SUMMARY

• IT Project Management Certified from UIS with 7 years of experience in business analysis and improvement
• Elicit business, functional and development needs with executives and various IT teams
• Facilitated JAD sessions, trained and supervised teams for quality and process requirements
• Extensive experience in UML creating Flow charts, Use Cases, Class diagrams, Sequence diagrams, Activity diagrams and State Transition diagrams
• 7 years experience with creating business and technical requirement documents through extensive business analysis (BRD, TRD/FRD, CCR, Roadmaps, User Story, EPICS)
• Experienced in Waterfall,AGILE (Iterative) methodology
• Extensive Analysis and mapping experience for supporting project needs and development efforts
• Worked on enrollment and eligibility systems - NASCO, Sales Portal, MMIS
• Experienced through all phases of SDLC along with Production Support and Operational Transition Efforts
• Performed GAP analysis, used Blue Works Live, Use Cases, Story Boards and Wire Frames/ UI Mockups
• Hands on experience with Project planning, operations support and setting mile stones
• Familiarity with data modeling concepts and experience in interpreting file/interface conversions
• Practical implementation using Rational tools, UML and BPMN modeling
• Experienced in creating/executing test cases/test scripts, UNIT testing and User Acceptance Testing (UAT)
• Strong in creation and interpretation of Business specifications and Test Plans, Test Scripts and Execution
• Experience with EDI Transactions 834, 837, 820, 270/271, 278
• Performed reporting using MS Excel functionalities, SQL and designed reports
• Proficient SQL skills, extensive hands on experience in using MS SQL Server
• Facilitated Joint Application Development (JAD) with all the stakeholders of the project for review and discussion of goals, project status, and resolving issues and conflicts
• Trained and supervised teams during projects regarding quality and mentored Business Analysts
• Created/maintained project plans using MS Project, resource allocation and assignments for work streams
• Created Project Management documents, track budget, create Network Diagrams to track project slack
• Create Risk Management Plan, create Critical Path Method and Program Evaluation Review Technique method to evaluate project status/success rate, knowledge of crashing projects
• Extensively worked with Data Modelers and Enterprise Architects on Master Data Management projects
• Experienced in identifying, developing and documenting business and functional requirements
• Proficient with eliciting requirements through one on one discussion, workshops and presentations
• Currently pursuing Project Management Institute PMP certification
• A dependable team player and good understanding of what is expected from a professional
• A well balanced understanding of business relationships, business requirements and a logical solution approach for acquiring set goals

TECHNICAL SKILLS

Methodologies: Agile, Waterfall, Iterative, JAD

Management & Modeling tools: MS Visio, Rational Rose, Bizagi Business

Process Management: Software, BPMN, Visual-Paradigm

Databases & RDBMS: Oracle SQL Developer, SQL Server, MS Access, NASCO, MMIS, FACETS

Testing Tools: MIS File Viewer, HP Quality Center

Web Technology: XML, HTML, JavaScript, VB Script

Project Management: Microsoft Project, ClearQuest, Rational Requisite Pro

Modeling Language: UML, Microsoft Visio, Rational Rose, Bizagi Suite, Blue Works Live

Other: MS Office, Share Point, Lotus Notes, Clarity, Crystal Report

PROFESSIONAL EXPERIENCE

Confidential, Worcester - MA

Lead BSA/PM

Responsibilities:

• Elicit business needs and create user stories, business & functional requirement documents, Failure Mode Risk Analysis through gap following Iterative methodology (Agile)
• Created and maintained Project plan using MS Project by creating milestones and Work Breakdown Structure
• Distinguish user requests from the underlying true needs via discussions using BRD, presentations and Use Cases, Epics and User Stories
• Crashed project due to aggressive timelines and scope creep keeping schedules intact.
• Created context diagrams, process flows and end to end interface diagrams using BPM notations
• Consult/guide business users and elicit requirements using interviews, document analysis, requirements workshops, business process descriptions, Use Case, business analysis and workflow analysis
• Create Context Diagrams, Use Cases, User Stories, End to End process flows, Use Cases and UML
• Use TFS, Share Point and MS SQL Server on a regular basis for project activities
• Use MS Excel and SQL queries to retrieve and analyze member and claims data within data marts
• Created Risk Management Plan, communication plan, Project Charter, issue log and track project progress as per the organizational PMO Standards and adhere to the review processes
• Facilitate in creating & executing the transition plan and Production support for project work to Service Team
• Create WBS tasks for core team members to accomplish and track progress keeping track of Float/slack days.
• Maintain documentation on TFS and track budget on a regular basis due to project uncertainty
• Evaluate Slack/float days and costs using MS Project and also verified project success through Critical Path
• Keep track of Regtap announcements, work with teams to solutionize and march towards implementation dates
• Review 834 Enrollment, 820 Premium Payment and Per Member Per Month (PMPM) data received from the State & Fed’s
• Perform analysis, data mapping for report creation and submission to CMS
• Conduct research on project-related topics, based on publicly available information and CMS newsletters
• Work closely with architects and developers to validate data sources, map data, create crosswalks and finalize testing criteria’s
• Interact and work closely with diverse group, executives, directors, VP’s, subject matter experts, solution architects, quality analysts, developers and Ops team
• Used Clarity for tracking assignments and logging work efforts
• Assist in provision Amazon Web Sphere - EDGE Server, design internal reports, resolve Issues and road blocks within projects along with maintaining issue log
• Perform data analysis and data mapping for report creation and submission to CMS
• Create Issue Log and remove road blocks within projects through teamwork and discussions
• Design Reports, create support plan, Operations Support Document, Communication Plan and provide bi-weekly status updates to the Service Delivery Manager
• Created testing criteria’s for the Enrollment, Medical Claims and Pharmacy Claims data files being sent to the EDGE Server
• Create roadmap documents with detailed to assist developers in creating the 3 reports in xml
• Built and maintained relationship with stakeholders and made efforts to keep the team moral up
• Facilitated JAD sessions, core team meetings to meet aggressive deadlines, acted as a liaison between the business, QA and development team

Confidential, Newark - NJ

Lead BSA

Responsibilities:

• Created evolving current and interim state end to end process flows using IBM - Blue Works Live (BPMN)
• Created BRD, Failure Mode Risk Analysis (FMEA), RTM, road maps, SIPOC and other business documents as per EPMO and Business Solutions Group (BSG) standards
• Assist in creating Risk Management Plan, maintain Project Plan and march according to set milestones
• Assisted Cognos, EDW, Finance and IT teams with the data mapping and aligning TRD development
• Created Project Estimates for the current effort and Future EOC integrated project for all impacted systems
• Developed UAT Plan, test scripts, Reports and presentations to documents for resource and cost estimation
• Maintain issue logs to keep track of different assignments and resolve requirement challenges
• Designed reports, screen wire frames/mock ups for Shared Savings UI and Contract Terms Repository
• Assisted IT teams with data mapping and aligning TRD development with the business needs
• Created Project Estimates for the current effort and Future EOC integrated project for all impacted systems
• Created detailed roadmap documents for Reporting requirements and Shared Savings UI and algorithm
• Create Work breakdown structure for sculpting down the scope and clarity of dependencies and work streams
• Captured business vision and needs through task oriented process flows, presentations, JAD sessions
• Created project elicitation presentations for higher management
• Analyzed business processes for shared savings, contract terms repository and EOC
• Create detailed Use Cases for all functionalities within the Episode of Care effort.
• Maintained the Project Plan using MS Project encompassing 3 work streams for the EOC
• Used the Internal PA Estimate document to calculate the project budget and cost associated with deliverables
• Assisted with data mapping documents for Provider and Claims data for report generation
• Maintain issue logs to keep track of different assignments and resolve requirement challenges
• Assisted in creation of the Contract terms Repository (user interface for managing and storing contracts) and Shared Savings Calculation used for complex billing UI display
• Assist the PM with project documents and assist in Q&A sessions for technical teams
• Created project cost estimates used for project budget approvals with detailed skillset and resource needs
• Involved in extensive data mapping for multiple systems in order to implement Trizetto PBA application with existing proprietary Horizon systems.
• Act as a liaison and work closely with the development teams for aligning business needs and requirements

Confidential, Baltimore - MD

Project Business Systems Analyst

Responsibilities:

• Involved in validating claims (837), provider and member (834) data within FACETS and other databases by using SQL to support the EDM initiative
• Created Business and functional requirements for Standard Industry Codes (SIC) within the Enrollment application process to assign groups specific codes depending upon the industry
• Performed gap analysis and created mapping documents for elements across various systems
• Retrieve data for analysis and assist in creating metadata, crosswalks and data dictionaries
• Updated Project plan using MS Project with activities for the address validation service to indicate the deliverables, testing and Production support phase
• Created and executed test scripts - testing data to ensure transformation rules and crosswalks are valid
• Created test scripts and conditions for verifying end to end data flow and migration
• Provided day to day support defect resolution for the STARS Sentinel upgrade used for identifying fraud and abuse in claims
• Used HP Quality Center for tracking and logging defects
• Removed data anomalies, validated test scripts and supported data model development using SQL Server
• Assisted data modelers and BDA’s to create models by providing definitions and explaining business rules for standardization and avoid nomenclature issues
• Created crosswalks to support list of values across enterprise for reusability and for supporting CDM
• Conduct reviews and act as the liaison to co-ordinate decisions and tasks between different teams involved in development and deployment
• Tracked and entered utilized efforts through Clarity for various assigned tasks.
• Extensively used SQL queries to filter data, perform analysis from FACETS data base and other data marts
• Perform source to destination mappings for internal systems for successful enterprise integration
• Maintain and update Issue logs for data strategy and governance, create end to end system workflows
• Reviewed interface requirement documents, message specifications and business definitions for alignment of attributes and along with the list of values

Confidential, Newark - NJ

Sr. Business Systems Analyst

Responsibilities:

• Involved in gathering and creating business and functional requirement documents, Interface Requirement Documents (IRD’s), end to end system work flows, interface diagrams, mapping documents and presentations.
• Created Wireframes/mock ups for Address Validation functionality along with message specifications, test scripts for enrolling and maintaining groups and individuals project
• Created crosswalks to support list of values across enterprise for reusability and for supporting CDM
• Performed extensive GAP analysis and created Message Specification Documents for service calls
• Define code categories used within NASCO and Horizon services to support calls and cross walks
• Perform source to destination mappings for internal systems for successful enterprise integration
• Gather interface requirements across platforms to support business rules and HCR changes
• Followed Iterative methodology and participated/arranged daily sprints to keep the pace of task assignments and achieve desired target dates
• Creating architecture solution flows, UML diagrams, service charters and detailed message specifications for development of messages/interfaces
• Extensively created Business Process Modeling Diagrams/Swim Lane Flows using BPMN notations and MS Visio indicating transformations and feeds
• Create Requirements Traceability Matrix (RTM) and assist in integrating solution architecture with teams
• Create metadata and provide assistance for creation of Canonical Data Model (Members, Billing & Payments)
• Extensively mapped Provider, Claims and Payment data using queries
• Develop interface requirement documents to support integration and end to end process flows
• Worked with batch service and downstream systems to leverage data and support system functionalities
• Extensively involved in testing data using queries and verifying test conditions created by BSA’s
• Maintain issue logs to keep track of different assignments and resolve requirement challenges
• Assisted data modelers and BDA’s to create models by providing definitions and explaining business rules for standardization and avoid nomenclature issues

Confidential, Lincoln - NE

Sr. Business Systems Analyst/Jr. PM

Responsibilities:

• Create BRD’s, GSD’s, FRD’s and Test Documents for successful 5010 implementation
• Created Vision, Scope, Communication Plan and Process Flow for the Provider Re-enrollment & Validation
• Created Story Boards, Wire Frames/Screen Mockups for nearly 25 screens within MMIS
• Assist NE Medicaid in the design, development, implementation and production support for MPS1 Sub-systems, RFS6 Screens, NMES, IVR System and NPI Implementation
• Received certificates from Client for extraordinary performance
• Used MS Excel for tracking county information during mailing out forms and keeping track of providers
• Created Risk Management Plan and Failure Mode Effect Analysis for multiple work efforts
• Created Network diagram to ensure critical path and project duration using Critical Path Method
• Assist in the requirements gathering of 270/271 Eligibility Request & Response and testing of 837 (PID)
• Export/Import data to acceptable format; create reports using MS Excel and SQL
• Created communication policies to step by step validation of production data using BPMN, Use Case Documentation and incorporating Work Breakdown Structure
• Captured Nebraska Medicaid Eligibility System requirements for MMIS and IVR for member eligibility
• Extensively used MS Excel for maintaining internal tracking policies using queries, mapping, importing/exporting data and other functions
• Gathered NPI requirements and implemented Crosswalk solution to accept NPI instead of the 11 digit Provider ID which involved complex internal processes pertaining to NPI Dates, Provider Eligibility and DOS
• Act as the Quality Analyst for the Validation team and extensively use Lotus Notes, Share Point and Clarity
• Create test documents and strategic testing scenarios for User Acceptance testing and System testing for MPS1 (Provider Eligibility), NMES IVR and RFS6 Sub systems
• Train and Supervise the Validation team, create Training Schedule, RTM, Communication Plan, Provider Re-enrollment and Validation forms, Return policy templates, Project Milestone/Timeline, Training Manual, User Documentation and reports

Confidential, Springfield - IL

Business Systems Analyst

Responsibilities:

• Created BRD’s, GSD’s, using GAP Analysis and other business techniques for Reciprocity program
• Acted as a liaison and conducted meetings, JAD sessions and presentations with the teams, DBA’s, Clients and SME’s to develop, design, and resolve processes, provide training and track project progress
• Assisted in data filtration process, created reports using SQL and complex MS Excel functions
• Modified and incorporated changes for the new Reciprocity year upgrades
• Extensively involved with changes to proprietary files sent to & received from other EPA
• Developed operational and technical flows using Unified Modeling Language, MS Visio and BPMN
• Created and executed test scripts, test conditions and testing scenarios
• Updated and assisted in maintaining the Requirement Traceability Matrix, prepared Charter
• Performed User Acceptance testing, extensively used queries to validate data
• Created screen mock ups and process flows for business processes
• Provided manager weekly status/progress report and assisted in creating project timeline
• Extensively used Clarity to maintain milestones and assist in task co-ordination between team members
• Develop User Documentation, training material and status reports on a weekly basis
• Worked with Team Leads, Technical staff and key users to identify track and manage project issues
• Managed the outreach program which involved dealing with all the EPAs within the United States