SUMMARY:

• Results - oriented professional with extensive IT and business knowledge in multiple areas, with proven project management, analytical, problem solving and programming skills. Over 15 years in IT have developed varied experience in:
• Project Leader Expert troubleshooting and problem solving
• Full Project Life Cycle Development Team Player and Self Starter
• Software Design, Development and Conversion Organized, Detail and Problem Focused
• System and Data Analysis Verbal and Written Communication

TECHNICAL SKILLS:

OS/Environments: MS-WINDOWS 3.11/95/NT/XP, OS/2, MS-DOS, UNIX

Software: MS SQL SERVER, ORACLE, SQL*Plus, PL/SQL Developer, MS SQL Management Studio, SYBASE SQL SERVER, SYBASE SQL ANYWHERE ISQL, WATCOM, LOTUS NOTES, SAP, R/3, HTML, XML, XSL, Java, POWERBUILDER, MS OFFICE SUITE (WORD, EXCEL, POWERPOINT, ACCESS, VISIO), Filezilla, Merant PVCS Version Manager, SourceOffSite, OnTime, AdminiTrack, SharePoint.

PROFESSIONAL EXPERIENCE:

Confidential, Parsippany, NJ

Senior Systems Analyst

Responsibilities:

• Worked on eCommerce projects to establish inbound and outbound EDI file connections and web based applications. Connections include EDI files that follow 5010 X12 ANSI standard formats such as 837 I/P/D, 835, 277/277CA, 999 EDI transactions, custom flat file layouts and real time web service calls for processing medical claims and issuing payments.
• Managed projects, such as Claim eligibility feeds, Electronic Billing, Electronic Referral processing, EMG Retro billing, 999 X12 automation, billing for Non-contracted providers, throughout the full process of SDLC from building a business case to production release and maintenance.
• Worked closely with internal business users as well as external clients to identify business needs, existing process gaps and provide possible solutions for processing medical bills via new EDI connections and web based tools for medical billing.
• Defined project scope, budget, timelines, resources, expected benefits, dependencies and risks.
• Conducted requirement gathering sessions with internal and external users, created business requirements documents, process flow diagrams, functional system requirements, file mapping.
• Performed as a liaison between business user, onshore and offshore developers and testers.

Confidential, New York, NY

Senior Business Analyst

Responsibilities:

• Conducted gap analysis, business and functional requirements gathering resulting in release of documentation such as Gap analysis spreadsheet, BRD, TRD, Traceability Matrix for major EDI projects, including conversion of EDI transaction processing from 40 10 to 501 0 HIPAA compliant version, consolidation of EDI transaction processing via single EDI Gateway - BizTalk 2009, CAQH CORE certification, ICD-10 implementation, Health Home, Healthcare Exchange for NYSDOH, FIDA, Medicaid Reclamation, BH/HARP Utilization Management, Multiple Clearing House, Extended institutional, professional and dental claims processing (837I, 837P and 837D) for various lines of business.
• Created non-functional requirements documents for 5010 HIPAA implementation, CAQH CORE Operating Rules and EDI Gateway Consolidation.
• Compiled Companion Guides for Confidential Trading Partners for Eligibility and Benefit Inquiry (270/271), Claim Status Inquiry (276/277) Request for Review and Response (278) and Enrollment (834) EDI transactions subsequently published on Web.
• Facilitated requirement gathering, documentation (BRD and TRD) walkthrough sessions with project stakeholders, including business partners, development, QA and UAT teams.
• Conducted testing of CAQH CORE Operating Rules Phase I and Phase II implementation using EDIFECS test suite.

Confidential, Newark, NJ

Business System Analyst

Responsibilities:

• Defined and managed high level business requirements for multiple healthcare innovative pilots.
• Facilitated requirement gathering sessions with pilot work groups.
• Translated high level statement of needs into business requirements.
• Created standard operating procedures for managing business requirement across multiple healthcare models.
• Created user acceptance testing scripts for web based Episode of Care Model.
• Conducted user acceptance testing.

Confidential, Secaucus, New Jersey

Senior Business Analyst

Responsibilities:

• Participated in full cycle of business market analysis, requirements gathering, design, development, implementation and user acceptance testing of meeting management system TouchPoint for Speakers Bureau business.
• Formed a liaison between Speakers Bureau Business owners and IT on site and off shore developers.
• Created business requirements, functional requirement and statements of work documents for client and vendor review and sign off.
• Created process flow diagrams, use cases and user interface documents for system development by offshore team.
• Facilitated Webex walkthrough sessions with offshore team, providing explanation of functional requirements and clarifications as needed.
• Participated in incident triage sessions as a part of TouchPoint production support.
• Established requirements gathering business processes for internal and external IT projects.
• Created TouchPoint user guide for existing system users roles.

Confidential, New York, New York

Lead System Analyst

Responsibilities:

• Participated in full cycle of design, development, implementation and user acceptance testing of multiplatform ERP and Supply Chain Management system BlueCherry for apparel and footwear industry
• Formed a liaison between the Project Managers and Technical Team Leaders/Developers.
• Performed extensive analysis of Client specifications with further translation into Technical documents.
• Planned database design and changes.
• Created data flow diagrams.
• Produced Screen, UI, and reports designs

Confidential, Franklin Lakes, New Jersey

Senior Business Analyst

Responsibilities:

• Participated in full cycle of design, development, implementation and user acceptance testing of Specialty Mail Pharmacy Order Processing System and development and enhancements of major components of Coverage Determination Process (CDP) systems for processing of Managed Care Programs, including managed prior authorization, managed Rx coverage and Rx selections formulary.
• Implemented conversion of CDP system from DMQ to MQ based access to MF and weekly feed of POLAR data repository with patient’s medical condition history from CDP, conversion of CDP system to be HIPAA compliant.
• Provided leading effort for projects involving IGSI resources, including gathering system requirements, creating technical specifications, design documentation, support the training of outsource consultants with knowledge transfer and recommendations, reinforcing, developing and instructing on policies and procedures.
• Coordinated scheduling, upgrade, testing, implementation and production release of system SMS packages for use in Specialty Pharmacy Call center.
• Validated different functional modules of Order Processing System by manual end-to-end test execution.
• Performed user acceptance testing.Managed software integration, QA and production releases.

Confidential, Riverdale, New Jersey

Senior Programmer/Analyst

Responsibilities:

• Participated in design and implementation of Return mail module in Data Entry system, which allows creating output files on UNIX with all available information about the debtors, whose address has been changed, for further processing in check collection workflow.
• Created multiple reports that provide collection agencies with information about debtors, checks, submitted for collection, overdue payments, contingency and noncompliance reports, process workflow reports for different merchants and stores.

Confidential, New York, New York

Lead Analyst

Responsibilities:

• Participated in development and implementation of Time Optimization project for monitoring and analysis of activities of sales people in the field.
• Played a key role in design, development and implementation of Account Monitor System for capturing data from Nielsen Scan-Track, SAP and ORACLE databases and create data repository for the company Top/Growth accounts. This system provides monthly summary data for trending and analysis of the Growth Accounts by regions and automates the process for accurate and timely Account Monitor Reports
• Performed data analysis and provided statistics to Marketing department.
• Provided support of daily sales data upload to be used in the field by sales representatives.

Confidential, Somers, New York

Programmer/Analyst

Responsibilities:

• Participated in creating corporate layer of PFC libraries.
• Designed, developed and implemented Next ID application for generating, of next ids in database and troubleshooting common next id problems, Crystal Maintenance application for interface with Crystal Reports.
• Utilized inheritance, custom user objects, different forms of dynamic SQL to perform user-defined run time requests, stored procedures.
• Implemented and maintained the major enhancements to Roadrunner application for generating of routing solutions, for reporting and analysis of field service data.
• Responsible for hardware and software installation and maintenance.