PROFESSIONAL SUMMARY:

• 11+ years of rich experience in Software Quality Assurance and Business Analyst with Healthcare IT Industries.
• Experience with Managed Healthcare system, primarily focus on Enrolments, Claims, Billings, Payments, Benefits, Plan/Products and Customer Services for different payers and providers’ environments.
• Experience with large - scale systems Mainframe MMIS, Trizetto Facets, SalesForce, EDI, EDW, SOA, BI, EAI and Client/Server/Web based applications.
• Experience with testing HealthCare applications Trizetto Facets, HIX (eHealth.com, uhone.com), Automated Enrolment applications like TPM, BO & Boxi Reports, BAM Dashboard, Clearing House applications like OPTUM (Healthy-E-Network), ACE, Claredi, ERA and other applications Client Portal, TMG Operation Dashboard, TMG Call, MCRR, and TMG Enroll and SalesForce.com CRM.
• Extensively worked on X12 EDI (270/271, 276/277, 820, 834, 837, 835) transactions and HL7 ADT messages to validate enforced HIPAA and HL7 Standards.
• Strong analytical and QA/testing skills, capacity for work and diagnostic ability, extensively covered Agile, Waterfall and RUP models of SDLC
• Experience with applications based on Pega PRPC, TIBCO EMS/BW, EDIFECS HIPAA Edits, CLAREDI, ENS, ACE, IEDI, EDW and MOOP.
• Experience in configuration Facets Modules Eligibility/Membership, Billing, Claim Processing.
• Experience in SalesForce CRM implementation for Contact center console and Sales side business.
• Experience in SOA web service testing for API endpoints, MQ’s, Enterprise Bus Service(EBS) with REST WADL, SOAP WSDL services in HTML, XML, and JSon formats with tools SoapUi included SoapUi Automation and Postman.
• Extensive experience in reviewing and analysing Business Requirements and writing detailed Test Plans, Test Cases, Test Scripts in Automation and Manual Testing for multiple environments.
• Experience in Data Analysis, Data Validation, Data Cleansing, Data Verification and identifying data mismatch for ETL Testing in Analytical Data Warehouse.
• Extensive experience in conducting different kinds of tests such as Integration, Regression, Functional, System Testing, Black Box, Load, End2End, UAT and Sanity Testing.
• Extensive testing experience in backend system using tools like Mainframe, Oracle Sql Server, MS Sql Server, Sybase, Squirrel Gemfire, PostgreSQL PgAdmin Greenplum, Sql DBX.
• Experienced with onshore/offshore project resources environment across the world.

TECHNICAL SKILLS:

Applications: SalesForce CRM, Facets, PegaBlueLync,eHealth.com, Health-E-Network, ACE, Claridi, ERA, Boxi Reports, TMG Call, TMG Operation, IEDI etc.

Bug Tracking/Execution Tools: HP QC/ALM, JIRA, MTM.

Web Technologies: Scripting SQL, VB, PL SQL, Java, C, C++, XML, HTML and Json.

Test Management Tools: HP QC/ALM, Test Director

Operating Systems: Windows 10/7/NT/2000/98/95, Unix, Mainframe - AS400, IBM CICS

MS Office Suite, MS Project, MS Visio, MS Outlook, Lotus, Notepad++:

PROFESSIONAL EXPERIENCE

Confidential, RI

QA Test Lead

Responsibilities:

• Severing as a QA test lead, Interact with stakeholders, business analysts, system analysts, designers and developers to review business requirements, performed Quality Analysis, test planning, estimation to design detailed testing requirements and validate system workflows for BCBSRI projects.
• Manage onshore/offshore QA model and lead QA analyst teams of 5-7 members(1 Onsite and 4-6 Offshore), delivering projects for planned release cycle under EPMO(Enterprise Project Management Office).
• Main tasks include requirement analysis, test strategizing, test cycle planning, estimation, test plan review, test execution and defect management review.
• Facilitate UAT(User Acceptance Test) to implement SalesForce CRM in coordination with Business SME’s, Business Department Head, BA, Developers, System Architect, offshore QA team.
• Review Test Strategy, Test Plan, Test Execution and Test Results with Business users and Project team.
• Conducting testing activities for Test Minor, UAT and Test Major environment for all BCBSRI projects ‘SalesForce CRM’, ‘Facets Accumulators’, and Analytics Data Warehouse.
• Implement QA activities for ADW system in existing EDR (Enterprise Data Repository) for reporting in the organization.
• Maintain and publish project reports on daily or weekly basis for testing process, execution and defect management also present any risk and issues for the projects
• Provide production implementation support to the business users and owners for every implemented projects.
• Mentoring new QA team members(Onshore/Offshore), conducting training session and transferring knowledge management activities and testing tools.
• Collaborated on client engagement strategy to drive entry into risk-driven project methodology, improving accuracy of project definition, sizing estimates.
• Working with the development team to create a suite of test data (both input files and expected results) that fully exercises data validation for Manual and Automation scripts.
• Working on Traceability Matrix which is a proof of document to ensure that all the specifications are been tested and has no defects.
• Involved test case creation, test execution and troubleshooting system workflows for every assigned BCBSRI projects.

Environment: Lotus, Outlook, Skype, MS SQL Server 2012, SQL DBX, SalesForce.com CRM, MS Office, Waterfall/Agile Methodology, Scrum and Sprint environment, Oracle, SoapUI 5.1.3, HP QC/ALM, Facets 5.10, HIPAA X12 EDI 5010, Oracle 11g, SQL, Sametime, DataStage, RedCard.

Confidential

Edison, NJ

Sr. QA IT Analyst

Responsibilities:

• Interact with Business Analysts, and Developers to review business requirements (user story), performed Quality Analysis for designing detailed testing requirements and validate system workflows for EDW-MOMS.
• Involve into Scrum call during pre-planning meeting to help the estimation process for the user stories based on the complexity.
• Create test plan, review created test scenarios and test cases for Functional, Regression and automation test suite.
• Working on Tractability Matrix which is a proof of document to ensure that all the specifications are been tested and has no defects.
• Educate the team on testing processes, tools, types of testing, and writing solid test scenarios & defects as well as the application of quality principles.
• Worked on Mainframe testing on COBOL, JCL, DB2, CICS, ISPF, FILEAID, DB2 for Medicaid MOOP Extracts on z/OS system.
• Testing Trizetto Facets Application for TMG business activities like Billing, Claims processing, Eligibility, Enrolment, in Reporting and Extracts included inbound/outbound X12 EDI files.
• Using Facets application for mocking test data to test ETL process included SSIS package, databases like ODS (Gemfire, Greenplum) and SOA web services included REST services, Json, MQ’s for applications like Enterprise Service Bus, Client Portal, ODM, MCRR and Data lake.
• Testing troubleshooting EDI files, resolving and escalating data related issues and validating data to improve data quality.
• Created, executed and support team for SQL queries to perform source to target testing Data completeness, validity, uniqueness, data integrity, data transformation, data quality, initial and incremental load tests.
• Executed Automation scripts and review failure analysis, update scripts in Selenium.
• Configured Facets Module like Subscriber/Member, Billing and Claim Processing for testing.
• Creating test scenarios in Facets application to test Legacy and EDW applications.
• Troubleshoot EDI file transmission problems and business rules related inquiries which enforced HIPAA guidelines in the X12 5010 Transactions (834, 837, 270, 276) in Edifecs FTP server.

Environment: SQuirreL 3.6, MS SQL Server 2012, SSIS (Sql Server Integration Service), PgAdmin 1.16, MS Office, Selenium, Agile Methodology, PostgreSQL, Scrum and Sprint environment, Mainframe, SoapUI 5.1.3, HP ALM 12.00, Facets 5.10, HIPAA X12 EDI 5010, Oracle 11g, SQL, TortoiseSVN, MS Lync, Outlook, Citrix.

Confidential, Spring, CO

QE Lead/Sr. Engineer

Responsibilities:

• Responsibilities included analysis business requirements, functional requirements, overall design, use-case analysis, initial summary, risk analysis, test plan development, test case generation, requirement tractability matrix (RTM), and documentation.
• Developed test plan, test scenarios, test cases and test case execution and updated testing tables for Functional, Regression, Load and UAT for given environments and support TCOE.
• Involved into Scrum call during pre-planning meeting to help the estimation process for the user stories based on the complexity.
• Working on planning, monitoring, and control of the testing activities and tasks to the team.
• Worked as a proactive team leader of quality engineering team for projects like Transaction Exchange (ENS), IEDI CH, ACE, CORE, Claredi, and Facets.
• Tested PEGA rule based claim application Health-E-Network for adjudication process and remittance process.
• Validated HL7 Message Validation and sending of ADT Messages like ADT A01, ADT A04 and ADT A08 and HL7 ORU R01 Version 2.5.1 for Electronic Lab Reporting.
• Configured Facets modules NetworX, Providers and Claim processing for testing Agreements and Claim payments.
• Tested Load testing on Jmeter for API and Web applications from Facets and Clearinghouse DB.
• Tested troubleshoot enforced HIPAA guidelines in the X12 Version 4010, 5010 Transactions IG’s with FTP/SFTP Servers by SOAP, API (Stomp Client), and HTML applications.
• Validated IEDI transactions 837, 835, 270, 271, 276, 277 and 278 related inquires along with ICD10 Codes implementations with tools like SoapUI, API, SFT, FTP, ENS, uhone.com and File Upload.
• Verified different kind of file formats (X12, DDE, Print Image, and HTML) for Claims (Professional, Institutional, Dental), Remittance, Real Time Eligibility and Claim Status.
• Performed backend testing with writing complex SQL queries for testing different DB’s for Facets, EHR, EMR and Clearing House applications.
• Tested IEDI applications like ENS (Electronic Network System), Health-E-Network, Claredi, ACE, ERA Admin, ERA Manager, uhone and Customer Service
• Executed Automation scripts and review failure analysis, update scripts and data tables for Hybrid Framework in QTP

Environment: TOAD, MS Office, Jmeter, Agile Methodology, VB Script, Scrum and Sprint environment, HL7, SoapUI, PEGA PRPC, Stomp Client, ACE, HP ALM, QTP, Facets 4.71/4.81, HIPAA X12 4010/5010, Oracle 11g, SQL, JIRA, Rally, X12, Print Image, HTML, Ortelius, Cisco Communicator, WebEx.

Confidential, Washington, DC

Sr. QA Analyst

Responsibilities:

• Analyze the business requirements, performed Gap Analysis, generate system workflows to initiate Quality Assurance process for AE v2, Facets (Upgrades, TPM, BAM, Broker Express, Extracts, Confidential Facets Letters, Start-up, Mass Transfer, and CJA Codes).
• Created test plan, test case writing, test case execution, report defects, bug documentation and issues investigation during manual and load testing for all projects.
• Tested TIBCO and PEGA business rules for Automated Enrolment applications TPM, BAM and Broker Express integrated with EDI 834 transaction in Facets for Group and IMD business which related to every submitter.
• Troubleshot file transmission problems in enrollment related inquiries by EDI (834, TA1, 997, 824) and enforced HIPAA guidelines in the X12 Version 4010/5010 Implementation guides.
• Ran Automation scripts and review failure analysis, update scripts and data tables for Hybrid Framework in QTP.
• Worked on testing system upgrades in TriZetto Facets 4.3 to 4.5 and 4.5 to 4.7, TIBCO and PEGA based applications, and Mainframe for Automated Enrolment systems.
• Worked on Mainframe testing on MVS file system, JCL, COBOL, ISPF, FILEAID, DB2, Extracts and Transfer Data to text file.
• Validated End2End testing for Pega and Tibco business rules with EDI enrollment files.
• Worked on eHealth.com, vendor extracts in Mainframe, Facets extensions, Enrolments, Business Object report, HPX and AE2 Applications (TPM, BAM, Error Handling, Broker Express and eHealth) for TriZetto Facets and Mainframe.
• Analysed experience with Data validation by testing and handling to write complex SQL queries for database testing for TriZetto Facets and all other applications.

Environment: Pega PRPC, HIX eHealth, TIBCO Foresight EDISM, TIBCO Foresight Validator, SFT, FTP, MVS z/OS, QTP, TriZetto Facets 4.3, 4.5, 4.7, HP ALM, SoapUI, Waterfall Methodology, 4010/5050 X12 Format, PostgreSQL, COBOL, MS Office 2007/10, Lotus Notes, Jmeter, VB Script, Mainframe 3270, SQL, SQLDBX, TRMS, HP Extreme, Oracle Developer, EDI X12, Business Objects 6.5, DB2, MS Lync.

Confidential, Missouri

Business Analyst

Responsibilities:

• Used TSO/ISPF Mainframe to test data files of claim process, including DB2 and VSAM files.
• Analysed functional requirements and create such as BRD along to FRD for ETL process.
• Act as a liaison between developers and end users to ensure technical compatibility and provide written business requirements for development projects
• Tested troubleshoot file transmission process with EDI claim related inquiries and enforced HIPAA guidelines in the X12 Version 4010 Transactions Implementation guides for submitters.
• Validated scheduled batch jobs using COBOL for downloading data into temporary tables to generate the data required for some of the claim applications.
• Created and executed testing for trading partners and validate HIPAA guidelines mapping for 837, 276, and 277.
• Used FTP environments to dropping transaction file to test the complete EDI transaction process of the project.
• Involved into validating Test Scripts, Test Cases and Test Plans for Functional, Regression and User Acceptance testing for Test and Production environments.

Environment: Mercury Quality Centre, RUP Methodology, JIRA, COBOL, Lotus Notes, SQL, EDI, Business Objects 6.5, DB2, Mainframe 3270, MS Project, MS Visio, Excellent presentation skills, MS Excel

Confidential

Business Analyst

Responsibilities:

• Analysed functional requirements and create requirements document BRD along to FRD for ETL process.
• Act as a liaison between developers and end users to ensure technical compatibility and provide written business requirements for development projects.
• Prepared ETL/Back-End Test cases to validate the business requirement outcome.
• Involved in review process and meeting and also involved in the transformations testing.
• Performed the record count validation, data integration, incremental and data validations.
• Performed functional testing, system testing, re-testing and regression testing.
• Documented the Requirement Traceability Matrix for tracing the Test Cases and requirements related to them.
• Involved Test Scripts, Test Cases and Test Plans for Functional, Regression and User Acceptance testing for Testing and Production environments.
• Troubleshooting X12 transactions files and configured ETL process for real time test scenarios for quality work which adherence to design test specifications.

Environment: Windows XP professional, MS Project, MS Visio, MS Excel, UNIX/Oracle Platform, XML, Oracle Application server, SQL, DataStage, Quality Center.