Business Summary

A versatile business and systems professional with experience of broad-based computer systems development experience across various platforms and networks. Extensive experience in all aspects of project management and systems development, including project planning, defining requirements, business analysis, systems analysis, systems design, program specifications, programming, testing, and implementation. Possess strong analytical, problem solving and research skills. Worked in the Health insurance healthcare , Life insurance, Property/Casualty insurance, IT consulting, Financial, Banking and Steel industries. I have worked on a variety of business and financial applications, independently and as part of a team. Projects are completed ahead of time and under-budget.

Technical Summary

• Languages: COBOL, Visual Basic VB 6.0, VB.NET 2005, Microsoft Access, SAS.
• Databases: DB2, IBM Mainframe, Microsoft SQL Server 2005 and 2008, Microsoft Access, Teradata, and Oracle
• Project Mgmt: OOA/OOP - Object Oriented Analysis/Design and Programming
• Relational Database System Analysis/Design RDBMS
• Possess strong knowledge of the System Development Life Cycle SDLC , Waterfall, and Agile projects.
• Managed Project staff of up to six 6 IT Staff Team Members
• Software: TSO/ISPF/PDF/SPF, IBM UTILITIES, PANVELET, TELON, SQL, IBM DB2, IMS/DB, IMS/DC. MFS, VSAM, , All Microsoft Office software, Microsoft Project, FILEAID, XPEDITOR, OS JCL, SOURCESAFE, OLE, ODBC, VBA, COM/DCOM, ADO, DAO, FTP, ADO.NET, SQL, T-SQL, SPUFI, IBM DB2 Connect, Rational Manual Tester, ClearQuest, LOTUS Notes, .NET Framework, HTML, SAS, HP Quality Center, HP ALM Quality Center, FTP, Beyond Compare software, and SQL Stored Procedures / Triggers. .
• Methodologies: Structured Systems Analysis and Design, Data Flow Diagrams
• Top-Down Systems Development, Pseudo-Code, and HIPO
• Cost Benefit Analysis CBA , System Development Methodology SDM and Testing Methodologies.

Education: CICS, Rational Robot, Rational Functional Tester, Crystal Reports, Web Development, XML, JAVASCRIPT, VBSCRIPT, ASP Active Server Pages , JAVA, ASP.NET, SAS Enterprise Guide, SAS Dataflux, Business Objects, Cognos reports, and Visual C .NET.

Work Experience

Confidential

Position: Business Information Consultant

• Performs Data Modeling on all health insurance subject data areas.
• Involved with BCBSA Blue Cross Blue Shield Association BDCT corporate meetings.
• Works with Senior Auditors, Middle and Senior Management, and Data Architects.
• The data that I pull is given to other team members where it is used to set contract rates for all transplants types providers contracts hospitals and surgeons in 14 states for Wellpoint.
• Will pull and analyze data and develop reports to support these programs trends in cost and utilization .
• Position will support the Centers of Medical Excellence CME team. Will be responsible for gathering data including but not limited to transplant, cardiac care, bariatric surgery, Spine Surgery, Knee Hip Replacement and other new business needs as developed for focused programs.
• May make recommendations based upon data analysis.
• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.
• Creates and publishes periodic reports, as well as any necessary ad hoc reports.
• Analyzes data and summarizes performance using summary statistical procedures. Develops and analyzes business performance reports e.g. for claims data, provider data, utilization data and provides notations of performance deviations and anomalies.
• Creates and maintains databases to track business performance.
• Provides technical assistance to lower level staff. Writes Teradata SQL.
• Responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics.
• Works for the Specialty Network Management / Provider Value Alignment Solutions / Payment Innovations area at Wellpoint.
• Environment: Used Teradata databases, SQL, Teradata SQL Assistant, Sharepoint, Microsoft Access, EDWard Data warehouse, Data Profiling, Data Mining, Data Modeling, and Business Objects.

Confidential

Position: QA Consultant QA Test Analyst

• As a QA Consultant QA Test Analyst responsible for performing Quality Control QA Assurance Testing on the JP Morgan Chase Commercial Card PaymentNet4 Migration project. J.P. Morgan Chase is in the Financial Bank industry.
• Defined and wrote test plans, test cases, and test scripts design steps via HP Quality Center and HP ALM Application Lifecycle Management Quality Center software.
• Wrote system defects via HP Quality Center and HP ALM.
• Wrote complex SQL to test Commercial Card system PaymentNet4 data.
• Using SQL data result sets, compared production data source system to new Payment4 target system data with Beyond Compare software.
• Performed data analysis and research on data and resolved production problems.
• Coordinated and directed efforts of internal consulting testing staff.
• Have some Automation Testing experience and exposure.
• Communicated defects statuses and project status to Business, Project, and IT management. Worked with data mapping documents.
• Strong analytical, problem solving and research skills.
• Performed testing of Sharepoint for QA Testing group security and permissions accesses.
• Environment: Used SQL Server 2008, SQL Server 2008 Management Studio, Oracle, Oracle SQL Developer, Sharepoint, HP Quality Center, HP ALM Application Lifecycle Management Quality Center, SQL, and Beyond Compare software.

Confidential

Position: QA Consultant QA Test Analyst

• As a QA Consultant QA Test Analyst in the Enterprise Testing and Business Analysis Services ETBS division responsible for performing Quality Control QA Assurance Testing on the Federal Employee Program FEP Streamline project.
• HCSC corporation is also known as Blue Cross Blue Shield of Illinois, Texas, New Mexico, and Oklahoma.
• Participated in a Lead Testing Role.
• Tested inpatient, outpatient, professional, dental, paper, and Medicare claims at health insurance company.
• Tested 837 EDI transmission claim data.
• Fed in claims data via FTP tools using 837 EDI data formats.
• Modified production data and created test data for all test cases in test environments.
• Defined and wrote test plans, test cases, and test scripts design steps via HP Quality Center.
• Wrote many critical system defects via HP Quality Center.
• Wrote SQL to test FEP streamline and Blue Chip systems using IBM DB2 Connect.
• Analyzed claims on mainframe BlueChip systems and released claims for adjudication processing. .
• Performed data analysis and research on claim data and resolved production problems.
• Wrote SQL to test the core application processes and the system functionality.
• Coordinated and directed efforts of internal consulting testing staff.
• Worked with Senior Business Analysts, IT Development staff, DBA's, Testing staff and management.
• Communicated defects statuses and project status to Business, Project, and IT management.
• Wrote time estimates for QA work to upper management.
• Strong analytical, problem solving and research skills.
• Have done system testing and UAT testing on projects.
• Environment: Used SPUFI, Sharepoint, Microsoft Access, FTP, IBM DB2 Databases, HP Quality Center, SQL, TSO, and IBM DB2 Connect.

Confidential

Position: Systems Analyst Advisor Business Analyst

• As an Enterprise-wide Business Analyst in the Enterprise Information Management area responsible for defining and managing the scope and requirements of Business Systems projects. Translates high level business needs into detailed business requirements that cover functionality, usability, reliability, performance, and ongoing support needs. Documented business and technical needs.
• Provides the link between the technical and business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business.
• Provides business expertise regarding the appropriate use of data elements and works to establish and maintain common business rules, data definitions, and usage of data to support an enterprise vision.
• Works with business users to develop user acceptance scenarios and creates system test plans. Have done both system testing and UAT testing on projects.
• Wrote SQL on Teradata and SQL Server platforms. Have done data mining, data analysis, and data mapping on many projects.
• Designed DataMarts for Senior Business Actuarial departments. Defined data models.
• Performs as the key business analyst in gathering requirements from our new Enterprise Data Warehouse EDWard .
• Responsible for all Senior business Medicare Parts A, B, C, Medicare Supplemental, Medicare Advantage, and Prescriptions for Actuarial department.
• Gathered business requirements successfully for Claims, Membership, Provider, Product Benefits, Revenue Premium , and Capitation subject areas.
• Responsible for gathering business requirements for the Anthem Care Comparison ACC project including WebMD . Assisted on CMS Reporting project.
• Responsible for requirements for the Senior Risk project and data to/from CMS Center for Medicare Services Government .
• Defined business requirements for Provider subject area such as Site of Service Steerage and Provider Outlier projects.
• Recommended a SAS technical solution for the Site of Service Steerage project. Recommendation accepted by business and technical staff.
• Projects saved Wellpoint millions of dollars each year.
• Defined business requirements for the marketing department on a Welcome to Anthem project which enhances and improves the member's web experience and enrollment process with Wellpoint.
• Defined business requirements for CMS ICD-10 diagnosis and inpatient procedure codes on all Senior projects at Wellpoint.

• Entered requirements into IBM ReqPro Requisite Pro and Excel template spreadsheets.
• Environment: Used Teradata databases, SQL Server 2005 and 2008 databases, SQL, Teradata SQL Assistant, Sharepoint, Microsoft Access, Datawarehouses, DataMarts, Rational Test Manager, IBM ReqPro Requisite Pro , Business Objects, SAS Enterprise Guide, SAS Web Studio, SAS Dataflux, Data Mining/Data Profiling, and ClearQuest.

Confidential

Position: Associate Senior QA Testing Analyst

• Performs Quality Control QA Assurance Testing on a new Customer Claims Service Project CCSP for a Claims Entry Preadjudication PRAP project on all lines of business web project . Includes ITS Bluecard, ITS Bluecard Host, ITS Non-Bluecard, 837 format, and Medicare both institutional and professional claims .
• HCSC corporation is also known as Blue Cross Blue Shield of Illinois, Texas, New Mexico, and Oklahoma.
• Defined and wrote test plans, test cases, and test scripts via IBM Rational Test Manager for Core processing, UI screens, and all Cognos reports. Wrote many critical system defects using Clearquest.
• Wrote SQL to test Cognos reports data.
• Worked with data mapping documents and Use Case documents for project.
• Performed data analysis and research on claim data and resolved production problems.
• Wrote SQL to test the core application processes and the system functionality.
• Tested front-end GUI screens online messages and business functionality , core application processes, Cognos reports, and back-end database processes in web environment.
• Coordinated and directed efforts of external consulting testing staff.
• Worked with Senior Business Analysts, Development staff, DBA's, Testing staff and management.
• Wrote time estimates for QA work to upper management.
• Strong analytical, problem solving and research skills.
• Have done both system testing and UAT testing on projects.
• Environment: Used SPUFI, Microsoft Access, IBM DB2 Databases, IBM Rational Test Manager, ClearQuest, SQL, TSO, and IBM DB2 Connect.