PROFESSIONAL SUMMARY:

• Over 10 years of extensive experience in the area of US Health Insurance domain with focus on Payer Health plans.
• 7 years of experience as Business Analyst in gathering, understanding, documenting the business requirements.
• Experience in Business Analysis: Planning Monitoring, Requirement Elicitation, Requirements management, Requirement Analysis, Solution Assessment Validation etc.
• Possesses Excellent Communication skills, interaction skills, behavioral skills, Analytical thinking Problem Solving skills.
• Strong experience in Agile/SCRUM methodologies as Scrum Business Analyst, and Scrum Master
• Rich hands-on experience with Healthcare IT systems in the areas of Laboratory Information systems, Pricing UnderWriting, Health Insurance Claims, Membership, Benefits, Sales, Medicare and Medicaid.
• Experience in analysis of Health Care Reform HCR regulations impacting Payer.
• Experience in providing IT solutions to the mandated changes laid down by US Federal government's Affordable Care Act PPACA / Health Care Reform HCR .
• Strong experience in diverse roles viz., Business Analyst, Systems Analyst, Technical Leader, Senior Developer, Software Tester, and Project Leader.
• Experience in Information Security implementation Coordination in Healthcare IT applications. Used ISO/IEC 27001:2005
• Experience in Project Management, and Onshore-offshore coordination in Application Analysis, Development, Testing, Support, and Maintenance under the T M, Fixed Budget, and Managed Services Models.
• Experience in Database design and development using Oracle 10g, and Oracle PL/SQL. Experience in Database Performance tuning and SQL query optimization
• Developing Oracle Stored Procedures, Functions, Packages, Cursors, Triggers, Views/MVs, Collections, Roles, database links etc.
• Experience in Quality assurance and Software Testing System Testing, UAT support etc. .
• Proficient in Version Control, and Change Management.

EXPERIENCE SUMMARY:

SKILLSET:

PROFESSIONAL CERTIFICATIONS, COURSES, ASSOCIATIONS:

• Professional, Academy for Healthcare Management, American Health Insurance Plans
• AHM 250-Healthcare Management-An Introduction, AHM 540- Medical Management, AHM 530- Network Management
• Course on Health Policy and the Affordable Care Act, University Pennsylvania, USA
• Oracle PL/SQL Developer Certified Associate OCA
• ITIL Information Technology Infrastructure Library 2011 Foundation certified.
• Brainbench certified in Winrunner 6.0
• Member, International Institute of Business Analysis IIBA
• Member, Project Management Institute PMI

PROFESSIONAL EXPERIENCE Project-wise :

Confidential

Role: Senior Business Analyst

Project: Quoting and Rating System QRS is the IT application for quoting and rating of small group customers of Aetna. Health Care Reform HCR law mandated significant changes in quoting and rating process. The major changes are rating logic change, new benefits plans. The project involves incorporate those changes along with Aetna's internal changes related to scalability and performance improvements.

Responsibilities Achievements:

• Participating in the Daily Scrum, Sprint Retrospective, and Sprint Planning how meetings
• Gathering business requirements for enhancements in the QRS application
• Interacting with business users and Subject Matter Experts for requirements elicitation thru JAD sessions, and grooming sessions
• Breaking down the requirements into Epics and user stories for Agile implementation
• Grooming the user stories with accurate Acceptance criteria and size the stories
• Preparing the traceability matrix connecting High Level Business Needs, Expanded Business Needs, Epics, and user stories
• Analyze the data sources build data decomposition and data flow diagrams.
• Analyze, modify, and write SQL queries utilizing multiple data sources.
• Representing the application BA teams in client meetings and documenting meeting outcomes
• Coordinating all internal and external follow-ups to close issues in support of the project requirements
• Listening to individuals questions and concerns, to ensure clarity and direction and a successful delivery of project or functionality
• Preparing use case diagrams catering to the application architecture document and also assisting the team in preparing specifications for algorithms to convert into pseudo codes/test cases
• Translating business requirements and objectives into functional specifications through Use Case Narratives and elaborating business intent for execution by IT, QA, and other operational groups
• Conducting Impact and Gap analysis in order to develop/ validate/ maintain the application based on the requirements
• Play Scrum Master back-up role in executing the scrum process.

Tools: Rational Requirements Composer RRC , Rational Team Concert RTC , Rational Requisite Pro, Rational ClearQuest, TOAD, and Microsoft Office.

Confidential

Role: Senior Business Analyst

Responsibilities Achievements:

• Translate ACA mandates for Health Insurance Exchanges and subsequent proposed regulations into functional requirements that a Qualified Health Plan QHP must meet.
• Categorize anticipated impacts to value chain components as either operational or technology-related.
• Analyze the existing requirements to find the Gaps, if any.
• Provide recommendations to handle missing requirements and/or gaps.
• Identifying and develop high-level test scenarios.
• Prepared traceability matrix connecting Regulations, Use cases, requirements, and test scenarios.

Tools: Microsoft Office, TCS Health Care Reform tool

Confidential

Role: Senior Business Analyst, Project Lead

Responsibilities Achievements:

• Gathered and analyzed requirements and documented the interfaces from BETS to XCELYS, Diamond, and other systems
• Prepared the traceability matrix connecting regulations, user stories, requirements, and test scenarios
• Backlog grooming, and user story writing
• Analyzed, proposed, and documented IT solutions for some of the changes mandated by the Healthcare reform law PPACA
• Developed and maintained documents covering user requirements and design
• Developed built technical documents and training and support material
• Managed a team of 23 members working on major enhancements Web client/server applications using C .NET and Oracle database in the Managed Services Model
• Acted as Onshore-offshore coordinator for development and support teams
• Track and report Managed Services Model MSM metrics to the customer on development and support services
• Involved in the Healthcare domain competency development in the organization through SME development training and other initiatives
• Implemented and coordinated Information security policies and standards at the offshore development center

Environment: Microsoft Windows 2003 server, .Net, and Oracle Database

Tools: Microsoft Visual Studio 2005/2008, Borland StarTeam 2008, Borland CaliberRM 2008, HP Quality Center 11.0, Remedy, and MS Office 2010

Confidential

Role: Technical Systems Analyst

Responsibilities Achievements:

• Involved in L2, and L3 support of Production interfaces with Claims Diamond, and XCELYS , and other systems.
• Supported System upgrades, Production deployment, UAT, Release mock shakedown, Job Scheduling, and Monitoring.
• Developed solutions to fix the production issues in Oracle PL/SQL code, and interfaces permanently.
• Created Oracle PL/SQL stored procedures, function, packages, Cursor and Triggers
• Managed Supported the deployment of tested PL/SQL code into production, as well as post-implementation support activities
• Analyzed errors in production environment and proposed workarounds and permanent solution.
• Follow change management methods with strict compliance to SOX Sarbanes Oxley Act
• SQL, and PL/SQL code tuning for better performance of PL/SQL programs.
• Mass data loads into Oracle database using sqlldr PL/SQL programs
• Documenting the production issues KEDB for future reference
• Involved in Process Improvements, and Value adds projects
• Prepare and report the metrics as part of Managed Service Model MSM
• Developed interactive dashboards and reports for Business Users and Managers

Tools: Visual Source Safe VSS , StarTeam, Microsoft Visual Studio 2005/2008, Oracle SQL Developer, PL/SQL developer, HP Quality Center, and Remedy

Confidential

Role: Business Systems Analyst

Project: National BETS is full workflow benefit administration application for OH and HI regions. The system is used to manage contracts, benefits, underwriting, rating and quotes for the region. The system has interfaces with NPS Pricing UW , CM Membership , DIAMOND Claims , DSS Business Intelligence and EPIC Cinical systems.

Responsibilities Achievements:

• Gather business requirements for enhancements in BETS and its Interfaces.
• Involved in data migration across systems.
• Involved in data analysis, data cleansing, and mass data loads into Oracle database.
• Gather and analyze the requirements for the Decision Support System DSS DW interface that uses ETL.
• Develop data mapping and Solution Design Document for ETL interfaces.
• Work with Data modelers and DBAs to create/update table structures.
• Interact with Business users, and Subject Matter Experts
• Analyzing the Requirements obtained from the client and estimating the time required to incorporate into the system.
• Prepare High level design documents with pseudo code Oracle PL/SQL, Windows batch programming, C .NET
• Involved in System test plan creation based on the requirement and design document
• Prepare Oracle PL/SQL code, Visual Basic code generation scripts using SQL DB Access tool
• Help the support team to resolve the Critical and High production issues.
• Involved in L2, and L3 production support.

Environment: Microsoft Windows 2003 server, .Net, Oracle database

Tools: Microsoft Visual Studio 2005/2008, Oracle SQL Developer, PL/SQL developer, StarTeam, VSS, HP Quality Center, and Remedy

Confidential

Role: Junior Programmer

Responsibilities Achievements:

• Understand the requirements, and design documents of Oracle PL/SQL code and Claims process including Claim Acquisition, Pre-Processing, Adjudication, and Post Processing
• Develop Oracle PL/SQL stored procedures, function, packages, Cursor, Triggers etc. in Agile/SCRUM Methodology
• Unit test the developed code, prepare Unit Test Plan UTP Unit Test Results UTR
• Prepare SQL scripts for database changes, and send to DBA.
• Support the claim processing in PROCLAIM production to resolve the issues.
• Performed transformations, mappings, and work-flows in ETL using Informatica power center
• Develop Unix shell Scripts for jobs, and data loads.

Environment: Oracle 9i, UNIX

Tools: TOAD, Informatica 6.x

Confidential

Role: Integration Engineer

Responsibilities Achievements:

• Interact with clients on requirements and define priorities based on business needs.
• Project Plan and plan the schedule for implementation.
• Write and run SQL queries against DB2, and Oracle databases for the test data
• Develop the SQL scripts for reports business users need
• Coding, unit testing and documenting test results.
• Develop and execute test cases for Integration Testing and Regression Testing.
• Onsite Offshore Co-ordination.

Environment: Java J2EE, DB2, Oracle, and UNIX

Tools: Mercury interactive Tools Mercury Quality center 9.0 , and WinSQL

Confidential

Role: Junior Programmer

Responsibilities Achievements:

• Maintain and support the Cerner's PathNet General Laboratory, Specimen Management, Blood Bank Transfusion, Microbiology modules.
• Managing the specimen flow all the way from collection to result storage reporting
• Develop and implement application back-up and recovery procedures.
• Provides Level 2 and 3 support for day-to-day production issues, maintaining documentation in the appropriate tracking systems while adhering to prescribed escalation change control procedures.
• Evaluates IT application updates and revisions and participate in testing.
• Installs maintenance/patches and software upgrades.

Environment: Java J2EE, Informatica Power center8, Oracle 8i

Tools: Informatica Power Center, PL/SQL Developer, and Oracle Designer