Summary:

I have been working in the field of IT for the past 8 years as a Healthcare Business Analyst, System Analyst and QA Tester. I am very passionate about my work, which has helped me throughout my career to accomplish many challenging tasks. I have helped companies in Business Process Improvement, Quality Analysis Testing and Implementation, driving the projects from road of ambiguity to clarity. I possess the quality to lead and also be a solid team player at the same time with my focus being toward the betterment of business.

• Extensive experience in gathering and understanding business requirements, communicating effectively with Stakeholders, SME's, Tech Leads and Business Users.
• Experienced Joint Application Design JAD facilitator and meetings coordinator/moderator with excellent interpersonal and conflict resolution skills.
• Expertise includes project planning, risks and issues analysis and mitigation, business requirements elicitation, budget management and literature and communication strategies
• Experience in writing Test Plans, Test Scripts, Test Cases and executing them.
• Assisting the QA team in planning and performing Functional Testing, Integration Testing, and Regression Testing.
• Extensive experience in conducting Joint Application Development JAD sessions for project definition involving analyzing requirements, creating prototypes, user interface, database schema and system design.
• Good Experience in Integrated Eligibility System IES and ACA.
• Experience in writing PL/SQL Stored Procedures, Triggers, Cursors and Functions and SQL statements.
• Experience in facilitating session between SME and providing them with recommendations to resolve issues for various business/technical groups.
• Extensive knowledge and experience in Software Development Life Cycle SDLC methodologies like Waterfall, and Agile Scrum, RUP .
• Expertise in capturing requirements to the core and developing precise Business Requirement Documents BRD and Functional Requirement Documents FRD .
• Proficient in conducting GAP Analysis, Risk Analysis.
• Experience in working with Data Management and Data Governance based assignments.
• Good Knowledge in Care Management / Medical Management and Utility Management area.
• Expert in Trizetto's Clinical Care Advance , Landacorp's MaxMC Medical Management and Trimed Care Management Pro software's.
• Theoretical knowledge in Trizetto FACETS.
• Working Knowledge of EDI, ANSI X12 and HIPAA Standards.
• Proficient with high-level Logical Data Models, Data Mapping and Data Analysis.
• Worked closely with the System Architect to implement Service Oriented Architecture.
• Worked closely with Change Management team to update the requirement changes and maintain them after implementation.
• Excellent knowledge of HIPAA Health Insurance Portability and Accountability Act transaction codes such as 270/271 Inquiry/response health care benefits , 276/277 Claim status request/response , 835 Payment or remittance advice , 837 Health care claim and 834 Benefit enrollment .
• Confident, pro-active, analytical, fast learner and detail-oriented candidate with excellent multitasking capabilities to perform exceptionally in ever changing and stressful environments.

Technical Skills:

Projects Summary:

Responsibilities:

• Interview business users Nurse and Doctors-MD's to gather requirements and analyzed the feasibility of their needs by coordinating with the Project Manager and technical lead.
• Partnered with the business stake holders, process owners, users to identify their requirements, produced detailed specifications, planned the project deliverables.
• Working closely with the company's IT department.
• Drafting the process activities through Ms-Visio as Use case Diagram.
• Conduct regular meetings and actively coordinated with Developers and Business Team worked with Functional leads, Business Analysts and Project Managers.
• Understanding Trizetto Clinical Care Advance/ MaxMC Landacorp Data model and helping business to understand and implement the same in new environment.
• Established great interpersonal relationship with the users and provided extensive user support for the central application. User support was a crucial aspect of this project.
• Reviewed test cases written by QA team and ensured all the functionalities are being tested thoroughly.
• Coordinated and conducted JAD sessions for Utilization Management and Case Management area requirements.
• Drafting detailed Business Requirement for IT to proceed with their Design document.
• Planned and coordinated the UAT effort prior to go-live.
• Conducted UAT walkthrough sessions to updates participants on the expectation and the UAT process.
• Strong SQL Knowledge to pull and configure data in backend for Data Management.
• Coordinated testing effort in creating EHR Electronic Health Record .
• Involved in Risk-Management Process, whereby identifying critical areas of business risk and modifying the business process to reduce the same.
• Provided support during UAT and addressed show-stoppers in timely manner.
• Collected UAT sign-off's and documented them for audit purposes.
• Did Defects Management for different phases of release.
• Administrator for the existing application, which involves receiving request through IBM Tivoli and configuring the users into CA Identity manager to grant/revoke access to application users.
• Inspecting Change Order Requests, completing cost effort estimates, planning and prioritizing the work for a suitable iteration
• Providing the management with Organizational metrics and reports.
• Assist in development of training materials for new technology and process improvements.

Environment:

MS-Visio, Share Point 2010, Microsoft Office Suite MS Word, Excel, PowerPoint , XML, JAVA, Clear Quest, Rational Req Pro, AQT, Trizetto Care Advance, MaxMC Landacorp ,IBM Tivoli , Toad , Filenet, Content Management Tool and CA Identity Manager.

Responsibilities:

• Worked as Business Analyst and analyzed the Medicaid Eligibility Determination System standards for documenting Business requirements document and Functional requirements document of the system.
• Conducted regular meetings and actively coordinated with Developers and Business Team worked with Functional leads, Business Analysts and Project Managers.
• Gathering Requirements from client and document the system requirements and GUI Specifications.
• Analyzed all the Business and System requirements and participating in Technical and Functional Requirement review meetings.
• Prepared Test Strategy document and Master Test plan, Test Estimations.
• Tracking, Managing and escalating appropriate issues in a timely manner.
• Reviewing Test conditions in compliance to the requirements.
• Involved in preparing the test strategy, test plans, test scripts, reviewed QA test plans for appropriate test coverage and conducted system testing functional, regression and integration testing.
• Identifying, Documenting, Tracking defects through HP Quality Center and Performing initial triage of issues. Updating and providing status on the defect tracker to higher management.
• Prepared the Business Flows.
• Performed SWOT analysis, GAP analysis for the modules in production, conducted Feasibility study and performed impact analysis for proposed enhancements
• Assessed current operational procedures, input and output variable and security requirements.
• Interfaced with internal clients and technical vendors on new feature requirements.
• Conduct massive requirement sessions with the stakeholders to elicit and analyze requirements.
• Execute complex integrated systems planning and solution alternative analysis and design.
• Performed Process change to align organization to process, strategy and adaptability for migrating projects.
• Involved in Risk-Management Process, whereby identifying critical areas of business risk and modifying the business process to reduce the same.
• Assist in development of training materials for new technology and process improvements.

Environment:

MS-Office, MS-Visio, MS-Access, MS-Project, Share Point 2007, Microsoft Office Suite MS Word, Excel, PowerPoint , XML, JAVA, Waterfall, SOA, Oracle Service Bus, Oracle Fusion Middleware, Oracle and SQL Server

Responsibilities:

• Followed the Texas Medicaid Eligibility Determination System standards in documenting Business requirements document and Functional requirements document of the system.
• Worked closely with Functional leads, Business Analysts and Project Managers. Conducted meetings and actively coordinated with Developers and Business Team.
• Responsibility includes analyzing the Business and System requirements.
• Prepared Test Strategy document and Master Test plan, Test Estimations.
• Gathering Requirements from client and document the system requirements and GUI Specifications.
• Tracking, Managing and escalating appropriate issues in a timely manner.
• Analysis of requirements and participating in Technical and Functional Requirement review meetings.
• Reviewing Test conditions in compliance to the requirements.
• Prepared the Core User Requirements Specifications CURS and the Functions Specifications FS .
• Prepared the Business Flows.
• Performed SWOT analysis, GAP analysis for the modules in production, conducted Feasibility study and performed impact analysis for proposed enhancements
• Assessed current operational procedures, input and output variable and security requirements.
• Interfaced with internal clients and technical vendors on new feature requirements.
• Conduct massive requirement sessions with the stakeholders to elicit and analyze requirements.
• Performed Process change to align organization to process, strategy and adaptability for migrating projects.
• Involved in Risk-Management Process, whereby identifying critical areas of business risk and modifying the business process to reduce the same.
• Performed Data modeling, data mapping and XML Mapping. Worked in SOA environment.
• Involved in formulating the test strategy, test plans, test scripts, reviewed QA test plans for appropriate test coverage and conducted system testing functional, regression and integration testing.
• Assist in development of training materials for new technology and process improvements.

Environment:

Oracle, SQL, SQL Server, MS-Office, MS-Visio, MS-Access, MS-Project, Share Point Microsoft Office Suite MS Word, Excel, PowerPoint , XML, JAVA and Waterfall

Responsibilities:

• Reviewed Business Requirements and analyzing the technical specifications.
• Support existing EDI systems/subsystems and migration projects for new/existing partners
• Automated repetitive tasks and processes in order to maximize performance.
• Conducted walkthrough for all ICD-9 compliant codes.
• Overall accountability for the construction, quality and timely delivery of the project.
• Worked with end users to determine business needs for new or enhanced systems or applications.
• Established and maintained communication channels with senior managers, key team members and stakeholders.
• Running the Autosys / EMT Job when scheduled jobs fail.
• Performed applications enhancements, troubleshooting, and bug fixes as required.
• Tracking, Managing and escalating appropriate issues in a timely manner.
• Developed and implemented 837 Maps.
• Claims 837 /Electronic Remittance 835 Issues.
• Ensured all Inbound / Outbound transactions are backed up appropriately and integrity checking are regularly carried out
• Post Implementation support
• Provided the management with Organizational metrics and reports.
• Assisted in development of training materials for new technology and process improvements.

Environment:

IBM WTX, Mercator, MS-Office, MS-Visio, MS-Access, MS-Project, Share Point , Rational Clear Quest, Microsoft Office Suite MS Word, Excel, PowerPoint and JAVA

Responsibilities:

• Interacted with business heads to finalize the business requirements for the application.
• Worked with internal and external users to define requirements and coordinated user management and developer expectations.
• Successfully conducted JAD sessions, which helped synchronize the different objectives of stakeholders and helped the developers comprehend user requirements.
• Collected and documented business processes as well as business rules. Provided key input in working with users in defining project and system requirements.
• Created business flow diagrams, performed SWOT analysis, and assisted in designing the web structure.to define requirements and coordinated user management and developer expectations.

Environment: MS Office, MS Visio, SQL, SharePoint, UML and MS Access