SUMMARY:

• Engineer in Computer Science with over 16 years of experience leading the implementation of IT projects. I had been responsible for initiating, planning, executing, controlling, and closing complex application and system implementation projects. I have excellent experience in leading the development and testing effort of several IT projects. I have over 8 years of solid experience in Healthcare Industry. I am looking to have a long term and successful career in managing projects.
• Over 16 years of experience in leading and managing software development, testing and production support processes. Managed several moderate size projects concurrently.
• Experienced in development, testing, installation and maintenance of Software Systems in Batch and On - Line environments for several projects ranging from 2-5 million dollars.
• Lead the analysis and development of Business requirements. Established excellent customer relationships with the business community.
• Solid working experience in setting up Designing, Implementing and planning company-wide Enterprise architectures.
• I have worked for more than 3 years on NASCO Applications like HRBK(Benefit File ), HEHK (claim processing and unit testing), HRUK (Ded Max Categories Application), HIQK (Online Inquiry Application ), HURK (Procedure file maintenance and other documentation), HRJK (Utilization/Review string )
• Expertise in Rational Suite (RequisitePro, Rose, Robot, Test Manager, ClearQuest, ClearCase) and Mercury Tools (QTP, WinRunner, Test Director) and SILK Automation tool
• Conducted several business case analyses for various Healthcare IS projects.
• Extensive experience and knowledge on HIPAA guidelines, Claim processing, enrollment and billing, Provider data management, Medicaid rules and regulations, ICD-9 diagnosis codes and EDI transactions - 835, 837, 271, 270, 276, 277, 278.
• Excellent technical knowledge of Client Server Technologies - Sybase, Visual Basic, ORACLE, SQL Server and relational databases.
• Skillful in Java, J2EE, EJB, Entity Beans, RMI, JSP, JNDI, IBM WSAD technologies.
• More than 7 years of experience in MQ Series and Middleware products such as MQSI, JACADA Integrator.
• Highly proficient in Mainframe technologies CICS, IMS, DB2, COBOL, VSAM, SPUFI, QMF, etc.
• Over 8 years of experience of leading the projects through all the phases of Software Development Life Cycle (SDLC).
• Experienced in EDI Mapping with Gentran and Mercator tools.
• Maintained RUP Processes using Rational Rose tools.
• Excellent organizational and communication skills.

TECHNICAL SKILLS:

SOFTWARE/LANGUAGES/OPERATING SYSTEMS/TOOLS: PROJECT MANAGEMENT TESTING PROCESS MANAGEMENT MAINFRAME MVS/ESA COBOL C C++ JAVA EJB XML JAVA BEANS VISUAL BASIC 7.0/6.0 VBA/SQR DEVELOPER 2000 SYBASE ORACLE IMS DB/DC DB2 INFORMIX SQL SERVER 7.0 CICS JCL MQ SERIES 5.1,5.2 MQSI MQ WORK FLOW TCP/IP LAN/WAN SEE Confidential NDM DIRECT CONNECT FTP GENTRAN SDLC RATIONAL SUITE CA PLATINUM TOOLS NIKU SERVER VISIO/IRWIN FILE-AID QMF SPUFICA-7 PANVALET PALLM TEX CICS CHANGEMAN VMC CA VIEW (SAR) EASYTREIVE ABEND-AID VSAM VS COBOL IIXPEDITER INTERTEST MAPGEN DB2GEN COOLGEN DESIGN-1/INSTALL-1 ANIMATOR RATIONAL ROSE TOOLS RATIONAL UNIFIED PROCESS WINRUNNER/LOADRUNNER UNIX/AIX/LINUX WINDOWS - NT

PROFESSIONAL EXPERIENCE:

Confidential

Senior Business Systems Analyst

Responsibilities:

• Analyzing the Research Station Database to produce reports using SQL Server.
• Created various reports to present data to management and recommend ways to efficiently automate.
• Worked on Automating Benefit Code
• Worked extensively on HIPPA repository to identify data elements related to 837 Institutional and
• Contribute to and support the corporation's quality initiatives by planning, communicating, and encouraging team and individual contributions toward the corporation's quality improvement efforts
• Use knowledge of the current and future capabilities of IT to support the business in achieving its short and long-term goals
• Participate in the formulation of the company business system architecture plans, assessing cost and feasibility of system requests and ensuring the plan supports both strategic and near-term needs
• Establish and maintain strategic and effective relationships with customers
• Meet regularly with business leaders to listen, understand, address key issues, and educate them about IT services, capabilities, and value; seek out information from customers and use it for improvements in products and services

Confidential, Detroit, MI

Sr Tech lead

Responsibilities:

• Mapping field from existing system to the new system.
• Conducting User acceptance with the Business unit.
• Adding new reporting features.

Environment: Windows Network, Oracle 11g, SQL Sever, MS Project, MS Office, Lotus Notes.

Confidential

Senior Benefit Coder/ Technical analyst /Business Analyst/Test Lead

Responsibilities:

• Review and analyze the requirements document (NAEGS AND GEIS).
• Coding Mnemonic as per the Benefit requirements
• Extensively worked on coding of Benefit File application which contains mnemonic code language that defines the benefit file logic.
• Interacted with Procedure File, Provider File, Diagnosis File, HIQK online screens as a part of Claim analysis.
• Created Accumulation rules based on the Product and the level.
• The rules created were related to Deductibles, Co- Insurance, Out Of pocket etc.
• I had helped the Business team with the User Acceptance test.
• I had also participated in promoting the code to Production system.
• Created and updated the mnemonic code in Deductible Max Application file which accumulates the dollars spent on medical services per annum.
• Involved in generation of Quality Reports in Benefit File Manager tool by using MS- Access.
• I lead the end to end test for the various rules. The end to end testing involved creating claims and running them through the efde process.
• I conducted portal testing, nasco testing etc.
• I have coded the values for the Super Particular Tables related to Ded, Co-ins. etc.
• I have also brought in my experience in the claims system in resolving the Production Problems as well as the MTM audits related to the Association requirements.
• Resolved P-logs (production issues) by updating benefit codes that are causing issues
• Interacted with HURK (Huron menu) for validating a claim by pulling procedure file and mnemonic documentation.
• Working on various products CHP, CDH, PPO, POS, and HMA etc. They are coded on different levels such as 016,048 and 056 levels.
• Used the following screen as per the requirements HIQK, HEHK, TPOL, HURK, HRDK and HRJK.
• I have worked extensively in creating Benefit string, Substring, Particular, sub particular columns, limit string, accumulation string, accumulation rules, and benefit tables.

Environment: Windows XP Professional, Lotus Notes, NASCO host (Terminal Emulator), Mainframes (IBM TPX 3270 terminal, Mnemonic Code Language, CICS, TSO, MVS, JCL, COBOL), PDM (Project data manager), MS-Access, MS-Word, Ms-Excel.

Confidential, Detroit, MI

Tech Lead- IT/ Business Analyst/ Test Lead

Responsibilities:

• Extensively worked on coding of Benefit File application which contains mnemonic code language that defines the Benefit file logic which was developed by using mainframe CICS screens.
• Responsible for promoting the code into production
• Analyzes benefits in existence by group, section, package and product and determines the benefit accumulation rules.
• Analyzed business requirements
• Participated in Business Analysis, Requirement Analysis and Data Analysis

Confidential

Sr. Tech/Test Lead

Responsibilities:

• Lead IT project teams through different phases of the software development life cycle related to HIPAA guideline implementation, EDI transactions, Social Security De-Identification, Confidential and Business Intelligence.
• Good Knowledge of the Nasco systems-, Claims, and Benefit file Manager, Provider Systems, and Diagonsis and Procedure tables.
• Extensive testing with the NASCO Systems.
• Familiarity with Nasco Screens-HIQK, TPOL, HRDK etc Screens.
• Verified Provider databases using HIQK for various NPI-PIN Combinations.
• Verified Paid Claims, History Claims on the NASCO for the accuracy of Claims as per the NPI-PIN relationship.
• Created and tested POD (Provider Options Database) Files for the NASCO Feed.
• Created data files that were routed to test for NASCO Claims.
• Coordinated and approved Claims for the National Accounts.
• Involved in the development of strategic plans for projects of high business complexity.
• Lead the design and development of custom solutions to augment the Business Objects environment to meet all the needs of the business requirements. Worked with the business, point solution leads, architects and other planners to translate report functional specifications into Business Object reports.
• Developed Test plans, Test strategy, Test cycles, Test scripts and roadmap for the system test effort in the projects.
• Coordinated the test scheduling of the project in accordance to the corporate testing plan.
• Facilitated Unit, System Integration, performance and User Acceptance Testing processes.
• Involved as liaison with the business community. Oversaw client/customer relations to ensure that service expectations are developed and met.
• Involved in mapping database fields between BCBSM ( Confidential of MI) and vendor applications.
• Designed and monitored development of front end applications using Web Methodologies. The application was communicating with the mainframe through the middleware MQI and invoking OLTP (CICS) to start the transactions.
• Monitored migration of the software product to production environment. Coordinated the go-live of system within the scheduled timeframe.
• Implemented BCBSM ( Confidential of MI) Project methodologies. Assisted in establishing and improving project management methodologies, procedures and policies.
• Successfully implemented projects on time and on budget.
• Established excellent interpersonal relationships with the business and project team members.

Environment: NASCO Screens HIQK,HEHK,TPOL,HRDK,COBOL II, DB2 7.0, IMS DB/DC, JCL, VSAM, FILE-AID, XPEDITER, SPUFI, SDLC, ENDEVOR, RUP Methodology, J2EE, WSAD, Web Sphere Server, Java Applets, Servlets, MQSERIES 5.3, MQ CLIENT, XML, NDM(Network Data Mover),FTP, Call Flow, NDM(Network Data Mover).

Confidential

IT PM/Lead

Responsibilities:

• Lead the project team in the effort of new software product development for ‘Providers’. The new software product enabled providers to submit prescription via wireless devices or office desktops directly to the pharmacies.
• Designed the architect of the new product to be launched.
• Conducted and facilitated meetings with various ‘Providers’ to obtain the product specifications and consolidated the same.
• Managed the analysis effort of conducting system requirements analysis and creation of use case documents.
• Lead the design and development of custom solutions to augment the Business Objects environment to meet all the needs of the business requirements.
• Lead the testing effort in the project ranging from Unit Test, System Integration Testing, and UAT.
• Conducted quality review of the Analysis, Design and testing artifacts of XML data and schemas.
• Coordinated the implementation and pilot launch of the new product.

Environment: SYBASE, MQSeries, Rational Requisite Pro, Java, J2EE, JSP, EJB XML, XSL/XSD, HTML/DHTML, WSAD 5.0, EJB.

Confidential, Atlanta, GA

Senior Technical Lead

Responsibilities:

• Lead and coordinated the effort to create system requirements, program specification and Implementation plan for Medicaid Management Information Systems for the Confidential .
• The objective of this project was to provide complete MMIS solution to Medicaid Enrollees. Implement HIPAA transactions and code set requirements for the following (ASC X12N 270/272,276/277, 834, 835, 837). These transactions were sent by Network Providers, Non-Network Providers, and Clearinghouses to request Claim Status information, Eligibility status Information, Member Enrollment regarding the beneficiaries.
• Monitored daily Build Verification Tests on newly deployed products.
• Created and maintained test plans, test strategy and published test schedules for the assigned areas. Lead the effort of conducting Regression testing, System testing and User Acceptance testing and Production support.
• Lead and coordinated the implementation of real time data propagation using IBM MQSI to enable the integration of data between disparate platforms and databases, including DB2, VSAM, and CICS. Successfully got implemented MQ for Online (CICS) and Batch Environment (MVS/TSO, Windows NT).
• Processed various EDI Transactions using Middleware MQ SERIES 5.2/5.3.
• Responsible for setting up the Middleware environment (MQSERIES ENVIRONMENT 5.2).

Environment: VB, Crystal Reports, ORACLE 8.0, XML, JAVA, RUP, JDK2.1, JMS, Gentran 6.1, XML SCHEMAS(DOM/SAX JCL, VSAM, FILE-AID, OWL,AIX XPEDITER, SPUFI, C, COBOL LE/370, SDLC, MQSERIES 5.2/5.3, NIKU, Easytrieve, SCEMAS(DOM/SAX), MSOFFICE(WORD,EXCEL,VISIO).

Confidential, Columbus, OH

Technical Lead

Responsibilities:

• Lead the effort of Business Analysis, documenting program specifications and creating Use Cases using Rational Rose tools.
• Designed and Implemented CICS systems. Monitored and reviewed the development of Visual Basic Screens and programs which were interacting with backend GUI using MQI.
• Creating Test Plans, Test Data, Traceability Matrix etc for Regression, System and User Acceptance testing.
• Coordinated the cross checking of PALLM edit fields with the Oracle GUI subsystem.
• Lead the implementation of real time data propagation to enable the integration of data between disparate platforms and databases, including DB2, VSAM and Oracle.
• Extensively conducted SQL Performance tuning.

Environment: VISUAL BASIC 6.0, Java, ORACLE 8.0, Rational Rose, C, C++, SQR,Gentran 5.0, VS-COBOL II, CICS, DB2 7.0, MQI/MQSI, JCL, VSAM, FILE-AID, CHANGE MAN, XPEDITER, PANVALET, CA-VIEW(SAR), PALLM, TEX, VMC, MVS TSO, WIN-NT, MS OFFICE, SPUFI.

Confidential, Columbus, OH

Senior Programmer Analyst

Responsibilities:

• Preparing Program Specifications, Developing Programs, Testing and implementation.
• Information gathering, analysis and preparing CICS Screens.
• Integrated MQ Series to send and receive data.
• Responsible for monitoring and troubleshooting MQ Series for the project.
• Oversee business analysis, trading partner coordination, and client communication.
• Mentored and coached new team members on various technical aspects of the project.

Environment: Oracle7.3, Gentran 5.0, Visual Basic 6.0, MS-Access, Win-NT4.0, Netware 3.1, DOS/VSE, MQSERIES 5.2, SQR.

Confidential

Senior Programmer Analyst

Responsibilities:

• Involved in complete Software Development Life Cycle.
• Understanding the requirements for the new system.
• Preparing high level and low level specifications, Creating Program specifications.
• Developing Test Cases for sting testing and system testing.
• Created Software Problem reports.
• Maps in CICS Environment were created using MES and DESIGN/1.

Environment: COBOL 370, MVS, JCL, CICS, DB2, IMS DB/DC, ENDEVOR, DESIGN/1, QMF (QUERY MANAGEMENT FACILITY), XPEDITER, MES, SQR.

Confidential

Programmer Analyst

Responsibilities:

• Designed screens using SDF and BMS.
• Prepared Program Specifications.
• Developed Programs.
• Conducted testing.
• Implemented the programs.

Environment: VSCOBOL II, CICS 4.1, DB2, MVS/ESA, JCL, Microfocus Work Bench, Oracle 7.1, Visual Basic 4.0, Win NT, QMF, SPUFI

Confidential

Programmer Analyst

Responsibilities:

• Extensively involved in coding, testing and writing link test scripts, link testing and software problem reporting.

Environment: Oracle Pl/SQL, WINDOWS