SUMMARY

• Working as a Project Manager with over Eight years of combined experience in project management and business analysis.
• Strong project management skills with relentless attention to details on simultaneous deadline projects.
• Experienced in new process and product development as well as system enhancements.
• Experienced in all phases of Project and Software Development Life Cycle (SDLC).
• Strong experience in managing and implementing large complex, multiplatform projects from initiation to closure using Project Management Organization (PMO) methodologies.
• Proven experience in delivering large multimillion dollar projects on schedule closely managing scope within approved budget.
• Strong leadership qualities with excellent ability to communicate and work with diverse range of clients, cross - functional teams and external vendor entities.
• Exceptional problem solving and critical thinking capabilities, who work well under pressure, adapted to function as thought partner.
• Experienced in creating Return on Investment (ROI) documents as justification to perform corporate projects both from financial and strategic standpoints.
• Experience in healthcare insurance industry areas like payer, claim adjudication, product development, risk adjustment reporting.
• Experience in gap analysis, cost benefit analysis, resource requirements identification and management.
• Motivated self starter with exceptional team building and interpersonal skills.
• Ability to adapt to and learn new tools, techniques and approaches.
• Experienced using Microsoft Office Suite, MS Visio and MS Project for project documentation, planning and management.
• Proven leadership qualities, communication, time management and coordination skills.

TECHNICAL SKILLS

Project Management: Risk Management, Issue Management, Change Management, Contract Management, Requirements Management, Resource Management, Communications Management, Return on Investment, Budget Management

Business Analysis: Business Technical Requirements Documents, Requisite Pro, Application Life Cycle Management

Life Cycle Methodologies: Software Development Life Cycle, Agile, Scrum, Rational Unified Process

PMO Tool: HP Project and Portfolio Manager (PPM), PPM Resource Management

Databases: MS Access, MS-SQL Server, Oracle

Testing Tools: Requisite Pro, HP Quality Center, HP Application Life Cycle Management

PROFESSIONAL EXPERIENCE

Confidential, NY

PMO Project Manager

Responsibilities:

• Identified and defined project scope based on organization's need to meet compliance criteria.
• Kicked off the project, and identified high level risk and issues considering time constraints.
• Identified resource requirements and obtained approval on them.
• Documented preliminary budget forecast and secured initial budget approval.
• Identified team members, defined their roles and responsibilities to develop communication plan.
• Documented detailed project plan and obtained stakeholders' approval to baseline it.
• Managed development of business and technical requirements.
• Worked with technical architects to define the technical solution - from extracting data via claims adjudication systems and transactions repository to data warehouse manipulation and subsequent translation in EDI format.
• Developed issue and risk management plan, reported project status in monthly dashboards for senior management.
• Actively worked on resolution of risks and issues and obtained project owner's approval on risks and issues closure.
• Managed resource allocation per task to execute and manage tasks in approved project plan. Maintained resource inventory by executing consultant engagement forms.
• Conducted weekly core team and monthly executive steering committee meetings for status and project progress reporting.
• Enforced stage gates at the end of every SDLC phase per release to obtain executive steering committee approval to move forward on the next phase of the project.
• Implemented project change management to address changes in business requirements arising from testing results.
• Coordinated between development team and end business users to conduct testing sessions to ensure scope delivery meeting quality standards.
• Maintained requirements traceability by connecting business and technical requirements to respective test cases in test plan.
• Managed and executed testing with NYSDOH to obtain production certification for both releases (HIX and SSP).
• Managed budget by tracking monthly actuals (internal and external resources) against forecast and reforecast budget to align it with approved budget.
• Measured project delivery performance based on responses received on data submitted to NYSDOH.
• Coordinated among BA, DA, developers and end users to facilitate interpretation of errors received from NYSDOH.
• Monitored response reviews and managed error remediation by addressing changes in business rules.
• Led communications with external vendors and delegates to obtain agreement from them on testing schedule with end business users and with NYSDOH for second release of the project.
• Oversaw post production support for the first of two releases of the project.
• Ensured transition of post production efforts for the first of two releases of the project from external IT resources to internal IT resources.
• Documented lessons learned at the end of first of two releases of the project.

Confidential, NYC, NY

PMO Project Manager

Responsibilities:

• Performed analysis of current functionality of EDS day 1 submission and response processes and identified future state to define project goals.
• Documented return on investment (ROI) to justify revenue benefits for technical steering committee.
• Identified and documented project scope to align with intended performance upgrades.
• Kicked off the project, identified high level risks impacting intended project timeline.
• Incorporated lessons learned of predecessor project to identify resource requirements.
• Documented preliminary budget and secured project funding.
• Managed external resources inventory to control spend.
• Documented detailed project schedule to meet with CMS compliance deadline as well as approved budget requirements.
• Obtained commitment from various stakeholders on their assigned tasks and timeline.
• Oversaw business and technical requirement sessions for all four releases of the project.
• Managed data testing with CMS to obtain certification production credentials.
• Coordinated with relationship managers of impacted vendors to explain project expectations on testing and production data submissions.
• Conducted weekly core team and monthly steering committee meetings to keep the project stakeholders aware of project status.
• Led quality (QA) and user testing (UAT) efforts for project deliverables.
• Ensured quality of delivered requirements by executing traceability matrix to link business requirements to technical requirements to test cases.
• Monitored and ensured timely implementation of project deliverables per release.
• Oversaw post production support for first two of the four releases of the project.
• Discussed, documented and distributed lessons learned from the implementation of the first two of four releases of the project.

Confidential, NYC, NY

PMO Project Manager

Responsibilities:

• Identified, documented and reviewed project scope with executive steering committee to obtain scope approval.
• Kicked off the project, identified high level risks impacting federal compliance guidelines.
• Negotiated resource requirements and documented return on investment (ROI).
• Documented preliminary budget and secured funding.
• Discussed and obtained consensus from core team on high level milestones to meet compliance deadline.
• Oversaw documentation and approval of business and technical requirements documents (BRD and TRD).
• Documented detailed project schedule and obtained commitment from business and IT teams.
• Updated and balanced project budget on a monthly basis against actuals received to manage funds.
• Communicated project communication plan to receive approval from various stakeholders on their roles and responsibilities.
• Kept core team and executive steering committee aware of project progress by conducting weekly and monthly status report meetings respectively.
• Tracked delivery status against schedule milestones.
• Enforced stage gate reviews to meet quality management plan against project progress.
• Led and executed testing sessions impacting front end to all downstream systems to enforce quality standards and defect remediation plan.
• Confirmed closing of risks and issues after mitigating and solving them; communicated the same with core team and steering committee to obtain their approval on risk closing.
• Formalized and obtained approval of project completion acceptance from stakeholders.
• Identified, discussed and documented lessons learned.
• Managed transition of project deliverables.
• Obtained financial and administrative project closure.

Confidential, NYC, NY

Lead Business Analyst/ PMO Project Manager

Responsibilities:

• Documented work breakdown structure and obtained core team's approval.
• Developed communication plan and responsibility assignment matrix - RACI.
• Documented preliminary budget; tracked the forecast against actuals on monthly basis for senior management reporting.
• Led and oversaw business and technical requirements documentation.
• Identified risks, issues and action items concluding from requirements.
• Managed resource allocation per task to execute and manage tasks in approved project plan.
• Enforced stage gates to keep steering committee members aware of project progress.
• Implemented change control management to address requirements changes derived from SDOH data dictionary updates.
• Led quality and user testing sessions to ensure task delivery meeting quality standards.
• Tracked deliverables development against scope and approved budget.
• Developed risk and issue management plan to address risks and issues.
• Coordinated with relationship managers of impacted external vendors, delegates and clients to ensure timely testing and production.
• Measured project performance against criteria set forth in the Charter, reconciled errors received on submission of data, monitored status of previously identified and newly found risks and applied corrective measures.
• Obtained approval from core team and steering committee on risks closure after remediation.
• Reviewed project deliverables completion with stakeholders; formalized and obtained approval of project completion acceptance from steering committee.
• Identified, discussed and documented lessons learned.
• Led transition efforts of project deliverables.
• Obtained financial and administrative project closure.

Confidential, NYC, NY

Lead Business Analyst

Responsibilities:

• Worked as a team member of a group of analysts in communicating with business and IT to analyze and document application system.
• Gathered, identified and documented business and test requirements for medical claim adjudication system.
• Updated the existing business requirement documents as a part of change management process to include and/or update new requirements.
• Walked business users and SMEs through the BRDs and PCRs to capture business logic for the adjudication systems.
• Served in a team environment to perform analysis of HIPAA compliant EDI transactions.
• Did gap analysis for EDI transactions to make them comply with new HIPAA rules.
• Wrote mapping specifications for various application users i.e., vendors and delegates.
• Mapped EDI transactions to copybooks based on HIPAA regulations and compatibility of EDI Gateway.
• Made recommendations to the main frame to update copybooks based on 5010 HIPAA rules.
• Updated the BRDs to include new business line.
• Based on the project change management documents gathered, analyzed and documented technical solutions for the BRDs.
• Worked closely with developers to understand and document technical logic for the medical claim adjudication systems.
• Documented the technical solutions of the business requirements as a part of Technical Requirement Document (TRD) for medical claim adjudication system.
• Provided walk through of BRD and TRD to the QA team to have them better understanding of the process.
• Documented RTM to trace and connect requirements to testing.
• Gathered, analyzed and documented business requirements for medical paper claim process.
• Wrote technical solutions for the medical paper claim process by working with developers.

Confidential, Bellevue, WA

Business Analyst

Responsibilities:

• Serve as a member of a specialized team interacting with developers and business users to analyze and configure application systems;
• Gather, identify and document business and test requirements for mapping;
• Use the gathered requirements to suffice the compliance of businesses according to HIPPA regulations;
• Perform object-oriented analysis, devising methods and approaches to solve problems and meet users’ need for HIPPA complaint EDI transactions on client-server platforms;
• Design, development, testing and support of inbound and outbound EDI transactions compliant to HIPPA rules;
• Worked extensively on Confidential SpecBuilder and MapBuilder;
• Reviewing mapping specifications for EDI transactions;
• Worked on HIPPA compliance and vice versa;
• Worked on various EDI transactions (270, 271, 276, 277, 278, 834, 835, 837)
• Generated maps from scratch;
• Generated custom guidelines and did guideline edits;
• Development of various maps such as EDI to EDI, EDI to Claim format, Claim format to EDI, Paper claims to EDI, EDI to paper claims etc;
• Identified problems in systems and de-bugged them;
• Document and track inherent system issues with EDI maps, upgrade system and correct errors in EDI maps to maintain system after implementation;
• Generating of custom guidelines for EDI transactions;
• Generation of Paper claims companion guideline and Paper Claim guideline generation;
• Support Team Lead in completing test objectives in a timely basis;
• Test and debug mapping and guideline applications

Confidential, Indianapolis, IN

Senior Business Analyst

Responsibilities:

• Identified internal and external system requirements, design and configuration set-up and documented and delivered Business Requirements Document to the project team.
• Worked as the primary liaison between the business user and the developers throughout project cycle.
• Interacted with the Subject Matter Experts and stakeholders to get a better understanding of client business processes and gather business requirements.
• Oversaw any change request process, and facilitated weekly meetings, coordinated with business project leadership to identify and gain commitment in the concept and rollout timeframe of project.
• Facilitated Joint Application Development (JAD) Sessions for communicating and managing expectations and to discuss the different ways and means for the integration of rational tools with the current system.
• Developed User Manual and Provided User Training. Involved in developing use cases. Played an extensive role in system testing, integration testing, unit and regression testing.
• Worked with FDA guidelines (21CFR), HIPAA (Health Insurance Portability and Accountability Act).
• Developed test plans, test conditions and test cases to be used in testing based on business requirements.
• Used Rational Test Manager for creating test plan, execution of the test and analysis of results.
• Implemented Medicare program for concerned patients.
• Played a key role in the planning, user acceptance testing (UAT), and implementation of system developments and enhancements.
• Implemented EDI tools to replacement-engineering of the portal.
• Worked on creating patient profile based on their medical plans including Medicare and Medicaid.
• Participated in providing implementation assessment for Rational RequisitePro, Rational Rose and Rational Clear Quest using Unified Modeling Language (UML) and Maintained Requirement Traceability Matrix (RTM).

Confidential, Meriden, CT

Business Analyst

Responsibilities:

• Defined functional requirements and specifications for use by the development team.
• Conducted Joint Application Development sessions for communicating with the all project leads and stakeholders the proposed process workflows.
• Created design document (UML diagrams) using Microsoft Visio for proposed system.
• Identified Use cases from the requirements and wrote Use Case Specifications.
• Used Rose to carry out the business modeling and object modeling effort to develop the business architecture for the application for rapid and controlled Application development. Responsible for creating the Gap Analysis of As -Is and To-be process.
• Participated in meetings with Developers, Project Managers and Quality Analysts to discuss business requirements, test planning, resource utilization, and defect tracking.
• Tracked and managed requirement changes.
• Involved in walkthroughs and meetings with development team to discuss related issues.
• Used Rational Rose to visually determine the proper structure, key elements and optimal design for your database and to aid efficient creation of tables, stored procedures.
• Wrote clear, concise detailed system requirements specification (SRS) documents and user documentation in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance.
• Verified the functional aspect as per the Business Process and validated the interfaces with the other systems and data conversion from the legacy system.
• Involved EDI as methodological base to enhancement of the project.
• Performed Back end testing, performance testing and load testing via navigation and workflow of the Application.
• Used Rational Clear Case, Configuration Management tool, to maintain different builds of the application with descriptions about all changes and versions.

Confidential, Milwaukee, WI

Business Analyst

Responsibilities:

• Facilitated highly interactive JAD sessions with project stakeholders, subject matter experts (SME), end-users, Developers, Testers and project management team for identifying and resolving issues.
• Identified, researched, analyzed and documented business Process Work flows.
• Developed detailed Business and Technical requirements document and Use Cases documents to effectively communicate the requirements.
• Prepared Gap Analysis for the Consumer Website.
• Worked with defect tracking and reporting tools like Rational Clear quest.
• Conducted extensive user interviews to understand Medical claim submission and billing procedures.
• Responsible for analyzing data and finding patterns.
• Extensively used SharePoint to document project processes and procedures, communicate requirement and version control them.
• Created and managed Service Center tickets to initiate System Change Request process.
• Reviewed test strategy and test plans to ensure that test cases reflects user needs for the functional, user interface(UI), usability and security requirements.
• Developed test cases for User acceptance testing and performed User acceptance testing(UAT)
• Conducted extensive user interviews to evaluate the process flow and recommended alternate flows for business process improvement.
• Assisted Project Manager in managing requirements by coordinating and facilitating requirement tracking using Requirement Traceability Matrix (RTM).
• Managed and reported team status as the lead BA.
• Actively monitored client expectations during all phases of SDLC.
• Created Stored Procedures, Triggers, Complex queries for various Data needs and Reports.
• Used Web services for the Application.
• Used ADO.NET and Microsoft application block for SQL to call stored procedures.
• Responsible for initiating and managing change request from the client by filling Change Control document.
• Conducted training for Business and IT team on effectively using Use Cases.

Confidential, Malvern, PA

Health Care Business Analyst

Responsibilities:

• Worked extensively with the users and with different levels of management to identify requirements, use cases and to develop functional specifications.
• Maintained and monitored project progress and status through MS Project.
• Created Use-Cases and Business Use-Case Model after accessing the status and scope of the project and understanding the business processes.
• Integrated RequisitePro with Rational Rose to provide all teams visibility and maintain tractability among requirements, use cases and change requests.
• Managed all the requirements in RequisitePro, making requirements available to all team members.
• Designed use cases and sequence diagrams using Rational Rose.
• Created requirements analysis and design phase artifacts using Rational RequisitePro, Rational Rose and to create Use cases, Activity and Sequence diagrams.
• Used the change management from rational to track changes to multiple artifacts by versioning artifacts, associating requirements specific change requests to streamline the defect/change tracking process.
• Undergone various phases like analysis, design, functional and technical specification, coding, testing and document preparation.
• Design and Development of user Interface(UI) screens using ASP.NET, CSS.
• Written stored procedures using SQL Server.
• Developed Web services for the Application.
• Some portions of client side validation done in JavaScript.