SUMMARY:

• Business Systems analyst with over 7 years of experience in Pharma, Biotech, HealthCare and Telecom.
• Several years of diverse and very strong experience in Information Technology/ Data/ Process Management with emphasis on Business Systems Analysis and substantial know-how of Business Processes, Business Requirements gathering, Business Process flow, Business Process Modeling, and related technical knowledge.
• Extensive experience in Requirement analysis, Business Modeling, and Use Cases development using UML methodology
• Adequate knowledge in Health Administration Claims processing auto adjudication , COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrollment, EDI, Medicare, Medicaid, CDHP consumer driven health plans
• Extensive experience in gathering system requirements, defining business processes, UML modeling, sequence diagram and activity diagram.
• Strong understanding of Software Development Life Cycle SDLC , including good knowledge of RUP methodology.
• Experience in developing project plans, identifying documents, and validating requirements and reengineering process.
• Experienced in complete AGILE, RUP, SDLC, Client /server architecture providing a well balanced understanding of business relationships, business requirements, worked for financial and technical solutions and help the team at all levels until final product release.
• Worked on healthcare standards such as HIPPA 4010, DICOMM, CPT, ICD-9 and SOAP.
• Extensive experience with Content Management tools such as Interwoven, Filenet, SharePoint and Documentum.
• Experience in applying Rational Unified Process RUP methodology using Modeling and requirement documentation tools such as MS Office, MS VISIO, and MS Project.
• Conduction JAD Session and communicating with Stakeholders, Development team, SMEs, System Analyst, Business Analyst and Project Manager.
• Excellent analytical skills for understanding the business requirements, business rules, business process and detailed design of the application.
• Excellent skills in Business Analysis, OO analysis, requirement analysis, Business modeling and Use Cases development using UML Methodology.
• Experience in using Rational RequisitePro.
• Facilitated JAD sessions with business owners, IT team Users to drive out detailed business requirements, experienced in Systems Testing, Integration Testing, and Software Quality Standards, Training, Documentation and implementation in a business environment

TECHNICAL SKILLS:

Operating Systems: UNIX, Windows 95/98/NT/2000/XP, Linux.

Databases: MS-Access, MySQL, SQL Server, Oracle, Teradata, DB2, Sybase

Application Servers: IBM Websphere, ATG Dynamo, BEA WebLogic.

Internet: HTML, XML, VBScript, ASP, JavaScript, JSP, J2EE.

Automation Tools: MS Visio, Rational Rose, Rational ClearCase, Rational RequisitePro, Documentum

Bug Tracking Tools: Mercury TestDirector, Rational ClearQuest

Testing Tools: Mercury Interactive Win Runner 7.6/8.0, Load Runner 7.8/8.0, QuickTestPro 6.5/8.0, Rational Robot, Test Director 7.6/8.2, Quality Centre 9.0

Standards Methodologies: Agile, Waterfall, Scrum, RUP, SDLC, HIPAA, Claims, EDI 837/835/834/276/277, ICD-9 and ICD-10

Utility Tools: MS Office Suite, MS Project, iRise, Adobe Photoshop

Data warehousing Tools: Informatica, Business Objects, Cognos, Erwin

PROFESSIONAL EXPERIENCE:

Confidential

Role: Business Analyst

Confidential Medicaid and Healthcare partnership TMHP carries out the Medicaid claims payment and Primary Care Case Management administrator duties for the state of Texas. As part of implementing PPACA, TMHP is been directed to implement the NCCI changes in their claims processing system.

Responsibilities:

• Gathered Business requirements from stakeholders and documented the business requirements along with the estimated level of effort required for the project.
• Developed Use Cases, flow charts by using Ms Visio for the Business user requirements document which State and business stakeholders have to review, edit and approve.
• Developed functional requirements based on the approved Business user requirements document by working closely with developers.
• Conducted internal peer reviews periodically with the developers and other technical team about the feasibility of the system requirements.
• Developed Test approach and Test plan involving all the functional requirements that are been documented.
• Involved in the meetings with the State and business stake holders for the review of the developed Business user requirements, Functional requirements, Test approach, Test plan, Performance testing approach, User Acceptance Testing approach and results.
• Mapped test plan back to functional requirements for ensuring all the requirements are been included in the test cases.
• Created screen-mockups using iRise to review the requirements and provide feedback on the screen design. Also, used Microsoft Paint to create ad-hoc screen mock-up to review with the users.
• Created, and maintained EDI business rules with strict adherence to HIPAA 5010, ANSI ASC X12 and industry standards 837 P,I,D , 276/277.
• Executed the test cases that are been developed during the test plan phase and documented the defects as well as how they are been resolved defects management .
• Created prototypes, screen mockups, and wireframes to communicate the design with clients and stakeholders
• Executed the Performance testing cases developed for the claims engine, EDI servers and T1 line.
• Interacted and provided support to the third party vendors.
• Used SQL in MS Access for retrieval of data from database.
• Monitored data is available in data warehouse for reporting purposes using MS Access.
• Established RUP Rational Unified Process methodology and provided assistance in developing Use cases and project plans.
• Used Business Objects XI for preparing ad hoc reports by querying the data warehouse.
• Supported project modifications deployment into production environment.
• Involved in interactions with Subject Matter Experts, Project Manager, Developers, and the Trading Partner in the JAD sessions and teleconferencing for the weekly project status meeting.
• Conducted GUI and functionality testing using QTP.
• Conducted data driven testing using QTP to conduct backend testing.
• Used Test Director and Quality Centre for updating the status of all the Test Cases Test Scripts that are executed during testing process.
• Incorporated Rational Unified Process RUP to create Business Requirement Document Specifications using MS Visio and MS Word.

Environment: Windows XP, MS-Project, MS-Office Suite, MS Visio, MS Share Point, iRise Studio, HP Quality Center, HP Project Portfolio Management , MS Access, Business Objects XI, MS Outlook, MS Office Communicator.

Confidential

Role: Business Analyst

Confidential is a Privately Held company in the Healthcare, Pharmaceuticals, Biotech industry. APS provides a wide range of customized healthcare solutions to clients responsible for more than 20 million covered lives throughout the United States and Puerto Rico.

Responsibilities:

• Established a Business Analysis methodology around the Rational Unified Process.
• Organized Joint Application Development JAD sessions with data steward and ETL teams while having walkthroughs for mapping documents.
• Researched the various steps in the lifecycle and then constructed the system in a way that the high risk customers would be easily identified and monitored.
• Worked extensively on CDISC and SDTM.
• Worked for Version document with SME. Primary Liaison between Business User and Development Team.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.
• Did extensive research and analysis on Web based Point of Sale POS systems and presented to Executive sponsor
• Helped the business through the Build vs. Buy decision for the POS system
• Consulted with healthcare insurance company to develop conversion specifications for other insurance Coordination of Benefits including Medicare .
• Provide business intelligence analysis to decision-makers using an interactive OLAP tool
• Developed use cases, process flow diagrams as-is/to-be flows and UI mockups/wireframes to represent business requirements.
• Design, development, implementation and roll-out of Microstrategy Business Intelligence applications
• Requirements Elicitation, Analysis, Communication, and Validation according to Six Sigma Standards.
• Deep understanding of Structured System Development Methodologies
• Wrote automated Test Scripts for Regression Testing using Win runner.
• Teamed up with both internal and external software development groups to provide functional requirements specifications in form of use cases, business process flows, and prototypes and management reporting requirements.
• Participated in UAT and worked with Mercury Quality Centre for bug and defect tracking.
• Implemented automated COB processing of Medicare claims into Facets
• Conducted user interview at both in-house and client locations.
• Involved in Inception Phase and prepared vision statement and initial data models that contain Business Requirement Documents and supporting documents that contain the essential business elements and detailed definitions.
• Designed business continuity, disaster recovery plans and training exercises.
• Provided key input in working with users in defining project and system requirements.

Environment: Mainframes, COBOL, JCL, Mercury, SAS, Unix, Quality Centre, test Director, Load Runner, Rational Robot, Db2, Oracle, Business Intelligence, RUP, Rose, AGILE, ETL, MS Project, SQL Server, Oracle, MS Word, MS Excel, MS Visio, LoadRunner, WinRunner

Confidential

Role: Business Analyst

Confidential Incorporated is a global biotechnology company committed to the discovery and development of breakthrough small molecule drugs for serious diseases. The Company's strategy is to commercialize its products both independently and in collaboration with major pharmaceutical companies. As a Business Analyst my role was to creating transport files as per the CDISC standards for electronic submissions to the FDA.

Responsibilities:

• Identified, researched, investigated, analyzed, defined and documented business processes
• Reviewed requirements together with QA Manager ,Vice President of Human Resources Business Analyst
• Excellent experience managing the whole testing process using Quality Centre.
• Developed SQL queries using SQL Navigator to extract data from the target tables to prove the data mapping.
• Facilitated four-hour long round table discussion with most HR directors, managers and analysts along with QA manager to get their input ad-hoc UAT in the project.
• Using Documentum monitored change requests and documented requirements, integrating them with Use Cases.
• Used iRise for a mockup application simulation and feedback during the JAD sessions.
• Resolved all the issues pertaining to Point of Sales POS and the various transactions made at POS are checked and processed.
• Involved in analysis for wide range of Six Sigma and Web-based initiatives, including user requirements.
• Reviewed Technical Specs together with the team of two developers
• Reviewed and performed validation to ensure accuracy.
• Involved in creating transport files as per the CDISC standards for electronic submissions to the FDA.
• Wrote Test Plans in MS Word for Manual Testing, System Testing, Integration Testing, Performance Testing, Regression Testing reviewed their consistency with the business requirements
• Tuning of Informatica Mapping, With Respect to Lookup Transformation Aggregation, SQL Transformation
• Rational Unified Process RUP was used to implement iterative SDLC.
• Built a business process model using Rational Rose and Visio.
• Wrote Test Cases in MS Excel for user registration, access to training material, and activity log-in, reviewed the test cases and finalized
• Creation and design of both Manual and automated test scripts using win runner.

Environment - Mercury Tools Win Runner 7.0, MS Office, Documentum, MS Project, MS Visio, Test Director 7.0/7.5, Load Runner 6.5/7.0, Rational Robot, Business Intelligence, Quick Test Pro 6.5, Quality Centre 9.0 , iRise, SQL Server, Oracle, RUP, Requisite pro, NT/00, XML

Confidential

Role: Business Analyst

Confidential telecommunications company and is the owner of US Cellular and TDS Telecom providing services nationwide. It enables profitable delivery of high-speed Internet, data, video, and voice services to consumers and businesses. The Company wanted a report-writing tool for their fast flow application, which would generate reports from the database faster, reducing the number of calls from the fields.

Responsibilities:

• Facilitated Joint Requirement Planning JRP sessions with SME's in understanding the Requirements pertaining to Loan Origination to Loan Processing.
• Identified, researched, realized, investigated, analyzed, defined and documented business processes and Use Cases Scenarios
• Applications Billing BVA area was validated using ETL tool and AMDOX billing and Inventory tool system
• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Created Mapping Documents, Report Mockups and modified existing report mock-ups as to CMS requirements and finalized for development
• Created source table definitions in the DataStage Repository by studying the data sources by importing the data from Mainframe.
• Accumulated system requirements from various departments through surveys and interviews.
• Conducted JAD sessions with management, SME, vendors, users and other stakeholders for open and pending issues.
• Created Process Flow diagrams, Use Cases Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Assisted project Manager in User Interface Designing and Development.
• Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
• Created Use Cases Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS Project.
• Created and managed project templates, Use Cases project templates, requirement types and traceability relationships in Requisite Pro.
• Worked extensively with MS Excel and MS access
• Performed performance tuning of SQL queries and stored procedures using SQL Profiler and Index Tuning Wizard.

Environment: Rational Enterprise Suite Rose, RequisitePro, ClearCase, ClearQuest , RUP, Casewise modeller, IBM WebSphere, Rational Robot, Mainframe, XML, MS Visio, TSYS, MS Project, MS Office, AGILE, Java, Unix, C , J2EE, JSP, Oracle, DB2, Sybase, SQL Server Reports, Quality Centre, WinRunner, LoadRunner, Quick TestPro

Confidential

Role: Business Systems Analyst

Confidential is a diversified health and well-being company. It provides healthcare services and health benefits to approximately 70 million people through more than 560,000 physicians and 4,900 hospitals across the US. The project consisted of HIPAA 5010 upgrade from HIPAA 4010 and ICD10 upgrade from ICD9 following the ANSI ASC X12 and industry standards. My role also encompassed supporting corporate and HIPAA compliance requirements thereby improving application development and testing processes.

Responsibility:

• Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Provided mapping for HIPAA code sets and EDI transaction processing .
• Documented the Process flow and Business Use Cases for the EDI transaction 837, 276/277 and tagged them in Requisite Pro.
• Facilitated JAD sessions and online meetings with the Users, SME's, Project manager, Developers and Testers to make sure the requirements are captured accurately.
• Developed BRD, FRD, Use cases, Test scenarios, Test cases for testing the functional and non-functional requirements using Requisite Pro and Rational Rose to create/maintain: Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
• Accurate processing of Medicare claims using the Diamond system
• Assisted Project Manager in updating and maintaining Project Schedule, assigning project resources and monitoring deliverables using MS Project.
• Helped manage risk analysis and mitigation plans, status reports, and client prepared business process models, defined milestone deliverables, and established critical success factors.
• Functioned as a liaison between the business line, operations, and the technical areas throughout the project cycle.
• Worked on different EDI scenarios for batch processing.
• Data mapping, logical data modeling, used SQL queries to filter data within the Oracle
• Developed solutions in compliance with the industry models / standard Six Sigma, and HIPPA regulations.
• Created Mock-up forms in MS word for better visualization and understanding of the software solution.
• Facilitated JAD sessions with management, development team, users and other stakeholders to refine functional requirements.
• Authored progress and completion reports which were then submitted to project management on a weekly basis in MS project.

Environment: Java, J2EE technology, Windows 2000 Advanced Server, TSYS, UNIX / Oracle Platform, Cognos, MS Visio, RUP, Rational Rose 2002, SQL Server 2000, TOAD, Rational Clear Quest, Rational ClearCase, Rational requisite pro, rational test manager, Rational Robot.