Luman Singh

• Over eight years of IT experience in Business System Analysis, UAT Testing, System Development life Cycle SDLC , RDBMS, Project Cycle Management PCM , Software Validation, Data Modeling, and Decision Support Systems.
• Full life cycle System Development experience including Requirements, Analysis/Design, Development/testing, and Implementation.
• Extensive experience in RUP Iterative and Agile System Development Life Cycle process, implementing the Rational Unified Process RUP in all four phases Inception, Elaboration, Construction and Transition.
• Expert in writing User stories and Epics.
• Participated in the designing test plans, test scripts for software development.
• Familiarity with White-Box and Black-Box testing techniques such as Load Testing, Regression Testing, Unit Testing, System Testing, Quality Center and Performance Testing.
• Strong knowledge of PPACA/HIX Patient Protection and Affordability Care Act/ Health Insurance Exchange .
• Knowledge of Medicare, Medicaid, PPO, POS, diagnostic codes and claims process.
• Created and analyzed Business Requirement Documents BRD and Functional Requirement Documents FRD .
• Experience in development of Process Flow Diagram, Use Case Diagram, Activity Diagram, and Sequence Diagram by using UML methodology using tools such as Rational Rose and MS Visio.
• Extensive experience in producing artifacts like the Business Scope Vision Document, Business Glossary, Business Modeling Guidelines and Business Use Case Models.
• Extensive experience with Business Process Management BPM .
• Specializing in working with technical staff to create, interpret, and implement business requirements into technical specifications. Excellent understanding of HIPPA standards 4010 and 5010 and HIPPA code sets ICD-9, ICD -10 and HL7 .
• Medical claims experience in process documentation, Analysis and implementation in 835, 837IPD, 834, 270/271, 276/277, 999/TA1 X12 Standards processes of medical claims industry from the provider/payer side.
• Excellent knowledge of Health Insurance Plans Medicare Part A, B, C and D products and procedures managed care concepts Medicaid and Medicare and experienced in determining the membership eligibility, billing experience within life and disability in health plans.
• Extensive knowledge of Medicaid Management Information Systems MMIS / Replacement Medicaid Management Information System RMMIS , Medical Information Technology Architecture MITA .
• Expertise in Unified Change Management UCM to manage change from requirements to release.
• Familiar with RDBMS tools like oracle TOAD , DB2, IBM Mainframe and MS SQL Server.
• Very Strong SQL skills writing queries and verifying data . Solid understanding of databases, data ware house, OLTP, OLAP, Data Modeling, Business Intelligent tools like Business Objects.
• Goal Oriented Project Management, Business Process Analysis and Modeling, Testing: Planning, Coordination, Execution, Process Re-engineering Analysis
• Documentation and delivering ODS to EDW information mapping for ETL Guide.
• Expertise in Unified Change Management UCM to manage change from requirements to release.
• Experienced with project management tools like MS-Project, JIRA, Creative Pro Office for status reporting, planning and error tracking and correcting.
• Developed test scenarios and implemented test plans for system testing and user acceptance testing UAT .
• Involved closely with the Developer and Testing team during defect resolution phase

TECHNICAL SKILLS:

PROFESSIONAL SUMMARY:

Sr. Business System Analyst

Oklahoma State Department of Health has to comply with Centers for Medicare and Medicaid Services CMS mandated ICD-10 requirements within the timelines. The objective of the project is to do the assessment for Oklahoma State Department of Health MMIS and other State systems . It is followed by implementation of the new claims processing MMIS Medicaid Management Information System which will replace the old legacy system and will automate all the business areas. As a Business Analyst and UAT Tester I was involved in drafting the migration plans for the Claims Processing data, implementation of the new ICD-10 codes, HIPAA 5010 guidelines and mapping everything from ICD- 9 to ICD-10 and vice versa using General Equivalence Mapping GEM . As a quality analyst I also developed UAT test cases and done UAT testing.

RESPONSIBILITIES:

• Involved in the testing of web portal of MMIS System.
• Gathered requirements from stakeholders for provider management and member management.
• Identified and validated business rules and data elements.
• Developed the stakeholder list and created stakeholder assessment matrix to prioritize them.
• Conducted Risk analysis and developed mitigation plans.
• Developed Gap Assessment and Impact Analysis Roadmap, Implementation Advanced Planning Document IAPD and developed the action steps to fill the gaps for the HIPAA compliance.
• Conducted interviews sessions with SME's and different divisions of state dept.
• Gathered all documents divided into different areas Policies, state plans, Manuals, Business Process, Systems and Interface.
• Posted all the Project artifacts/documentation on Share Point.
• Conducted CMS ICD-10 Training.
• Submitted Deliverable Expectation Documents DEDs for the ICD10 Assessment Matrix Report and ICD10 Implementation Options and Recommendation Report to Oklahoma State Department of Health for initial review.
• Performed detailed analysis for the following functional areas that is going to be impacted by ICD-10 codes
• Conducted Impact analysis when there is any change in the requirements and updated the Business Requirements Document BRD and Systems Requirements Specification SRS .
• Facilitated meetings with the technical team and client team to analyze the current process and gather requirements for the proposed process.
• Wrote some basic SQL queries for Oracle database and prepared test data.
• Used SDLC System Development Life Cycle methodologies like the Agile and the RUP.
• Used detailed knowledge of the application features and functionality to assess the scope of the business needs throughout the analysis and completion of enhancement specification.
• Conducted Business Impact Assessment and the results were compared with the EHR standards to determine the current level of compliance and developed an action plan for approval by the project steering committee.
• Conducted Business Process As Is/To Be sessions with various department directors and staff to ensure the Testing Plan and Test Approach would meet the identified Business Requirements, and the Training Program covered all identified new and changed processes.
• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 utilizing the ICD-10 codes.
• Proposed strategies to implement HIPAA 4010 in the new MMIS system and eventually move to HIPAA 5010.Facilitate HIPAA integration and applied ANSI ASC X12 standards for 837 I, P, D , 270/271, 276/277, 278, and 835 and 837 transactions.
• Created and maintain requirement traceability matrix RTM .
• Facilitated JAD sessions for Requirement Validation with Dept. Of Health Human Services DHHS to gather requirements for the new MMIS.
• Analyzed different data crosswalks, complicated logic and look ups required by different fields for the source to target transformations.
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
• Analyzed EDI X12 data elements captured by the existing system to validate it against the data elements required for new system.
• Worked with legacy team in developing BRD for multiple system change requests and participated in system testing.
• Prepared Test Cases /Test Data according to Business requirements and assist QA team in testing using ALM.
• Developed UAT test cases associated with the functional requirements.
• Coordinated different activities involved in QA and User Acceptance Testing.
• Maintained a bi-weekly status report for the requirements team and incorporated the same to the PMO status reports send to CMS.
• Participated in developing test plan, test scripts, and test scenarios and designed user documentation.

Environment: UML, Windows, Mainframe, SQL, Microsoft Office, Test Director, Rational Unified Process RUP , Agile, MS Access,, Quality Center, SharePoint, HTML, XML, Java Script, Java, ASP, DB2.

Confidential

Business Systems Analyst

• The project was to implement the conversion of 835 EDI transactions from 4010 to 5010 along with ICD 9 to ICD 10 codes. I was also responsible for preparing requirements documents for conversion of 834 4010 to HIPAA compliant 5010. In the later phase of the project, I conducted User Acceptance Testing UAT and verified performance, reliability and fault tolerance issues. RESPONSIBILITIES:
• Performed a project analysis on new projects, including requirements, personnel, and costs.
• Strong visual modeling and business process modeling skills in Rational Unified Process RUP and Agile Modeling with tools like Rational Rose, MS Visio.
• Provided reports and other documentation on projects to client and internal staffs, as needed.
• Worked with team leaders and supervisors to ensure project and organizational deadlines are met.
• Coordinated updates with client's staff and implement efficiencies in documentation maintenance.
• Extracted and maintained SAS data sets from the raw data created by the data management group.
• Involved in 835 files validations for HIX at Claim level, Line level, Service level and Transaction level.
• Extensively involved in Batch interfaces and MMIS batch jobs in setting up, running and debugging job runs.
• Facilitated ICD 9- ICD10 conversion requirement gathering session and created high level Business Required Document.
• Organized and conducted extensive JAD sessions with users to identify and understand requirements.
• Extensively used SQL queries and procedures for data validation in both source system and target system.
• Responsible for doing the gap analysis for the interfacing system.
• Documented the Business Requirements Document BRD and the Functional Specification Document FSD .
• Reviewed various customer transactions using the FACETS application.
• 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.
• Involved in forward mapping from ICD 9 to ICD 10 and backward mapping from ICD 10- ICD 9 through GEM.
• Wrote Use Cases, prepared use case diagrams using Rational Rose and followed Rational Unified Process at every stage of the process.
• Developed UAT test cases associated with the functional requirements.
• Participated in developing test plan, test scripts, and test scenarios and designed user documentation.
• Create Data Flow diagrams and User Interface designs.
• Developed detailed Test plan, Test Cases, Test scripts for testing the functionality, GUI and security testing.
• Managed the entire UAT set up UAT testing effort with the Business users.
• Conducted User Acceptance Testing UAT and verifying performance, reliability and fault tolerance issues.
• Participated in weekly status meetings to present status and incorporate any digressions from the original scope.
• Carried out a thorough target organization assessment and risk analysis.
• Analyzed the As is and To be system documents to show the current and proposed functionalities of the system using MS Visio.
• Worked with the clients on the final signing process in the User Acceptance stages.

Environment: Windows, UNIX, Oracle, Requisite Pro, Rational Rose, HIX, Facets, SQL, MS Office, Visio.

Confidential

Business Analyst/Quality Analyst

Coventry provides group and individual health insurance, Medicare and Medicaid programs and coverage for specialty services. Coventry was acquired by Aetna in May, 2013. I worked as a Business Analyst with the IT Integration Team to interpret the claim functions within the IDX system and learn the client's legacy system requirements and functions to successfully migrate legacy system claim data to IDX system

RESPONSIBILITIES:

• Gathered Business Requirements from the Subject Matter Experts SMEs and documented the requirements in the BRD. Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners.
• Organized meetings and led JAD sessions to ensure legal and compliance deadlines of CMS Centers for Medicare and Medicaid Services are met.
• Worked with the UAT and QA teams to conduct an assessment and determine how effective UAT and QA guidelines can help the company achieve timely completion of projects.
• Involved in GUI Testing, Unit Testing, System Testing, Integration Testing, Regression Testing , performance Testing.
• Documented the UAT Plan for the project and worked with the UAT team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
• Effectively elaborated the Current process and gave a clear picture of the proposed process for the projects in the organization.
• Experienced with HIPAA compliance and Healthcare systems.
• Vendor Management Worked as a facilitator for Testing Efforts and New Requirements between the Healthcare Company and its various Vendors.
• Performed thorough analysis of the companion guides from each trading partners Medicare, Medicaid and Commercial clients and identified the changes that specific clients need.
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
• Understood the as is system and developed to be system concept and also prepare the System Process Maps.
• Conducted JAD sessions.
• Conducted presentations of the QA test results with analysis to the stakeholders and users and documented modifications and requirements.
• Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Developed UAT test cases associated with the functional requirements.
• Assisted QA team in creating Test Cases and perform User Acceptance Testing, documented the in detail defects using the Defect Tracking report.
• Used Test Case distribution and development reports to track the progress of test case planning, implementation and execution results.
• Defined test cases, created test scripts and interacted with QA / development teams in identifying and resolving errors and in User Acceptance Testing UAT .
• Maintained the Traceability Matrix Table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.

Environment: IDX, MS Visio, Word Excel, PowerPoint, Rational Rose, Requisite Pro, SQL, and Oracle, UAT.

Confidential

Business Systems Analyst

The main objective of the project was to make sure that the available MMIS should be able to meet the functionality required to electronically send/receive and process the HIPPA compliance standard transaction. As a Business Analyst I was involved in providing support throughout the complete lifecycle of the project which included development of user interface, web service and verified provider Medical/Dental/Institutional claims and reimbursement processing.

RESPONSIBILITIES:

• Analyzed and collected business requirements identified system interfaces and created the requirements specification documents.
• Identified Use Cases from the requirements. Created UML Diagrams including Use Cases, Activity/State Charts, Sequence and diagrams, Data Flow Diagrams and ER Diagrams using Rational Rose and MS-Visio thus defining the Business Process Model and Data Process Model.
• Conducted JAD session with different stakeholders while developing user interface and web services.
• Performed requirement analysis by gathering both functional and nonfunctional requirements based on interactions with the users, stakeholders, document analysis, user interviews, and documented those requirements in the BRD.
• Involved in 837 I, P, D , 834, 835, 820, transactions.
• Consistently utilized MS-Project for planning and project tracking purposes.
• Involved in understanding of department workflows and process flows with respect to applications.
• Developed Test plans and mapped them to Requirements with QA team.
• Gathered requirements through interactions, meetings and periodic walkthrough with SME's.
• Developed and updated Requirements Traceability Matrix RTM using Rational Rose, mapped the developed Test Cases to the requirements to ensure that the requirements were fully tested and implemented according to the specifications.
• Evaluated and tested the new and modified software application to verify that programs function according to both technical and business requirements.
• Developed, executed and validated user acceptance test plans UAT and implementation support.
• Performed GAP Analysis to figure out what we have and what we ought to have, to be better-off.
• Developed project schedules, conducted project status meetings and managed resources during all phases of the SDLC.
• Created and maintained the Requirements Traceability Matrix RTM .
• Interacted with Developers and Users in resolving risk factors and other issues.

Environment: MS Visio, SQL, Java, Oracle, SQL, PL/SQL, Load Runner, MS Project, MS Office, Rational Requisite Pro, Rational Rose, Clear Quest.

Confidential

Business Systems Analyst

Confidential is one of the biggest retail companies in Confidential which sells clothing, home electronic and various products. Confidential is their online site where you can buy things online with credit card. This project was a web-based application, which allowed customers to get a view of all the products in the store and buy them online. The application mainly dealt with the online payments and billings of the merchandise bought by non-registered customers

RESPONSIBILITIES:

• Hosted requirements gathering meetings with various teams.
• Involved in JAD sessions with SMEs and business users to analyze and gather the requirements for UI.
• Documented requirements and received sign off.
• Helped PM in finalizing scope based on the requirements.
• Worked on PLM team center.
• Developed documentation of processes as-is and to-be using various techniques including value stream mapping VSM .
• Hosted functional design sessions with functional analyst and prepared use case diagrams based on UML.
• Coordinated with the technical team for any functionality related questions.
• Develop end-user training documents and manage training deployments.
• Coordinated discussions with third party like banks for setting up payment gateway.
• Successfully used Scrum Analysis Model Agile for gathering requirements by facilitating Use Case Workshops and sessions.
• Worked with release manager to schedule various releases in Test/staging and production environment.
• Organized weekly Project Status and Task Review meetings.
• Created PowerPoint presentations and project updates using MS Project for management review.
• Developed, executed and validated user acceptance test plans UAT and implementation support

Environment: Agile, MS Office Suite, MS Project, UML, Use Case Analysis.

Confidential

Business Analyst/Quality Analyst

Provided consulting in the area of business process analysis and designed Shell infrastructure projects. Supported the QA team and involved in User Acceptance Testing.

RESPONSIBILITIES:

• Managed and assisted in the project scope, deliverables, milestones, schedules, and budgets
• Collaborate and act as a liaison between business, vendors, and IT organizations by planning, conducting, and directing the analysis of business problems.
• Evaluated processes, procedures, and provides recommendations for redesign improvements
• Analyzed the scope of the project and worked with business end-users to define business needs.
• Coordinated JAD sessions group meetings with stakeholders, end users and system owners and development team to define system requirements and system interface specifications
• Performed GAP analysis and developed the Business Process Models BPM using Visio and UML diagram.
• Employed Agile Methodology to conduct the system development
• Delivered the comprehensive Business Requirements Document BRD and Functional Requirement Specifications FRS document.
• Documented Use Case Narratives and used MS Visio to model UML Diagrams like Use Case Diagrams, Activity Diagrams, Sequence Diagrams, Class diagrams and Business Process Diagrams for the application's design.
• Created wireframes and developed UI mockups and Conducted back-end testing of the application using SQL queries
• Supported QA team wrote test-cases and used Quality Center while performing User Acceptance Testing to make sure all requirements are developed correctly.
• Documented the UAT plan for the project and worked with the UAT Team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
• Performed integration testing, product testing, User Acceptance Testing UAT and data driven testing.
• Coordinated and managed the Change Request CR Control process for the project by facilitating group meetings, one-on-one interviews and corresponding through emails with work stream owners to discuss the impact of change request on the project.
• Conducted regular meetings with development team members, Project Manager and testing team to better understand system functionality in order to improve quality.
• Involved in writing and implementation of the test plan, and various test cases for UAT.
• Conducted User Acceptance Testing UAT and developed the test plans, test scenarios, test cases and test data to be used in testing based on business requirements, technical specifications and product knowledge.

Environment: MS Visio, SQL, Java, Windows 2000/2003, MS Project, MS Word, UAT, MS Excel, Rational Requisite Pro, Rational Rose