules for the international user subscription and impact of localization.
• Followed SDLC, which included requirements specifications, design, analysis and testing. Followed RUP methodology with Agile/Extreme Programming and using Rational Test Suite for various phases of RUP.
• Provided technical Expertise on the use of Rational Clear Case and Requisite pro, which were used for Data archiving and Requirements Management.
• Defect Tracking with Clear Quest, Configuration Management with Clear Case.
• Involved in preparing test plan and test cases based of functional requirements using Rational Test Manager.
• Work experience in maintaining datamarts dealing with ETL (extraction, transformation, load) using Oracle and Informatica.
• Dealt with data mapping issues between various source systems and staging area and data-marts.
• Worked with Business users to come up with Reporting Requirements. Reports were developed in Cognos.
• Produced various artifacts Functional Requirement Specifications (FRS) and User Requirement Specification (URS).
• As a point person responsible for resolving business rules/conflict resolution for the development team.
• As member of system architecture team designed and reviewed user interface.
• Developed Business case and assessed the ROI.

Confidential, Cincinnati, OH

Business Systems Analyst

Responsibilities:

• Helped conduct meetings with the end users and performed interviews to gather the requirements from them and to convert those requirements into Requirements document for the development and testing teams.
• Analyzed the business requirements to get a thorough understanding of the testing requirements and developed test plans and created test cases in Rational Test Manager for extensive coverage of the requirements during testing.
• Worked with the developers to understand the ERD (Entity Relationship Diagram) and thus create comprehensive test plans, following the RUP model, for the applications and also gather test data for the data driven test cases.
• Used Rational Rose for providing visual modeling (UML Models) of the business process for the project and providing cross-reference between the code and the requirements during elaboration phase of the design process.
• Provided the sequence and flow diagrams for various modules in the project using Rational Rose.
• Investigated, documented and monitored the defects in Rational Clear Quest.
• Participated in weekly review meetings to report the documented test metrics and defects found in the System. Closed bug reports once they are resolved and verified.
• Involved in Training and Documentation.
• Used MS Visio to create process flowcharts and workflow Diagrams
• Managed Traceability matrix to trace business Requirements, Functional Requirements, and Use Cases.
• Identified opportunities for business process improvement and initiated efforts to make improvements.
• Assisted in designing test plans, test scenarios and test cases for integration, regression and user acceptance testing.

Environment: Rational Suite, ASP, VB, HTML, C++, Java, JavaScript, Oracle 8.0, Windows NT, Business Objects, Informatica 5.1

Confidential, Chicago, IL

Business Systems Analyst

Responsibilities:

• Extensively gathered requirements from all users, experts, and key personnel to understand the current functionality of the existing system.
• Performed in-depth Gap analysis with different business groups to ensure that the system initiatives are met.
• Assisted in modeling and documenting the end-user's AS-IS workflow and TO-BE business processes.
• Created artifacts such as use cases, and developed Use Case Diagrams, Activity Diagrams and Sequence Diagrams using Rational Rose and MS Visio.
• Analyzed and maintained business and system requirements using Requisite Pro.
• Involved in documentation during various phases of product life cycle.
• Designed requirements traceability matrix to trace/manage business requirements.
• Researched best industry practices and implemented best practices via template and process improvement.
• Used Rational Clear Case and Clear Quest as Configuration Management and Change control tools.
• Interacted with the development and testing teams to improve overall quality of the Application.