SUMMARY

• Experience in Business Systems analysis, Project Management, Requirement Management and Business Process Modeling Notation
• Experience working with end users to create business and functional requirements and applying structure to loosely defined complex problems
• A solid base in gathering business requirements and documenting business processes
• Experience in Requirements management tools like Rational Requisite Pro, ClearQuest and JIRA
• Use case modeling in Microsoft Visio and Blue Works Live
• Experience in NASCO and FACETS systems
• Experience in Software Development Life Cycle (SDLC), conducting JAD and RAD sessions
• Experience in communicating and working with business users and leadership
• Experience in data analysis and dataflow analysis using use cases, dataflow diagrams
• Technical writing skills include drafting contracts, SOP’s, documentation and editing of user manuals
• Experience in structured query languages and analytical techniques
• Experience in UAT planning, execution and facilitation with the stakeholders and business users
• Over 12+ years of experience working in various domains as Business Analyst/Project Manager, Solution Design, Development, Testing and Validation
• Working experience on FACETS/NASCO systems with deep understanding of business processes and IT landscape within life sciences
• Familiarity with current industry improvement standards like Six Sigma, Capability Maturity Model (CMM) and SOX IT controls
• Skilled at building relationships, active listening, and reading the underlying dynamics of different groups

TECHNICAL SKILLS

Applications: Microsoft FrontPage XP, UML, SQL

Databases: ORACLE, Microsoft Access

Office Tools: Microsoft Office Suite, MS Project, Outlook, Lotus Notes

Business Tools: Blue Works Live, JIRA, UML, Requisite Pro, Visio, Mercury Test Director, ClearQuest

QA Tools: Test Director, Quality Center, Clear Quest, Win Runner, TFS (Team Foundation Sever)

Méthodologies: SDLC, RUP (Rational Unified Process), Agile

PROFESSIONAL EXPERIENCE

Confidential, Newark NJ

Senior Business Systems Analyst/ Project Implementation Manager

Responsibilities:

• Experience as a key lead role in major enterprise wide company initiatives and demonstrated leadership
• Acted as a representative of IT for the Enterprise Initiatives and responsible for leading teams and other resources to ensure alignment of technical solutions with business requirements
• Worked on multiple enterprise wide IT implementations (Commercial and Medicaid) like, implementation of new medical management system for Commercial and Medicaid line of businesses; MLTSS and DSNP products; Out of Network Reimbursement Strategy project for Pricing; Provider self - service portal to submit authorizations; Automation of enrollment paper applications for MA, DSNP and PDP members - Print on Demand; Enhancements to NJ Choice data exchange process between state of NJ and HNJH for MLTSS population; Automation of Medical Appeals mail intake process; Integration of Medicare into Govt. Programs as part of Government Programs Restructuring; Self Service Claims Adjustment request for provider community and other various delegation projects like Magellan FTP claim file and Magellan IVR
• Artifacts created include IRF’s (Initial Request Form), PA estimates (Planning Approximation), BRD’s, RMP’s (Requirements Management Plan), OSP (Ops Support Plan) etc for both Medicare and Medicaid
• Created workflows for clinical work streams like Case Management/Disease Management/Appeals/Claims/Prior Auth, Quality, Complaints and Grievances etc
• Provided SME direction to the portfolio and ensured all documented requirements support the delivery of business value, fulfills goals and objectives and meets stakeholders needs
• Interacted with divisional leadership, Enterprise Architecture and SME’s to develop solutions that improved process performance and efficiency while enhancing customer experience
• Presented project status update reports to the leadership teams and deployed tools and methodologies (ex. SIPOC) to identify process and operational efficiencies to minimize operational costs
• Utilized IBM’s “Blue Works Live” tool to produce high quality process modeling artifacts
• Lead UAT planning, execution and documented UAT test cases and tracked defects
• Worked collaboratively with SIT and Dev teams and took ownership of issues identified during testing
• Participated in project meetings to review progress, address issues and mitigate risks
• Prepared detailed project plans to track and review project performance, progress and mitigate risks
• Developed solutions to solve business problems across business areas and presented to business teams
• Identified and presented new project opportunities to leadership

Confidential

Lead Business Systems Analyst

Responsibilities:

• Worked within Program Modernization Solutions group for State of Tennessee’s Medicaid program
• Successfully implemented PDMS (Provider Data Management System) project to accept enrollment and recertification requests for different provider types like Department of Children’s Services (DCS), Department of Intellectually and Developmental Disability Providers and different physician groups
• Elicited and documented business requirements, business rules for handling groups and facilities in PDMS
• Documented current and future state workflows for enrollment activities handled in PDMS; New Provider Registration and Provider Recertification
• Documented data migration process and performed data mapping of provider data within TennCare MMIS to PDMS database using SQL
• Worked with Enterprise Architects to explore design solutions options and review with client
• Facilitated weekly/bi-weekly status meetings for assigned products and reviewed client agendas/status reports
• Documented detailed specs for issues identified as part of post-production support
• Coordinated builds from DEV to Integration test, Integration to UAT, and UAT to PROD
• Collaborated with client to obtain sign-offs on UAT testing and PROD builds

Confidential

Systems Analyst/Project Manager

Responsibilities:

• Worked on CDR (Commercial Data Repository) project for commercial line of business
• Responsible for managing cross-functional teams to deliver project on time and within budget
• Responsible to oversee project requirements, forecasting analysis and manage working relationships with project stakeholders, internal and external clients and vendors
• Responsible for overall planning, including tracking progress and issues in order to manage expectations
• Responsible for business/data analysis, data reporting, mapping of data sources, table updates etc
• Responsible for producing reports from various sources to provide business with actionable information
• Executed SQL queries using TOAD to validate the data and report findings for accuracy
• Acted as a liaison between IT, Vendors and business customers to present recommendations, risks and establish contingency plans

Confidential, Franklin Lakes NJ

Senior Project Business Analyst/Project Manager

Responsibilities:

• Worked on migration project within cross-functional project team to provide business analytical support
• Documented clients functional and transactional requirements
• Took ownership of issues and executed work plan for issue resolution
• Created executive project tracking summaries for leadership and escalated issues when appropriate
• Worked with other teams (e.g. Dev/QA and vendor teams) to schedule fixes
• Ensured Issue logs are always up to date and lead issue readouts in lightning rounds
• Ensure successful "hand-off" to other teams when required
• Communicated confidently with all levels of staff and leadership
• Played client facing, consultative role and offered system solutions to enhance client implementations

Confidential, Upper Saddle River, NJ

Senior Business Analyst/Product Manager

Responsibilities:

• Responsible for the planning, execution and ongoing administration of multiple products within the PDBA (Product Design & Business Analytics) division
• Responsible for gathering and prioritizing product requirements and defining roadmap for approved products
• Worked closely with sales and marketing, Client management, Health Affairs, Operations, Finance teams to ensure business goals are achieved throughout products lifecycle
• Acted as SME on the product and a resource to internal stakeholders to provide information and explanations
• Established & maintained comprehensive understanding of regulatory requirements for approved products
• Worked on multiple Bio-Pharma products for Oncology program and web based medical management and pharmaceutical applications (“IHMS” & TRAX)
• Experience managing external client projects (Genentech/Novartis) with client-facing consultative skills
• Developed Use Cases and clinical workflows for FDA approved cancer drugs
• Collaborated with medical writers to develop scripts for all approved FDA drugs as part of content mngmnt
• Collaborated with Client Managers and end users to document product specific requirements
• Acted as liaison and trusted advisor to operations and clinical teams by providing technical/functional support
• Collaborated with leadership to define product strategy to develop and execute related product roadmaps
• Support activities included mapping of user requirements to existing applications and develop wireframes
• Prepared management reporting on business initiatives, issues and facilitated requirements walkthrough
• Worked on reporting to analyze and consolidate web reports through GAP analysis for Oncology products
• Documented business processes and identified opportunities for improvement
• Performed UAT by emulating different roles like TEN (Triage Enrollment Nurse), Care Managers and MD’s
• Created UAT test scripts for Oncology program and validated that the application is performing as designed
• Worked closely with Dev/QA teams throughout project lifecycle and helped interpret business requirements
• Identified defects reported by user community and gave closure

Confidential, Bloomfield, CT

Senior Business/Systems Analyst

Responsibilities:

• Worked on a web based application called “CIGNA OneView” within Enterprise Application Services area
• Worked on SOA (Service Oriented Architecture) business models/governance, and Enterprise Service BUS
• Working knowledge of SOAP, Schemas, WSDL’s, XML’s, SQL and stored procedures
• Created artifacts like FSD, Data Sheets, Invocation Outcome and the Business Conditions document
• Created flow diagrams to represent functionality of service operations and conducted internal reviews
• Worked on multiple operations across Member, Claims and Provider domains (ex: request replacement of pharmacy id cards, search member, plan sponsor account notes, search claim by identifiers etc)
• Participated in design reviews with the designers to validate that the design is as per functionality defined in the Functional Specification
• Coordinated with the business/technical teams to set up SOA Governance and SLA’s for service operations
• Facilitated consumer reviews for assigned Service Operations and responsible for end to end Service roll outs

Confidential

Lead Business Systems Analyst / Project Coordinator

Responsibilities:

• Worked within the DMO (Data Management Optimization) group for CLDW (Commercial Lines Data warehouse) project
• Performed analysis for actuarial systems as part of source system data to document functional requirements
• Performed data analysis and data mapping activities for ETL processes
• Worked in collaboration with SAS experts during SAS installations and configuration
• Responsible for all project management activities as a part of project planning phase
• Responsible for documenting requirements to produce artifacts such as BRD, SRD and FSD
• Performed gap analysis and participated in brainstorming sessions with stakeholders and ETL teams
• Facilitated sessions with the business/stakeholders for decision making, issue resolution and status update
• Analyzed data sources and their target data marts as part of commercial lines data source consolidation efforts
• Performed data grouping and created data flow diagrams to represent the data mapping
• Performed data mapping with respect to the IIW (Insurance Information Warehouse) subject areas
• Created test plan and test cases and executed SQL queries using TOAD to validate data

Confidential, Bloomfield, CT

Business Analyst

Responsibilities:

• Worked within PPR (Project Process & Requirements) group to implement Non CIGNA PBM project which involved automation of information sharing for accumulators with ESI and Medco
• Responsibilities included gathering, analyzing, and documenting functional/business requirements
• Facilitated requirements gathering sessions with business SME’s and vendors to create Use Cases
• Documented business rules and business process models based on process impact assessments Responsible for preparing and maintaining Requirement Traceability Matrix (RTM)
• Tracked changes and updated Cigna’s Sharepoint site and the Project Impact Inventory
• Facilitated business requirements gathering sessions with the client, and overlooked the creation of Use Cases
• Participated in all end to end review sessions and validation sessions

Confidential, Washington DC

Business Analysts / Technical Writer

Responsibilities:

• Worked on the “Single Family Restatement” project
• Managed and maintained workstream documentation according to SOX standards
• Led client facilitation meetings to gather and document business requirements
• Created deliverables as per Confidential ’s SLCM (Software Lifecycle Methodology) including Requirements, Architecture diagrams, System Design, Interface Specification
• Ensured all deliverables were under version control in accordance with the SLCM standards
• Maintained Requirement Traceability in conjunction with the Business Users and development team
• Coordinated and managed communication between workstream and Restatement Quality Management-RQM
• Ensured all production evidence was acquired, tested and approved
• Developed UAT plans and Test Cases to be used in testing, based onbusiness requirements
• Worked on Sarbanes Oxley (SOX) 404 Controls
• Ensured that the workstream followed Sarbanes Oxley (SOX) 404 Controls as mandated by Confidential

Confidential, Middletown, CT

Business Analyst / QA Analyst

Responsibilities:

• Worked on web based application “Biz Link with Cash Management”. The web based application provided online access to business accounts information for cash management, transfers and payroll direct deposit purposes.

Confidential, Middletown, NJ

Business Analyst

Responsibilities:

• Worked on “Home Loan Wizard” and Refinance Guide designed to provide customers with ability to self asses and determine loan programs they are qualified for refinancing and other mortgage lending services.

Confidential, NY

Business Analyst

Responsibilities:

• Worked on an integration project with an existing web based application for online claim submission and other requests.