SUMMARY:

• Over fifteen years of IT experience in solution architecture, process architecture, business analysis, data analysis, design, implementation and software testing.
• Experience with analyzing business needs, gathering requirements, planning, organizing, documenting, and testing software applications.
• Hands on implementing web, portal, web - services and enterprise applications using object oriented analysis and design (OOAD) methodology.
• Methodologies: experienced with rational unified process (RUP), agile (Scrum) software development, waterfall methodology, six sigma standards and UML.
• Experience in participating JAD sessions for project definition, analyzing requirements,
• Documentation includes: Business process documentation, HLDD's and LLDD's.
• Experience in creating prototypes, wire frames and UIDD's. Developed use case diagrams, sequence diagrams, state diagrams and activity diagrams.
• Experience in business process definition, risk analysis, use case analysis and process flow diagrams.
• Strong analytical skills, evaluation and high degree of initiative. Coordinate all aspects of project planning, scheduling tasks, tracking, and monitoring risk analysis.
• Worked extensively with dimensional modeling, data migration, data transformation, data loading, data modeling, Meta data model and performance tuning.
• Design and implement innovative data solutions for complex business problems.
• Experience working with business and technology client representatives to identify functional and technical requirements. Translate complex functional, technical and business requirements into architectural designs.
• Experience in building overall solution blueprint, long term roadmap of BI platforms to measure effectiveness of business processes
• Experience in providing cost effective solutions that meets client requirements and industry best practices.
• Clear and concise articulation, presentation, and documentation of technical opportunities, constraints, recommendations, and action items to both internal and external audiences.
• Extensive experience in data analysis, ETL techniques for loading high volumes of data and smooth structural flow of the data. Experience in understanding database structures and write SQL/PLSQL.
• Experience in creating conceptual, logical and physical data models and determines the most appropriate method to represent the data for business consumption. This includes all forms of physical representation of data, such as relational, dimensional, object, key-value (such as column families), and graph.
• Adept at writing data mapping documents, data transformation rules, maintaining data dictionary, data migration documents and interface requirements documents.
• Experience in gathering reporting requirements from the business users for business intelligence, data warehouse application.
• Experience in writing test plans, test cases, generate test scripts and maintain reports for defect tracking.
• Experience in integration testing, system testing, user acceptance testing (UAT), functional testing/black box testing, grey box testing, regression testing, GUI testing, performance testing.

TECHNICAL SKILLS:

Operating Systems: Windows, UNIX, Linux, Z/OS and AIX

Languages: SQL, PL/SQL, VB, C++, C#, Java, JavaScript, HTML and XML

Packages: Rational Rose, Requisite Pro, Clear Quest, I log J-Rules, Redmine, Parature and Jira

Databases: MS Access, Oracle 8i/9i, DB2, NETEZZA, Teradata and MS SQL Server.

Office tools: MS Office (Word, Excel, Power Point, Outlook), MS Visio, Lotus Notes, Microsoft Share Point, and MS Project.

Testing Tools: QTP, Rational Functional Tester, Rational Requisite Pro, Quality Center, ALM, Clear Quest and Bugzilla.

Reporting Tools: Crystal Reports, SSRS, Cognos, SAP Business Objects and SAS

Version Control: PVCS, SVN, CVS and Clear Case.

Payer Solutions: FACETS, NASCO, HealthRules Payor, HealthRules CareManager, HEALTHsuite, AMISYS and Epic HealthLink Tapestry

PROFESSIONAL EXPERIENCE:

Confidential, Middleton, WI

Data Management Consultant-Process Architect

• Analyze the current Gundersen & Quartz data structures and business needs, work with Enterprise architects to finalize the data integration road map.

• Design and document the departmental data process flows, include the IT applications, internal and external interfaces to fulfill the existing business process requirements.
• Part of delivering multiple data projects by understanding the business and technical requirements.
• Technical Transition Team: Gundresen business shall be migrated from their current Payor application (Amisys) to the Quartz Payor application (Tapestry). The data team responsibility is to enhance the current downstream process to accommodate Extract and reporting requirements.
• Responsible to analyze the data need and design the data process flows, perform Data profiling, Data quality check, GAP analysis, Impact analysis and publish results with definite solution.
• Coordinate with Data Modelling team to update the Data warehouse atomic tables and provide the Mapping rules to ETL development team to enhance the current process.
• Responsible to analyze the current outbound file feeds to external vendors and update the Mapping documents to match the future needs. Coordinate with ETL development team to make the developmental changes.
• External Vendor feeds includes HRA vendors, Medical Management Vendor, EOB Print vendor, PBMs, Dental Vendors and HEDIS data to Verscend.
• Reports BO Universe: As part of the Gunderson Integration project, able to Analyze the current BO universes impacted with EDW atomic changes and coordinated with BO team to make the necessary updates.
• Medicare Advantage (MA): For MA population, able to analyze the Delta Dental claims and accumulator data.
• Document the mapping rules from source to target for inbound and outbound feeds to the vendor.
• Lead and coordinate development teams to build the process accept inbound feed from the vendor and load into the repository.
• Lead and coordinate development teams to build the process to extract the data and transmit to the vendor.

Environment: NETEZZA(EDW), SQL, Oracle, Informatica, SAP Business Objects, SAS, Epic HealthLink Tapestry, AMISYS, Ms Visio, & Ms projects.

Confidential, Philadelphia, PA

Data Management Consultant-Process Architect

Responsibilities:

• Responsible to design data process flow including the new IT applications/solutions to fulfill the existing business process requirements.

• Responsible for coordinating and initiating the project activities. Generated detailed system requirements with cost projections. Created and owned the IT estimates, process documentation and traceability matrix.
• Responsible for facilitating JAD sessions with Work stream leads, IT leads and Enterprise Architects to define the scope for file feed extraction and report generation.
• Responsible for documenting Vision, Blueprints and Estimates (HLE) for data extraction, reporting and rationalization process.
• Able to manage multiple medium to moderate size Program releases.
• Works closely with project teams and PM leadership to address IT tasks, risks and coordinate the IT project deliverable.
• Extracts: Analyze the existing inbound and outbound file feeds from external vendors and clients. Rationalize the feeds and regenerate the required file feeds in new platform. Feeds Includes Enrollment, Eligibility- Commercial/ Medicare advantage, Claims, accumulators, providers and finance data.
• Operational, Compliance and Client Reporting: Analyze the current reports. Rationalize the reports and regenerate the required reports in new platform.
• Data Sourcing & Governance: The project management decision is to leverage existing IBC’s AEDW as future repository for inbound feeds, outbound feeds and reporting purpose. As part of the sourcing effort the data governance team was established to monitor the data needs and comply with standards.
• Medical Management: Analyze and document the current medical management process, list all the interfaces and feeds. Design the future process, capture the requirements and enhance the existing processes.
• Membership and Enrollment reporting: Design an automated process to eliminate the manual process for generating feeds and reports for internal and external purpose.
• Actuarial and underwriting: Design an automated process to eliminate the manual process for generating reports.
• Responsible for initiating, planning, executing, controlling, and delivering.
• Performed requirement gathering & analysis by actively soliciting, analyzing business requirements and prepared technical Specification Document.
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify the transformation rules with respect to the business logic.
• Engaged in a series of working sessions with business and various internal /external technical teams to gather requirements for data transformation.

Environment: SQL (EDW), Teradata (AEDW), Access DB, SSIS, SSRS, MDX, UNIX, HealthRules, Medical Management, Aerial, HealthDialog, Magellan Health, Ms Visio, Ms projects.

Confidential, Ft Washington, PA

Implementation Analyst

Responsibilities:

• Participated in HEALTHsuite Mercato employee training and gained knowledge on technical and functional areas of the product.

• Analyze GAPs identified during the discovery phase with John Hopkins Health Care to implement HEALTHsuite Mercato,
• John Hopkins Health Care is replacing their existing MC400 & IDX with HEALTHsuite Mercato.
• Responsible for interacting with business owners (John Hopkins Health Care) and product owners in identifying the enhancement scope for provider credentialing and fee schedules.
• Able to analyze clients existing credentialing business process flow and in corporate the functionality with in Healthsuite application. Able to architect and document requirements for the provider credentialing module.
• Work closely with project manager to scope the delivery timelines.
• Responsible to work with configuration team to understand the workflows. Documented Business Requirement/ Functional Specification Document (BR/FS).
• Gathered requirements to document business scenarios and responsible for creating use cases and wireframes.
• Act as lesion between client and product development. Able to prioritize the requirements and document in detail.
• Able to master the HEALTHsuite provider module to identify the workaround for the client to meet their business requirements.
• Engaged in a series of working sessions with internal configuration and technical team to quantify in scope and out of scope items for the enhancements.
• Walkthrough the Business Requirements and Functional Specification with client and get the documents signed off.

Environment: Java, J2EE, COBOL, OLTP, SQL, DB2, Ms Visio, Redmine, Parature, HIPAA X12, WebSphere Partners Gateway (WPG), MC400, IDX and HEALTHSuite.

Confidential, Dresher, PA

Technical System Analyst- Data

Responsibilities:

• Able to work on multiple projects in analyzing the business and technical requirements.

• Projects:
• Benefit Focus: Replace existing Group Insurance Enrollment system with Benefit focus. Build process to send and receive feed to/from Benefit focus. Build process to, map and load data from/ to iMax into Enterprise Data Hub (EDH), load data from EDH to DW and BI region for analytical purpose.
• Voluntary Claims (Dell): Build process to send Enrollment feed and receive Claim feed from Dell for Voluntary Claims. Develop process to load data into DW and BI region for analytical purpose.
• Responsible for initiating, planning, executing, controlling, and delivering process modification projects.
• Responsible for interacting with business owners in identifying the scope of transforming data from source to target area.
• Able to provide the work estimates to the IT team, created and owned the process documentation and traceability matrix.
• Performed requirement gathering & analysis by actively soliciting, analyzing business requirements and prepared the Functional Specification Document (FSD).
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify the transformation rules with respect to the business logic.
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of the data.
• Engaged in a series of working sessions with business and various internal /external technical teams to gather requirements for data transformation.
• Conducted Walkthrough sessions with Business, development team and testing teams.
• Involved in conducting manual testing at various phases of the project development.

Environment: DB2, Oracle, Informatica, Power center, Informatica Analyst, COGNOS, Tableau, XML, Web Services, ALM, GIDW, EDH, Benefit Focus, Enrollment Universe (Data Mart), SAS and Ms Visio.

Confidential, Newark, NJ

Sr. Business System/Data Analyst

Responsibilities:

• Responsible for initiating, planning, executing, controlling, and delivering process modification projects.

• Able to work on multiple projects in analyzing the business and technical requirements.
• Able to manage multiple medium to moderate size Program releases.
• Projects:
• PBM: Replace Caremark with Prime therapeutics for Rx Claims process in phase 1, Build process to pass Commercial and Medicare accumulator (History/Daily) feed from NASCO to Prime therapeutics. For Health Care Reform (HCR) mandate updated the process in phase 2. In Phase 3 adjustments for Tier2 capitation was implemented.
• CDH Payment Processing: Replace My Health Bank with Evolution 1, for HRA, HSA and FSA Plans. Build process to pass history, monthly and daily Eligibility/Claim feed from NASCO, NMS & Employers data to E1.
• ICD 10 mandate: Update QME logic for the payment processing application.
• PG Audit: Build process for Performance Guarantee groups for BPM tool.
• Health Care Reform- SBC: Summary of benefits and Coverage generation for Individual, Small medium, Large and National groups.
• CPL Labor Funds: Benefit Mismatch report generation.
• CMS mandate Medicare Advantage Quarterly EOB: Build process to extract feed from EDW to generate Quarterly EOBs for Medicare advantage members.
• Responsible for interacting with product owners in identifying the scope of ICoE team in transforming data from source to target areas.
• Able to provide the work estimates to the product owners, created and owned the process documentation and traceability matrix.
• Performed requirement gathering & analysis by actively soliciting, analyzing customer requirements and prepared the Technical Requirement Document (TRD) and Technical Design Document (TDD).
• Performed analysis on inbound/outbound file layouts and analyze sample data to identify the transformation rules with respect to the business logic.
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of the data.
• To transfer latest valid data to the external vendors and internal processes able to analyze and create Gap documentation for Horizon’s EDW and MDM stores. Work with respective teams to include/Update the schemas.
• Engaged in a series of working sessions with business and various internal /external technical teams to gather requirements for data transformation.
• Conducted Walkthrough sessions with Business, development team and testing teams.
• Other documents designed are data mapping documents, updating layout files and business test cases.

Environment: DB2, Oracle, SQL Server, EDW, MDM, Informatica, Power center, IDE, IDQ, SSIS, OLTP, OLAP, XML, Web Services, SAS, Ms Visio, Share Point 2010, Siebel, TOAD, Thunderhead, Clear Quest, QTP, Quality Center, HIPAA, NASCO, NMS, E1(Evolution 1), ICD 10, CDH, HRA, HSA, FSA, Commercial and Medicare Accumulators, Prime and Caremark.

Confidential, Burlington, MA

Sr. Business System Analyst- Data Conversions

Responsibilities:

• Responsible for interacting with customer (Independent Health, Buffalo, NY) to scope and deliver a wide range of technical services from a functional and design perspective.

• Support developments by clearly articulating the customer’s business needs while continually verifying that the implementation approach and resulting technical developments meet the needs.
• Engaged in a series of working sessions with customers to gather requirements for systems integration. Work with customer to facilitate large scale and complex data conversions.
• Acts as a customer advocate, working closely with all stakeholders to understand and clearly articulate the customer’s business needs and to verify that the implementation approach meets those needs.
• Created overview document for data conversion, data mapping documents, detailed instructions, specification documents, pre-requisites, sample files, loader formats and business test cases.
• Obtain understanding of customer's business model and intended use of HealthRules.
• For data conversions worked closely with the configuration analysts in setting up CTML polices for accounts, accumulator adjustment, authorizations, claims (converted), provider, membership (& subscription), premium billing and provider.
• Provision appropriate environments for staging, analysis, executing and testing conversions
• For every conversion entity (accounts, accumulator adjustment, authorizations, claims (converted), customer service, fee schedules, membership (& subscription), premium billing and provider) able to define and document business use cases with customer.
• Advising customers on conversion data sourcing, mapping, transformation, and load technical developments
• Responsible for writing user stories to provide a definition of each requirement so that the developers can produce a reasonable estimate of the effort to implement it. Able to update Microsoft share point portal with the updated project documentation.
• Responsible creating use cases, usage scenarios and traceability matrix.
• Using an iterative agile methodology could work side-by-side with the customer and the developers to create the technical developments throughout a series of rapid iteration deliverable.
• Engaged with the customer to demonstrate and test the iterative work product while making sure along the way that the developments meet their needs. Involved in conducting manual testing at various phases of conversion process.
• Able to advise customers on accessing the correct web services, database schema's, conversion loaders and other technical components that are part of the HealthRules product.

Environment: DB2, Data warehouse, MDM, ERWIN, COBOL, OLTP, OLAP, XML, Web Services, Informatica, IDE, Rally, Cristal Reports, SQL, Ms Visio, Share Point 2010, Siebel, QTP, Quality Center, HP-Exstreme, HIPAA X12, Health Rules and Agile methodology

Confidential, MO

Business Data Analyst

Responsibilities:

• Performed requirement gathering & analysis by actively soliciting, analyzing customer requirements and prepared the requirements specification document for the application.

• Involved in gathering reporting requirements from the business users. Involved in building data warehouse application,
• Developed information cycle diagrams, data flow diagrams, in MsViso.
• Writing data mapping documents, data transformation rules and maintaining data dictionary, data migration and interface requirements documents. Able to update Microsoft share point portal with the updated project documentation.
• Created logical data modeling using tools like CA ERwin data modeler
• Able to analyze and Map source to target mappings using client Tool CDMA (Code and Data Mapping Application) to further develop enterprise data warehouse for Confidential .
• Applying Master Data Management (MDM) concepts for data alignment, maximizing analytics and business intelligence promoting corporate objectives and initiatives
• Performed data analysis and ETL techniques for loading high volumes of data and smooth structural flow of the data.
• Involved in data mapping of EDI transactions (834, 837 and 276), creating work flow and activity and use case diagrams.
• Involved in gathering reporting requirements from the business users.
• Updated requirement documents as per business user feedback and changes, involved in generating test plans and test specifications as per business requirements
• Involved in conducting manual and automated testing at various phases of the project development.
• Prepared test data for positive and negative test scenarios as per application specifications and application requirements and wrote test plans.
• Manually performed integration and build verification testing.
• Knowledge in relational database concepts like tables, primary and foreign keys, views and referential integrity. Proficient in the data manipulation using SQL for the retrieval of data from the relational database.
• Responsible for defect tracking and reporting. Participated in the bug review meetings.

Environment: DB2, CDMA, ERWIN, Data stage, Informatica, Cristal Reports, SQL, Data warehouse, Siebel, MsVisio, Documentum, Share Point 2010, HIPAA, Medicare Advantage, Medicaid, FACETS and Quality Center Confidential, TN

Sr. Business Analyst

Responsibilities:

• Performed requirement gathering & analysis by actively soliciting, analyzing customer requirements and prepared the requirements specification document for the application.

• Involved in gathering reporting requirements from the business users. Involved in building data warehouse application,
• Created activity diagrams and sequence diagrams to analyze the requirements and recommend solutions. Involved in creating UML, use case diagrams activity diagrams and state diagram using enterprise architect.
• For project management purpose worked on Microsoft project, used Microsoft share point for maintaining the updated documentation.
• Facilitated Joint Application Development (JAD) sessions with all IT groups for communicating & managing expectations and to discuss various means for integrations with current system using an adoption through execution strategy and to collaborate resource allocation and project completion.
• Created prototypes for Internet and intranet application, worked with UI team in designing of web pages and micro site for portal application.
• Updated requirement document as per business user feedback and changes in the functionality of the application.
• Involved in generating test plans and test specifications as per business requirements.
• Involved in conducting manual and automated testing at various phases of the project development.
• Prepared test data for positive and negative test scenarios as per application specifications and application requirements and wrote test plans.
• Performed integration testing, build verification testing and system testing.
• Involved in white box testing of the java code with developers in the unit testing phase
• Responsible for defect tracking and reporting. Participated in the bug review meetings,
• Organized meetings to discuss outstanding issues with QA team and developers.
• Involved in user acceptance testing.

Environment: RAD, IBM Web sphere, Mainframe, UNIX, CICS, LDAP, JPA, EJB, JCL, COBOL, OLTP, OLAP, XML, PMBOK, HL7, ICD9, MediTech, Patient Keeper, Data warehouse, Lotus Notes, Tivoli Access Manager, Microsoft Share Point, Rational Unified Process (RUP) and Quality Center.

Confidential, PA

Sr. Business System Analyst

Responsibilities:

• Responsible for gaining a good understanding of user needs and accurately representing them in a well-documented software functional specifications document.

• Gathered business requirements, interacted with the business users, designers and developers, project manager and QA team to get a better understanding of the business processes.
• Involved in creating project management documentation, fallowed PMBOK standards.
• Interacted with the “End-Users” by interviewing them, by preparing appropriate questionnaire to better understand end-user needs and the business process.
• Followed a structured approach to organize requirements into logical groupings such as requirements for customer, client, group, member, eligibility, prescriber, pharmacy, COB, Claims (Rx, ASO), CRM, AR /AP, GL and Reporting that critical requirements are not missed.
• Involved in creating business process documentation. Identified use cases from the requirements.
• Created UML diagrams including use case diagrams, activity diagrams, sequence diagrams, and collaboration diagrams using MS-Visio.
• For project management purpose worked on Microsoft project, able to update Microsoft share point portal with the updated project documentation.
• Created Prototypes for Internet and Intranet application, worked with UI team in designing of web pages and Micro site for portal application.
• Analyzed and optimized the process, prepared business requirement document and managed requirements using Rational Requisite Pro.
• Worked with project teams in preparing Software Requirement Specifications (SRS), Software Design Documents (SDD), and User Interface Design.
• Facilitated JAD sessions with business and technical units to fine tune, prioritize and detail requirements and use cases.
• Managed change of the requirements and associated requirements to other requirements for traceability.
• Involved in risk-management process whereby identified critical areas of business risk and modified the business process to reduce the same.
• Involved in drawing data flow diagrams and process flow diagrams using Enterprise Architect for the Claim Adjudication module.
• Identified business rules, built a rule based application that automates fine-grained, variable decisions used for claim adjudication, in Ilog Jrules.
• Writing Data Mapping Documents, Data Transformation Rules and maintaining Data Dictionary, Data Migration and Interface Requirements Documents. Able to update Microsoft Share Point portal with the updated project Documentation.

Environment: DB2 on Z/OS, WebSphere, XML, JMS, RSA (Rational Software Architect), Cognos, UNIX, UML, LDAP, Informatica, Web 2.0, Clear Case, OLTP, OLAP, Web Portal, Data Migration, Data Warehouse, Microsoft Share Point, HIPAA, Medicare, Medicaid iLog JRules, Siebel, Rational Unified Process (RUP), Rational Requisite pro, Enterprise Architect, Rational Functional Tester and Bugzilla.

Confidential

Business Analyst

Responsibilities:

• Actively engaged client and third party integration partners in requirements gathering and validation. Conducted and lead requirements elicitation meetings with client end users to document system requirements and used Requisite Pro for management of these requirements.

• Developed business use cases using UML for new product functionality after conducting requirements elaboration sessions with client teams.
• Used tools such as MS Visio, Rational Rose to define business use cases, activity diagrams, and sequence diagrams.
• Maintain the data architecture activities. Responsible for creating and maintaining multi-dimensional data models.
• Experience with Software development life cycle (SDLC) methodology, framing out Business Transaction rules and related Documentation, creating Test Plans based on Functionality and Business rules, creating Test Cases, Test scripts out of Manual Test Scripts/Test Cases.
• Responsible for working with the manager and other users and creating Work flow diagrams as per the data analysis.
• Involved in generating Test Plans and Test Specifications as per Business requirements
• Involved in conducting Manual and Automated testing at various phases of the project development.
• Prepared test data for positive and negative test scenarios as per application specifications and application requirements and wrote test plans.
• Performed Integration testing, Build Verification testing, System testing manually.
• Responsible for defect tracking and reporting.
• Participated in the bug review meetings, updated requirement document as per business user feedback and changes in the functionality of the application.

Environment: Tomcat5.0, Apache HTTP Server, IIS6.0, C#.NET, Asp.Net, MySQL, SOAP (Web services), C++, MS-SOAP, XML, Ms Visio and QTP.