SUMMARY

• Over 14 years of professional experience in the Information Technology industry, with expertise in areas of as a Business Systems Analyst, Software Quality Lead, Project Manager, Systems and Database Administrator. Effective team member with excellent professional interpersonal skills
• Extensive Experience in Financial, Insurance, Telecom and Health Care Industries.
• Strong experience in Complete Software development Life cycle (SDLC) of Data warehouse and Business Intelligence Applications.
• Hands on experience in Waterfall, RUP and Agile (scrum) methodologies and thorough understanding of Object Oriented Analysis and Design (OOA&D) concepts.
• In depth knowledge of HIPAA, ICD, HL7, EDI (file formats like 837 I/P/D, 270/271, 276/277, 835), Managed Care, Claims and Medicare business areas
• Extensive design experience in creating UML diagrams such as Use Cases, Activity Diagrams and Sequence Diagrams using MS Visio and Rational Rose
• Good conceptual understanding of Data Warehousing and experience writing and optimizing SQL queries
• Proficient with web technologies such as HTML, XML, Web Services, Ektron and Alfresco
• Comprehensive knowledge of SDLC with experience in black box, regression, integration, UAT, load and performance testing
• Excellent communication and presentation skills with experience in development, implementation and integration of strategies within a team oriented environment.
• Expert on business operations models, database planning, and solutions.
• Provide leadership, technical expertise, effective communication and guidance.
• Manage the team and stake holders. Prioritize multiple tasks to meet the deadline.
• Create project plan. Manage Scope, Time, Cost and Resources on the Project.
• Excellent business knowledge in managing and facilitating projects on Finance Planning and Budgeting, Sales, Marketing, and MIS applications.

TECHNICAL SKILLS

Hardware: Sun (Sparc 1, 2,10 & 2000), RS6000, HP Matrix, Cisco’s UCS

Languages & Platforms: Java, J2EE, Microsfoft .Net PlatformVeritas Vol. Manager 2.5/3.0.1/3.1 FileSystem 3.4, Veritas first watch 2.2.5.1, VCS 1.3Veritas NetBackup 3.2, ESQR, T - SQL, PowerBuilderWindows 3.1, 95, X-Windows, C, C++, Fortran 77, Perl 5,Korn Shell

Operating Systems: AIX 3.2.5, Solaris 2.8, NT 4.0, Windows 95/98/NT/ XP

Tools: MS Project, MS Visio, Rational Enterprise Suite Rose, RobotTest Manager, ClearQuest, Requisite Pro; Mercury Interactive TestDirector.

Database: Sybase 11.0.2, Oracle 7.0, Paradox, Access, Informix

Web Applications: ASP, JSP, Servlets, ASP.net, XML, SOAP, WebservicesEktron, Alfresco.

Certificate Courses: Sybase System 11 (Systems Administration), PowerBuilderVisual Basic, OOP in C++, SAP R/3 ABAP/4

Data Warehousing: Informatica, SSIS, Cognos, SQR & Business Objects.

PROFESSIONAL EXPERIENCE

Confidential, NYC

Sr. Business Data Analyst

Responsibilities:

• Worked with the core team to gather businessrequirements from multiple stakeholders, accounting, operations and management groups - and reconciled conflicts by conducting Joint Application Development (JAD) sessions based on the project scope.
• Analyzed Business Requirements and segregated them into high and low level Use Cases and Activity Diagrams using MS Visio.
• Performed GAP analysis involving the current state and proposed state.
• Worked closely with other BAs and ETL Leads/Managers and was responsible to perform detailed data requirements analysis and create design specifications and operational documentation.
• Provided the ETL team with the Data mapping document and assisted them to create the mappings.
• Worked closely with the architects, database administrators and technical team during Data Mapping and Data Integration
• Involved with Analysis of reference data from Accounting Systems and Investment Accounting Groups.
• Analyzed and presented the Business with information on data anomalies, issues, input errors, field value ranges, data patterns, referential integrity gaps and the level of record incompleteness that is in the source systems.
• Organized meetings with the SMEs and Data Owners to walk through the findings and determine the cleansing process.
• Participated in various sessions with Business to understand the business rules and to come up with naming conventions to standardize the data.
• Played a key role in the user acceptance testing (UAT), and implementation of system.
• Extensively used SQL scripts/queries for data verification and Validation Confidential the backend.

Confidential, Pittsburgh, PA

Sr. Business System Analyst

Responsibilities:

• Prepared logical data model in the form of Business Context diagram to include various entities and attributes in order to facilitate the design of Data model in the form of ER Diagrams. Studied current information structures and data models of the current databases to better understand the design of target data source.
• Performed custom data conversions and developed custom software for risk management applications including general claims, vehicle accident and administrative tracking. Performed all data field mappings.
• Used Rational Rose to model the process using UML to create behavioral and structural diagrams.
• Used Rational Clear Quest to track required changes and Rational Clear Case to maintain different versions of the project documentation
• Modeled Business requirements into workflows to depict various scenarios of system to request RFI and RFP responses from major vendors.
• Responsible for identifying, documenting and testing the data mapping feeds from several reference data systems, to risk applications
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.
• Intricately involved in Business Process Flow development, Business Process Modeling, and ad hoc Analysis
• Performed detailed comparative analysis of response to RFPs of vendors and Graphically Represented the recommended solutions in PowerPoint to Senior Management
• Prepared Business Context Diagram, Use Case diagrams and corresponding Activity Diagrams using Rational Rose to depict the workflows.
• Prepared and maintain Business Rules Spreadsheets (BRS) identifying Rules, Triggers and corresponding data fields from Legacy to target System.
• Captured Data flow diagrams and formatting of the data flowing through interfaces.
• Lead the effort of Data Migration from disparate data sources into normalized data to eliminate redundant information and organizing the tables to easily maintain the table structures.
• Prepared Test Cases based on base-lined Requirements Document, prepared Requirements Traceability Matrix and provided Performance Testing Requirements. Worked very closely with the Test team to Test all iterations during the Testing Phase and documented all the defects.
• Facilitated the User Acceptance Testing (UAT) with Business Users, documented any issues or defects and eventually got sign off from the right parties.
• Prepared training materials in the form of User manuals by preparing step-by-step guide to all screen flows in CMS.
• Assisted in development of User Interfaces and prepared screenshots to get business’s buy-in on the requirements.

Confidential, PA

Business Systems Analyst / Project Manager

Responsibilities:

• Gathered and documented business requirements for the enhancements related to eligibility and benefits application for providers and Members as input for Functional Requirements Specification (FRS).
• Created activity diagrams and sequence diagrams using MS Visio to communicate the system activity flow to the Dev team and QA team.
• Perform a baseline assessment and related interfaces, the existing service level agreements and/or policies and operational business procedures for readiness to comply with HIPAA as well as ICD-10 requirements.
• Ensured HIPAA compliance related to display of minimum benefit information that the Provider is required to pass on the EDI transactions.
• Conducted analysis of HIPAA compliance and took part in discussions for designing the healthcare transactions to be HIPAA 5010 compliant.
• Identified risks, problems, requirements and concerns to comply with ICD-10 changes.
• Involved in mapping and validation of different EDI transaction used for claims filing like 837 (I, P, D) for claim submission, 835 for the healthcare claim payments and 834 for Enrollment.
• Worked on Claim Data for Medicare Advantage Plans for Part A, Part B for 837 and 834 formats.
• Involved in mapping data from different EDI files onto database using different routing transformations.
• Actively worked on Data analysis and Report analysis with respect to ICD-10 impact.

Confidential, NJ

BSA / Data Integration Analyst

Responsibilities:

• Worked with the core team to gather businessrequirements from multiple stakeholders, Business Teams and management groups - and reconciled conflicts by conducting Joint Application Development (JAD) sessions based on the project scope.
• Created Functional Specifications Document and designed high and low level Use Cases and Process / Activity Diagrams using MS Visio.
• Performed GAP analysis and Impact Analysis involving the current state and proposed state.
• Worked Closely with Application Architects and Business teams to converge on requirements for the Enterprise Consumer Matching WebService.
• Worked closely with Data Architects and ETL Leads/Managers and was responsible to perform detailed data requirements analysis and create design specifications and operational documentation.
• Provided the ETL team with the Data mapping document and assisted them to create the mappings.
• Worked closely with the architects, database administrators and technical team during Data Mapping and Data Integration
• Involved in data modeling and building fact and dimension tables.
• Analyzed and presented the Business with information on data anomalies, issues, input errors, field value ranges, data patterns, referential integrity gaps and the level of record incompleteness that is in the source systems.
• Organized meetings with the SMEs and Data Owners to walk through the findings and determine the cleansing process.
• Participated in various sessions with Business to understand the business rules and to come up with naming conventions to standardize the data..
• Played a key role in the user acceptance testing (UAT), and implementation of system.

Confidential, Harrisburg, PA

Business Systems Analyst

Responsibilities:

• Worked closely with Business Owners and Stakeholders to outline Business Requirements.
• Involved in all the phases of SDLC of the project. Conducted requirement gathering and analysis, verified requirements with business areas and acted as the primary liaison between the business area and the development team. Involved in developing class and behavior diagrams.
• Gathered legacy business requirements by shadowing Customer Service Representatives (CSRs), Customer Relationship Representatives (CRRs), preparing questionnaires, to identify limitations in the current system and GAPS in the proposed system.
• Acted as a liaison between client and payer/intermediary. Experienced in payer rules, requirements, governmental regulations and HIPAA compliance. Interacted with claims payment and enrollment to review, analyze and document business processes. Worked with HIPAA 270,271,835,837 transactions. Performed validation of 270,271,835 and 837 Professional and Institutional format files according to EDIFECS engine.
• Assisted Project Manager in developing design and specification, according to the requirement and information gathered in JAD interview sessions and other information gathering sessions.
• Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliances/Regulations and HIPAA Regulations.
• Developed prototyping, prepared the test data and checked for the feasibility of the system.
• Performed requirements gathering process in iterative approach using RUP methodology.
• Used Rational Rose for creating the Use Cases Diagrams, Activity Diagrams, Class Diagrams, and Sequence Diagrams etc.
• Involved in the complete SDLC system providing SOW to the client notifying the client about the work to be done in detail, specifying both hardware and software involved (Scope of Work).
• Updated the User Interface (UI) diagrams for the BSO application in MS Visio.
• Review requirements and understand technical recommendations and constraints, and develop comprehensive and accurate functional specifications; Data Mapping, and process flows.
• Work with Compliance and Regulatory operations to follow and monitor different IT process bound by CMS Regulations.

Environment: Windows XP, Business Objects, MS Excel, Word, Visio, Java/J2EE, UML, power point, SQL, DB2, SAS database

Confidential, PA

Business / Data Analyst

Responsibilities:

• Helped in defining Change Management Process for Release Management Team.
• Mapped process flow; assess as-is processes through user interviews, data collection and analysis, design and evaluation of to-be process solutions.
• Prepared Business Object / Business Process Models that included modeling of all the activities of business from conceptual to procedural level. Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
• Assisted the QA team in designing the Test Plan and Test Cases for User Acceptance testing.
• Designed and developed Use Cases using UML and Business Process Modelling.
• Consulted with healthcare insurance company to develop conversion specifications for other insurance Coordination of Benefits (including Medicare).
• Developed data conversion programs for membership, claims, and benefit accumulator data - converted thirteen corporate acquisitions. Developed data field mappings. Provided programming and support for claims processing functions and auto-adjudication.
• Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to a health plan)
• Identified gaps in the business process.
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data
• Assisted process owners in process training and implementation.
• Streamlined the Restatement Financial Data Warehouse access review Process.
• Gathered requirements from users of the Clear Quest (CQ) tool for any Enhancements or change requests for any defects.
• Planned and defined system requirements to Wire Frame with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.
• Coordinating with the development team to set up test environment for issue escalation and issue resolution process for SIT and UAT testing to enable smooth operation
• Interacted with the users and logged any defects, enhancements from the UAT.
• Wrote test cases and test scripts for the User Acceptance Testing
• Led and conducted JAD sessions for requirements gathering, analysis and design of the system.
• Created context and workflow models, information and business rule models, Use Case and Object Models during the analysis using rational tools.
• Designed and developed project document templates based on SDLC methodology
• Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans.
• Involved in reviewing test plans and test cases and ensuring test cases reflect user needs. Also responsible for conducting user training and user acceptance testing to ensure and verify system is designed according to user needs.

Environment: RUP Methodology, Mainframe, DB2, MS SQL,, MS Visio, MS Office (MS Excel, MS Word, MS PowerPoint).

Confidential 

Sun Solaris System Administrator/ Sybase DBA

Responsibilities:

• Installed and configured Sun Solaris 2.5 on Sun Sparc Servers and workstations
• Setup and configure NIS+, NFS & DNS Servers
• Administered and Setup user account, mail systems, and local security scheme for clients
• Configured and Maintained Raid Arrays for Solaris 2.5.1 Application Servers with Sun Sparc Storage Array & BoxHill Raid Boxes 5300 Turbo+
• Performed System Administrative tasks to monitor System performance/ degradation for CPU, I/O and memory resources, daily backups and monitoring disk usages, Application servers
• Upgraded and Installed patches on servers and Confidential client sites
• Performed ongoing Maintenance tasks to Troubleshoot network problems with Routers, Gateways and Firewall systems, permission, ownership, Internet for large network.
• Installed and configured terminals for StarRep/AV, BAM, RAMP, LOS|LIMBS Applications, CDE (Common Desk Environment) Software, and Netscape 3.0/4.0 Confidential the client site. Performed distribution of software packages and application code to client workstations
• Wrote k-shell scripts for adding, deleting, and updating the UMT’s (User Manage Table) data in production and for regular Backups and Dump of the database
• Administered file systems (mounting/unmounting) and Disk space management
• Responsible for monitoring the system swap space and creating additional swap space when required
• Installed Sybase SQL Server 10.x/11.x on Sun Servers and configured it according to client needs
• Involved in configuring Character sets. Also, used BCP utility to load data in/out of the database
• Created data segments, index segments, data & log devices
• Used dump and load command for Backup and Recovery Plan