SUMMARY

• Excellent understanding of Software Development Life Cycle (SDLC), Software Test Life Cycle (STLC) and Test Methodologies from project definition to post - deployment documentation.
• Excellent understanding of the entire process across various SDLC methodologies including AGILE & WATERFALL.
• Expertise in creating various Business process flows, Activity Diagram, Use Case Diagram, Data Flow Diagram, and Entity-Relationship Diagram.
• Extensively used Rational Test Management Tools for Test execution, defect reporting, defect tracking, management metrics, and change requests submission.
• Strong experience and understanding of healthcare industry, claims management process, Knowledge of Medicaid and Medicare Services.
• Exposed to Medicare and Medicaid domains of thehealthcaresystems and industry for Inpatients, Outpatients, and Reimbursement Methodology.
• Expertise in Data Analysis/Business System Analysis/Data Modeling and BI reporting.
• Experienced in using various requirement & document management tools including SharePoint, Quality Center (ALM).
• Hands on experience as an expert user of MS Excel, MS PowerPoint, MS Access, Business Objects.
• Strong experience in working with project management tools likeJira,Rally.
• Designed and developed test scripts for functional testing, Regression testing and Interface testing.
• Expertise in data mapping. Hands on experience writing SQL queries to validate correct mapping.
• Ability to work as independent and team member in challenging and cross platform environment.
• Highly motivated team player with excellent analytical, problem solving, interpersonal and communication skills.
• Gained experience on Quality Center, Microsoft Word, Microsoft Excel, Microsoft SharePoint, Microsoft Visio, Microsoft Access and Clarity.
• Configuration and development of service catalog and application form in ServiceNow.
• Worked as a ServiceNow Technology Analyst with Incident Management, Problem Management, Change Management with extensive knowledge on implementing end-to-end Service Catalog.
• Strong experience and understanding of healthcare industry, claims management process, Knowledge of Medicaid and Medicare Services.
• Extensively worked on business requirements modeling and development of servicenow, CRM, Mmigration projects with office 365 in diverse business with various domains.
• Expertise in working with PMO, Engineering, and Other Organizational Units while tracking milestones and deliverables.
• Fundamental regulatory comprehension of the pharmaceutical industry by being involved with processes pertaining to regulatory review.
• Hands-on experience specifying, establishing, and managing test environments and test data.
• Ability to work in multi-team environment with people from diverse cultural backgrounds.
• Excellent written & oral communication skills.

TECHNICAL SKILLS

Project Methodologies: Rational Unified Process (RUP), Waterfall, Agile

Business Modelling Tools: Rational Rose, MS Visio

Requirement Management/Tools: Rational Requisite Pro, Wire Frame, MS Visio, SharePoint

Testing Tools: QTP, HP ALM, and Quality Center

Scripting Languages: SQL, PL/SQL, VBScript

Data Bases: Oracle, SQL Server and MS Access

Web Technology: HTML, XML, SOAP UI

Operating System: DOS, Window

CM Tools: SVN, Clear Quest, JIRA, HP ALM

PROFESSIONAL EXPERIENCE

Confidential, IL

Business System Analyst

Responsibilities:

• Worked directly with the Project Manager, Business Owner, Subject Mater Experts (SMEs) Project Owner, Scrum master and Stakeholders to gather business requirements.
• Interacted extensively with Business stakeholders and Subject Matter Experts, Users to understand the business process and to gather accurate requirements and developed the detailed Business Requirement Documents (BRD) for the enhancement process of the workflow.
• Defined business requirements and acceptance criteria that support CMS, State and Vendor interfaces related to healthcare business platform.
• Created Data mapping documents, logical data models, class diagrams and ERP diagrams and extensively used SQL queries to filter data within the Oracle database
• Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for processing of Medicaid Claims.
• Was involved in documenting changes to the Benefits Administration, Enrollment Processing and Claims Processing Systems based on the Medicare Plan Changes initiative.
• Used JIRA as ticket management tool and confluence for documentation, used Rational Rose for Use Case Modelling.
• Extensively designed Data mapping and filtering, consolidation, cleansing, Integration, ETL, and customization of data mart.
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of the data.
• Manage Product Backlog, along with PO, in Jira. Also create, update and manage project documentation in Confluence.
• Involved in preparing several Use Cases, Business Process Flows, Sequence Diagrams, using MS Visio.
• Knowledge of collaboration web content management in SharePoint.
• Built Tableau visualizations against various Data Sources like Flat Files (Excel, Access).
• Use of an Agile and SDLCProjectapproach as well as a hybrid of the two as the company migrates to Agile, JIRA,MSProject and SharePoint.
• Designed and created Excel sheets to provide market analysis charts.
• Collaborate with data modelers, ETL developers in the creating the Data Functional Design documents.
• Created Data mapping documents, logical data models, class diagrams and ERP diagrams and extensively used SQL queries to filter data within the Oracle database.
• Tracked stories using JIRA software.
• Followed the UML based methods using MS Visio to create Use Case Diagrams, State Chart Diagrams and Sequence Diagrams.
• Designed and developed Use Cases using UML and Business Process Modeling.
• Defined business requirements and acceptance criteria that support EDI Interfaces related to healthcare business platform including but not limited to 837, 834, 820, 835, 999, 277, 270 EDI transactions.
• Analyzed, defined requirements and implemented end-to-end business process workflows of information is sent and received from various sources, systems and vendors.
• Defined the information/data movement layout from a business point of view to establish a smooth process for clients.
• Validate claims of the member via EDI with the database and then the processing is done afterwards.
• Established and defined timelines for data exchanges in the BRD.
• Reviewed the Business requirement, Functional Design Documents and Technical Specification documents
• Facilitated Joint Application Development (JAD) Sessions for communicating and managing expectations.
• Performed Data analysis from the data warehouse along with business intelligence solutions delivery team.
• Performed Gap Analysis (“AS IS” - “TO BE”) to derive requirements for existing system enhancements.

Confidential, Philadelphia, PA

Business System Analyst

Responsibilities:

• Worked on the Data Warehouse team analyzing data files that had to be compiled from disparate non-production sources and readied them for production.
• Tasks included: comparing data to requirements documentation, creation of data layouts and data dictionary.
• Created UML diagrams such as Use Case diagrams, Swim Lane, Activity and Sequence diagrams.
• Identify Member, Provider, Coverage, Medicare, and Medicaid.
• Utilized JIRA to log and monitor any defects.
• Worked extensively on Business Requirements, Functional Specification, Data-Integration, Data Mapping, and Data Warehouse access using SQL and Crystal Reports, ETL process, use cases modeling (UML) using MS Office (Word, Excel, Access, Visio) and dashboards.
• Analyze the SharePoint governance model to ensure that development efforts are aligned with corporate technology policies and procedures.
• Used MS SQL for extracting the claims report for ETL (Extraction, Transformation and Loading),imported the report in excel for analysis.
• Managed all the Change Requests Document that came in through after signoff and maintained all the artifacts on SharePoint.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI x12 Transaction, Code set and Identifier aspects of HIPAA.
• Used JIRA and Confluence to view, manage and report on “Work in Progress”.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals.
• Participated as member of a project team performing various lifecycle tasks for an intranet application with SQL Server database. Developed logical and physical database models and data dictionary documentation.
• Planned and defined system requirements to Wire Frame with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.
• Involved in writing extensive SQL Queries for back end testing oracle database.
• Retrieved files using SQL statements.
• Utilizing ServiceNow managed various requests (adding, viewing, editing, deleting, etc.)
• Worked on Workday upgrades and new features management as per requirements from business.
• Monitored Data entry in Workday to sync with legacy system for final testing.
• Customized the entire Salesforce.com applications to in corporate the business requirements which involved creating Web Forms and processing the data in SFDC with the extensive usage of Web services API.
• Created Stored Procedure and Views, Indexes, SQL joins and Sub queries.

Confidential, Baton Rouge, Louisiana

Business System Analyst

Responsibilities:

• Communicated business priorities to the organization to effect business solutions.
• Converted Business Requirements to the Functional Specification.
• Worked with Quality Control Teams to develop Test Plan and Test Cases.
• Worked on data management, data modeling and data mapping from XML to Facets.
• Conducted JAD sessions to gather and document requirements that enhance a wide range of functionalities including Claims processing, eligibility and enrollment, provider networks, and electronic data interchange for our Facets core application.
• Prepared Business Object / Business Process Models that included modeling of all the activities of business from conceptual to procedural level.
• Analyzed the source data coming from Legacy system, Oracle, DB2, SQL server, PeopleSoft and flat files. Worked with Data Warehouse team in developing Dimensional Data Model.
• Designed and implemented ETL processes with SSIS packages using Heterogeneous data sources (SQLServer, Flat Files, Excel source files, XML files,Text files,etc.) andthen loaded the data into destination tables by performing different kinds of transformations using SSIS.
• Analyzed the mainframe reports for member/eligibility/claims and mapped the fields withFACETSbatch jobs and reports.
• Worked on BigDataanalytical models.
• Creating Data Mapping specification for the team to avoid potential issues in data migration and data mitigation projects.
• Created packages using SSIS to extract and merge data from various OLTP database sources to a data warehouse by scheduling SQLAgent Jobs to call the packages.
• Responsible on creating user stories in an Agile Scrum framework in scratch.
• Conducted UAT walk through meeting with different Stakeholders on Claims Processing, GUI Modifications, Extract and Report validations.

Confidential, Conshohocken, PA

Business Analyst

Responsibilities:

• Implemented both Agile and Waterfall for multiple projects, being actively involved from Analysis through Implementation.
• Designed, prepared and implemented test cases for User Acceptance testing.
• Collaborated with other pharmaceutical research departments, authors and global dossier managers; determined and maintained electronic databases for regulatory information.
• Involved in the writing requirements for enhancement of the web portal and mobile application.
• Conducted user acceptance testing with UAT team. Safety reporting on system-based projects, acted as a liaison, writing documentation and increased project coordination.
• Updated Use Case document to capture new screens through wire frames. Updated process flows by creating Use Case & Activity Diagrams.
• Used Quality Center to manage requirements, requirement versions, traceability, and test case coverage.
• Used Quality Center for Defect Management and test case management.
• Conducted JAD Sessions for requirement analysis.
• Set up MS-SQLSVR Data Warehouse as one-off repository ofERPreporting data.
• Set up all SQL query & ETL scripts from liveERPdatabase to Data Warehouse.
• Identified supplemental infrastructure upgrade requirements for eachERPversion upgrade.
• Did data analysis, created data mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.
• Tested User Interface inconsistency and application functionality during UAT.
• Reviewed the Business requirement, Functional Design Documents and Technical Specification documents
• Designed and developed scenarios based on business requirements.
• Interacting with other teams through walkthroughs, teleconferences, meetings, etc. to resolve various issues.
• Performed Gap Analysis (“AS IS” - “TO BE”) to derive requirements for existing system enhancements.