SUMMARY

• A Sr. Technical Consultant with 8+ years of experience in solving current and future business problems by implementing creative solutions for Healthcare and Financial Services industries
• Proficient in defining roadmap for creating and implementing data models in a multi - cloud environment
• Deep understanding of cloud technologies such as Amazon Web Services (AWS) and Google Cloud Platform (GCP) microservices such as AWS EC2, AWS S3, AWS Redshift, AWS Lambda (serverless), AWS IAM, GCP Storage, GCP DataPrep, GCP BigQuery
• Ability to design and construct cloud architectures using AWS and GCP that are well-integrated, operationally excellent, secured, resilient and efficient
• Provided technical and functional evaluation of various technologies
• Ability to appropriately articulate, recommend, and document various technologies as a strategic fit for an organization
• Skilled in creating proof of concepts (POCs) to demonstrate potential technical solution
• Expert in Requirement Elicitation, Analysis, Specification, and Validation
• Experience in creating UML (Unified Modeling Language) diagrams
• Excellent communication skills, interpersonal skills, leadership qualities, and ability to work independently
• Strong understanding of various SDLCmethodologies such as Waterfall and Agile
• Comprehensive knowledge in Federal regulations such as HIPAA (Health Insurance Portability and Accountability Act), PHI (Protected Health Information), and healthcare compliance such as Exclusion Monitoring
• Good knowledge in healthcare insurance domain including Medicare. Proven experience with HIPAA X12 EDI transactioncodes such as 270/271 (inquire/response health care benefits), 834 (Benefit enrollment) 835 (Payment/remittance advice), 837 (Health care claim)
• Experience in gathering business and technical requirements, creating Business Requirement Document (BRD), Functional Specification Document (FSD), Requirements Traceability Matrix (RTM), Test Plan, Test Case, Gap Analysis and Impact Analysis
• Ability to write SQL queries for the retrieval and management of data
• Deliveredthorough QA testing reports that determined product quality and release readiness
• Quick learner, self-starter, can learn and adapt to new atmospheres and technologies with confidence and ease

TECHNICAL SKILLS

UML Tools: Microsoft Visio, Lucidchart

Databases: Oracle, SQL Server

Methodology: Waterfall, Agile

Project Management Tools: MS Project, JIRA

MS Office Tools: MS Outlook, MS Word, MS Excel, MS PowerPoint, MS Visio

Business Intelligence Tools: Tableau, SAP Business Objects, QlikView

Cloud Technologies: AWS EC2, AWS S3, AWS Redshift, AWS VPC, AWS IAM, Google Cloud Platform (GCP), Linux, PowerShell, JSON

Programming/Scripting: Python, Core Java, PowerShell, Linux

ETL Tools: SSIS

PROFESSIONAL EXPERIENCE

IT Business Analyst

Confidential, Sacramento, CA

Responsibilities:

• Designed ETL data pipelines to ingest data from multiple data sources, transform the data, and transmit the data securely to the vendor
• Single-handedly resolved last minute technical issues by consulting IT Client Engineering and PeopleSoft team to meet the project go-live date
• Identified risks and security threats on time and mitigated them by documenting procedures for the System Integration team thereby preventing Personally Identifiable Information (PII) data leaks
• Researching on a digital transformation solution to store all enterprise data in a centralized repository which will be used for reporting, advanced analytics, machine learning, and visualization, thereby enabling leadership to make data driven decisions
• Hosted vendor product demonstrations to choose a system for a healthcare compliance process called Exclusion Monitoring
• Established criteria for the decision makers to score potential vendors, thereby aiding them in making an informed decision
• Partneredwith the Compliance department to gather and document business and technical requirements, to design future state business processes
• Researched on federal guidelines and available data populations to help the stakeholders finalize data selection criteria
• Collaborated with multiple departments to document the system processes and design technical solution to transmit data from multiple data sources
• Createddiagrams in MS Visio to demonstrate workflows to the Compliance department for a better understanding
• Partneredwith IT Business Operations for the evaluation of vendor system based on UC Office of President guidelines
• Implementedsecurity best practices thereby adhering to Confidential policies
• Presented on data lakes (Smart and Adaptable Data Models) at the UCTech conference and demonstrated using GCP, AWS S3, Python, and SQL
• Designed user provisioning process and worked with IT Customer Service to implement it in ServiceNow
• Developed test plan and led test execution to ensure the acceptable quality and integrity of the solution
• Worked independently with the Windows-Server team to integrate UCDH ADFSwith the vendor system
• Led and documented weekly team meetings, and maintained decision logs
• Devised a technical solution to avoid errors in production and delivering production support
• Creating transition documents for the production support team
• Instrumentally bridging the gapbetween business and technology by being a creative problem solver and active listener

Business Systems Analyst

Confidential, Atlanta, GA

Responsibilities:

• Gatheredrequirements and prepared business requirement documents (BRD)
• Responsible for translating BRD into functional specifications and test plans. Closely coordinated with both business users and developers for arriving at a mutually acceptable solution
• Conducted JAD sessions to define the project and to reduce the time frame required to complete deliverables
• Createdand maintained data mapping document(s) in reference to the claim process transactions
• Involved in /EDI transactions Analysis, Design, Implementation and Documentation
• Reviewed in preparing the Test Scenarios for Health Care Claim Payment/Advice
• Maintained Requirement Traceability Matrix (RTM)
• Presentedthe nursing outcomes to C-Level executives in Confidential Nursing and Data Management group using Crystal Reports XI
• Demonstratedstrong analytical and project management skills, including a thorough understanding of how to interpret business needs and to verify that the new system being place has functionalities justifying business needs
• Worked on Medicare Advantage (A, B, C), Medicare Part D (MA-PD), Medicaid Options (Under 65 and Over 65) and Managed Care (Care, Disease and Case Management and in Insurance regulations and Claims Processing and claim scrubbing in HMO, PPO, Medicare and Medicaid.
• Acted as an SME on various subject areas including state reporting, death benefits, Medicare, Bill review and RX eligibility
• Provided reporting guidance to ensure compliance with CMS, DHCS & DMHC reporting requirements
• Performed UAT testing, End-to-End Testing, Functional, and Regression Testing
• Createdstar schema data models and visualizations to gather data insights using QlikView and Tableau

Business System Analyst

Confidential, Columbus, OH

Responsibilities:

• Conducted JAD session with project’s stakeholder identifying problems and coming up with the best alternative to resolve that
• Did the forward and backward data mapping betweenthe fields in mainframe and FACETS
• Collaborated with users and the different teams involved in the application development for better understanding of the business and IT processes
• Documented the requirements to meet end-state requirements and complied Business Requirements Document, Software Requirement Specification Document, and Use Case document
• Performed SWOT and GAP Analysis to discover new functionality requirements, prioritized them based on actual business needs. Involved in Risk Analysis and auditing business processes
• Compared and validated 5010 system test results with 4010 results for the same test scenarios
• Communicated with the stakeholders throughout the lifecycle of the project, constantly updating them on benefits and risks associated with the project
• Developed an analysis model that included Use Case diagrams, and Activity diagrams using UML methodologies in MS Visio, which provided the development team a view of the requirements for design and construction phases
• Effectively managedchange by deploying change management techniques such as Change Assessment, Impact Analysis and Root cause Analysis
• Facilitated User Acceptance Testing (UAT) and Black Box testing
• Trained and testedsupervised machine learning models to predict likelihood of claim being denied
• Analyzed historical remittance data to identify patterns associatedwith denied medical claims

Business Analyst

Confidential - Cleveland, OH

Responsibilities:

• Managedthe process of gathering functional requirements from key stakeholders and Subject Matter Experts
• Responsible for the core activities of the test team including creating and executing test cases, analyzing and documenting results and drawing a traceability matrix to match the requirements with the final test scenarios
• Participated in release cycles of software developed using Waterfall and Agile methodologies
• Integratedvarious systems with HEDIS and created design for HEDISand other systems to pull data in HEDIS
• Documented Software Requirement Specification (SRS)
• Created UML Diagrams such as Use Cases, Sequence Diagrams, State Diagrams, Activity Diagramsand business process and workflows
• Facilitated User Acceptance Testing and verified performance, reliability and fault tolerance issues
• Collaborated with billing, collection, verification, and document management department to ensure proper compliance accuracy and timeliness in the processing of claims
• Evaluatedand performed testing within Facets for Rejected QA Scenarios
• Performed Gapanalysis to assess needs that could not be met by core HER
• Exported and manipulated data using SQL and advanced Excel functionalities to produce reports on a daily, monthly quarterly, and annual basis for Executives

Business Analyst

Confidential

Responsibilities:

• Documented business requirements and communicated the requirements with the development team for design and implementation of business solutions
• Worked with Business Analysis team to prepare a detailed Business Requirement document (BRD) and System Requirement Document (SRS)
• Analyzed Business Requirements to develop functional and detail design specifications
• Conducted Requirement Gathering Sessions with the stakeholders. Incorporated stakeholder feedback throughout the project lifecycle to ensure project quality and customer satisfaction
• Interactedwith the project team to help define the Business and System Objectives, confirmation of scope, identify constraints and the measures of success for the system to be developed
• Monitored change requests and documented requirements, integrating them with Use Cases