Summary:

• Over 16 years of extensive hands on experience with Project Life Cycle management, Documentation, Interface analyst Methodologies, User acceptance testing, system testing, functional testing and implementation of RUP software quality.
• A highly experienced QA Architect, SQA Analyst, Interface Analyst, Business Analysts and Senior Programmer Analyst Professional with more than fifteen years of IT experience. Diversified skills including design, coding, debugging, analysis and testing of mainframe, client/server and web based applications in the financial, government, insurance, communications and healthcare industries.
• Export knowledge in the creating of plans, test cases, test scripts, regression, interface, integration, performance and load testing.
• Expert knowledge in design coding of mainframe application testing including debugging, technical design and system design.
• Led a team of more than 15 testers both nationwide and offshore.
• Great knowledge of Data Warehouse/datamart and the loading of it from multiple source systems.
• Hands on experience in all types of testing such as Black Box, White Box, Grey box,Sand Box, Regression, Integration, Load, Stress, Performance and User Acceptance testing, Model creation, Use case development, and Business Case Validation. Developed Test plans, Test Templates and Test cases.
• Expert knowledge in development methodologies Waterfall, RUP, SDLC and TAF Test Architecture Framework and hybrid .
• Excelled in solving technical issues and communicate the results to the appropriate team member.
• Recognized for creativity and innovation in the resolution of difficult and complex situations.
• Proven experience in QA Audits, Impact Analysis, Risk Analysis, Root Cause Analysis, Defect Management, Technical Architecture, Design, Development and Delivery experience.
• Proven experience in the creation of HL7 Interfaces and Design Document for multiple hospital systems
• Proven experience as system analysts in the creation of user requirements, procedures, and problems to automate or improve existing systems and review computer system capabilities, workflow, and scheduling limitations.
• Extensive business domain knowledge and experience in Healthcare, Banking, Pharmaceutical, Insurance, and Engineering industries, Web/Internet based businesses, EDI/back-end integration, Client/Server Internet, application development, testing and delivery experience.
• Recognized for creativity and innovation in the resolution of difficult and complex situations. Exceptional inter-personal and communication skills, a creative problem solver and enjoy complex, difficult challenges.
• Recognized for creativity and innovation in the resolution of difficult and complex situations.

Technical Skills:

• Quality Assurance Software Tools: File-Aid, File-Aid/DataAger, File-Aid/DB2, File-Aid/RDX, Xpediter/Exchange, SQA Suite, Comparex, LoadRunner Knowledge , QTP Knowledge , HP/Quality Center version 11.0.0, WinRunner, PVCS, SQA/IBM/Rational Suite, ClearQuest, Hyper Station, Open Connect 1.7.3, Strobe, Compu ware QA Tools and Peregrine center
• Operating Systems: IBM/DOS, MS DOS, MVS/OS 390, UNIX and Windows
• Software Languages: Micro Focus COBOL, System/370 assembler ALC , COBOLII, Easytrieve, Visual basic, C , Java Scripts and ADS 7.0
• Window Applications: MS Excel, MS Access, MS Word, Visio, Microsoft project and PowerPoint
• Databases: Oracle 10.0, VSAM, IDMS/ADSO, Sybase, IMS DB/DC, DB2, Model/204, Total, SUPRA Cincom ,
• IAM, SQL Server 2000, EPIC Chronicles, TeraData Warehouse and DAF
• Middleware: IBM Mqseries
• Interface Engine: E-Gate, Neon, Cloverleaf and Vitria.
• Utilities: OS/JCL, CICS, MANTIS, Endeavor, ChangeMan, ISPF/TSO, Librarian, SyncSort, SAR, Abend-Aid, LU 6.2, SPUFI, DB2/QMF, HUMMINBIRD, SQL Advantage IDCAMS, IEBGENER, IEBCOPY, BTEQ Basic teradata Query Teradata, SQL Assistant and TOAD.
• Vendor Products: Medipac, Healthquest, Maxmc, Macess, Epic Bridges Interface,Hyperspace COMLINK, NASCO, Flexilab,Flexirad Sunquest,Vantage QA IBM, Powerscribe, CERNER clinical system, Cognos Impromptu, PLASM, TriZetto Facets 3.11,4.41,4.51,4.71,4,81 TriZetto QNXT,ITS 10.1 and ECLIPSYS Clinical system.
• Other: Mercator, Gentran, ECMAP, Claredi, SNOMED CT, Trizetto HIPAA Gateway, XML, HL7, EDI, WSF2, Business object and Data Mart
• Methodologies: RUP, Hybrid and Waterfall
• Major Clients: IBM, Kaiser Permanente, Novartis, Vanguard, Agilent Technologies, Care First, Excellus, Unisys, Vanguard, US government, Blue Cross Blue Shield of MI ,Trizetto and , Blue Cross Blue Shield of NC

Professional Experience:

Confidential

Environment: XP, Misys, , HP Quality Center , HP ALM and Microsoft office.

Role: Sr. Senior QA

• Served as a Sr. QA and participated in the writing of test Scripts for UAT and SIT testing.
• Wrote test script for Members benefits verification
• Wrote test scripts for facets products testing
• Wrote test scripts for claims processing
• Wrote test scripts for SIT testing

Wrote test scripts for UAT testing

Confidential

Environment: XP, TriZetto Facets 5.xx Networx, Mysql, X12,Web, SalesForce, Connecture ,Citrix , HP Quality Center , HP ALM and Microsoft office.

Role: Sr. Senior QA

• Served as a Sr. QA and participated in the writing of test Scripts and give recommendation to client management to improve process.
• Wrote sql statements using SQL Advantage to query TriZetto Facets table
• Wrote test script for Members benefits verification
• Wrote test scripts for facets products testing
• Wrote test scripts for Connecture Health Reimbursement Arrangements HRA for small group Testing
• Wrote test scripts for Connecture Care Flexible Spending Account FSA for small group Testing
• Wrote test script Connecture testing
• Wrote test scripts for claims processing
• Wrote test scripts for blue cards testing
• Wrote test scripts for SIT testing and participated in the execution of these scripts
• Wrote test scripts for UAT testing
• Tested Claims using the new ICD10 format

Environment: XP, TriZetto Facets 4.81 Networx, Mysql, X12,Web, Mainframe, DataWarehouse, Hipaa Gateway,Citrix and HP Quality Center and Microsoft office.

Role: Sr. Senior QA

• Confidential QA and participated in the writing of test Scripts and give recommendation to client management to improve process. Wrote test cases, scenarios and the execution of theses scripts for the Facets 4.81 implementation.
• Wrote sql statements using SQL Advantage to query TriZetto Facets table
• Wrote test script for WPS provider verification
• Wrote test script Hipaa gateway interfaces testing
• Wrote test scripts for NetworX
• Create procedure to breakdown Facets Keyword file to a more readable format
• Wrote test scripts for Pharmacy claims
• Wrote test scripts for SIT testing and participated in the execution of these scripts
• Wrote test scripts and test case for system testing
• Wrote test scripts for integration testing
• Tested Claims to using the new ICD10 format
• Created binary true table for complex claims validation.

Environment: XP, TriZetto Facets 4.51 Networx, Pricer/Modeler,, Oracle, X12,Web, Business Objects 6.5, SQL Server, Citrix and HP Quality Center.

Role: Sr. Senior QA and BA

• Served as a Senior QA in the writing of test Scripts for the Facets upgrade from 4.61 to 4.71.
• Wrote test script for more than one hundred TriZetto Facets patches and enhancements. Those patches included all of the major TriZetto Facets modules claims processing, UM, Membership, provider, billing, NetworX, Pricer/Modeler, EDI, application support and accounting
• Validate results using Excel and Mercury HP quality center
• Wrote sql statements using SQL Advantage to query TriZetto Facets table
• Wrote test script for Caresource provider web verification
• Wrote test script for Business Object report testing
• Wrote test script for Ingenix HSS APC Grouper/Price Calculation
• Validate MAXIMUS application confinement result test cases
• Wrote business user document for TriZetto Facets wire retrieval and direct debit applications.
• Wrote business user document for NetworX Pricer standalone product
• Wrote test scripts for NetworX, Pricer/Modeler
• Wrote test scripts for UAT testing and participated in the execution of these scripts
• Wrote functional test scripts

Environment: IKAsystems, Data Warehouse, ArgusHealth, X12,Facets 4.7.1 HP quality center, Oracle, RxFocus ,SAS, COGNOS, MS SQL server 8.0.

Senior QA

• Served as a Senior QA and system analyst in the creation of test plan and scripts for Performrx reporting and data warehouse testing.
• Advised client of the best method for integration testing in a Data Warehouse environment.
• Created system testing reporting document for ETL testing verification.
• Created testing artifacts documents for project.
• Created test strategy and plan for data warehouse and performance testing
• Wrote test scripts and test cases for performance and system testing

Environment: XP, Trizetto QNXT 4.64, PORTICO,EZCAP,Great X12, plain Accounting,DHI data warehouse ,COGNOS, MS SQL server 8.0.

Senior QA and BA

• Served as a Senior QA and system analyst in the creation of the test plan for ACT V finance and membership module of the project.
• Wrote test script and test case for system testing
• Perform integration testing
• Create UAT and integration document for user
• Conduct research for provider and member payments.
• Tested Claims to using the new ICD10 format
• Perform system and user acceptance testing for the QNXT finance module.
• Created binary true table for finance cash distribution.
• Wrote sql statement to validate reports results for accuracy
• Created testing artifacts documents for project.
• Wrote report defects for the testing manager.
• Guide full-time personal in the creation of desktop procedure.
• Created desktop procedure.
• General System Requirements
• Created Finance Use Cases
• Created Functional Requirements document
• Created Design-EOP For Members
• Created Design-QNXT Detail Payment Balancing Report
• Created Finance Process Workflow

Environment: XP, Mainframe, TRON, IBM, DB2, Oracle, Teradata Warehouse, Basic Teradata Query BTEQ , Teradata SQL Assistant/Web Edition, ETL, IRWIN, Web, Business Objects.

QA ARCHITECT

• As a QA ARCHITECT Senior Design, plan, execute, monitor, improve testing process for a testing engagement..
• Advised client of the best method of integration testing in a data warehouse environment.
• Created unit testing reporting document for ETL testing verification.
• Created testing artifacts documents for project.
• Created test strategy for semantic layer testing
• Use Teradata SQL within BTEQ
• Use comments within a BTEQ session
• Run BTEQ batch jobs
• Create and use scripts, run files, and macros
• Use the REPEAT and the HANG command, interrupt and abort requests

Environment: XP, TriZetto Facets 4.51 Networx, Pricer/Modeler, Sybase, Oracle, X12,Web, Business Objects 6.5, Macess, MAXMC, Ruby Reports, SQL Server, Citrix and HP Quality Center.

Role: Sr. Senior QA and BA

• Served as a Senior QA and BA in the creation and writing of test Script, BRD and testing the upgrade from 4.41 to 4.51.
• Executed test scripts for more than one hundred TriZetto Facets patches and enhancements to all major modules claims processing, UM, Membership, provider, billing, Networx, Pricer/Modeler, EDI, application support and accounting .
• Tested Claims to verify that new ICD10
• Compare 4010A1 and 5010 claims looking for discrepancies in the new claims format.
• Validated results using Excel and Mercury HP Quality Center.
• Developed SQL statements using SQL Advantage to query TriZetto Facets table.
• Using Visio create documentation for every batch jobs that are part of the facets application.
• Wrote test script for Business Object report testing.
• Created test script for Ingenix HSS APC Grouper/Price Calculation.
• Validated MAXMC application confinement result test cases.
• Wrote business user document for TriZetto Facets wire retrieval and direct debit applications.
• Developed test scripts and initiated business user document for Networx, Pricer standalone product.
• Wrote test scripts for UAT testing and participated in the execution of these scripts
• Created claims use Cases
• Created claims Process Workflow

Role: Sr. QA Lead

• Built and managed team from use case writing to application tester.
• All deliverables and testing where produced based on the Company SDLC HYBRID test architecture framework Methology process.
• Created test strategy and got sign-off from the client
• Wrote test plan for ITS provider Audit
• Managed client test team as well as ours, also managing client expectations well and delivering quality test effort on time and within budget.
• Wrote query against Informatica to extract data for user reporting purposes and user acceptance validation.
• Wrote query to extract data from data marts for reporting.
• Used Business Objects to extract data from the universe data based on the metadata.
• Managed the entire testing at our Test Labs and delivering reports online and on a timely fashion.
• Wrote scripts to test ITS Home and Host claims for NASCO.
• Used Open Connect Web based applications to access NASCO legacy data by calling these java objects, securely retrieving information from the mainframe.
• Use the Point and click transactions that are created at design time and business logic that are is easy identified.
• Used multiple host screens, local database and legacy transactions that are were condensed in to single screens. Multiple host screens, local database and legacy transactions may be condensed in to single screens.
• Deployed web service through eclipse and maintaining versions on different region dev, test, and production .
• Wrote RTM for project
• Execute the test scripts and record results.
• Load defects into peregrine defect tracking tool center
• Wrote system test cases Provider Data Audit
• Wrote test Grid using Microsoft excel for PDA Provider data Audit
• Create UAT test grid
• Wrote UAT test scripts
• Wrote functional test scripts
• Execute mainframe job streams to test P A claims Physician Assistant billing, PA and registration via MQSI and TriZetto Facets 4.41
• Used NDM to send TriZetto Facets and BCBSM claims to IBM

Confidential

Environment: Windows XP, MVS/390, DB2, LRSP, X12, CICS, IMS DB/DC File -AID, MS Access.

Senior QA Lead

Served as a senior QA lead wrote Test plan for Blue card balancing testing.

Developed the test plan for BlueCard adjustment.

Wrote ETM for multiple test environment for LRSP Long range system planning , Financial Processing-Disbursements and ITS.

Defined testing environment

Confidential

Environment: Windows XP, MVS/390, DB2, TriZetto Facets, X12, Flexx, Blueexchange, NASCO, CICS, File-AID, Microsoft Suite

Business Analyst

• Served as a Business Analyst, wrote System Development/Enhancement Work Paper to test HIPAA 835
• Wrote file extract processing tool using File-AID to extract FEP, Major Medical and Medicare claims from Flexx claims file.
• Created HIPAA cross-reference excels spreadsheet for HIPAA rejection code mapping.
• Created new detail design document for new program and current programs processing.

Confidential

Environment: Windows XP, MVS/390, DB2, CICS, File-AID, NASCO, X12, ITS, MS Access and IBM Rational Suite

Senior QA

• Served as a senior tester wrote test scripts using IBM Rational tools to test claims for NASCO system.
• Attended training by IBM personnel for NASCO ONLINE claims entry corrections and pending.
• Used Compuware file-aid tool to extract data from IBM Mainframe to a client server application via Oracle tables.
• Used Compuware file-aid tool to extract NASCO CLAIMS from the local system and populate NASCO TRLOG file.
• Wrote scripts to test ITS Home and Host claims for NASCO.
• Developed manual test scripts using IBM rational test manager to test claims for new groups that was added to BCBSM national plan.
• Wrote SQL using IBM Rational Robot to extract data from Oracle and Access table and populate the claims tables for the NASCO nightly run application.
• Wrote test case and manual script using Rational test Manager to verify claims results.
• Used Rational RequisitePro to load project requirement.

Confidential

Environment: UNIX, mumps, database, Chronicles, IBM MQSeries, eGate, bridge interface, EPIC, MISYS, TestDirector 8.0 and HL7.

Senior Interface Analyst and QA

• Served as a Senior Tester and Interface Analyst, wrote test cases and test scripts using Test Director for EPIC-care bridge interface , and Misys Laboratory system.
• Created IDD for Epic / Kmate for Pharmacy Interface and National NDC Health/ Epic and Outpatient Pharmacy Interface
• Added patient data to Chronicles database using EPIC Reg/ADT hyperspace screen.
• Tested HL7 Logical Observation Identifiers Names and Codes LOINC for Laboratory Misys results and orders via eGate interface engine and MQSeries integration broker system in a UNIX environment.
• Executed Manual test scripts using HP TestDirector.
• Used Chronicles Basics commands to search the epic tables
• Created order using EPIC hyperspace patient management Reg/ADT.

Confidential

Environment: Windows XP, UNIX, MVS/390, DB2, CICS, File-AID, X12, Microsoft Suite, Sybase, Hyperstation, TriZetto Facets, NASCO, ITS, Informatics Data Warehouse , Business Object, Oracle database.

QA ARCHITECT/lead

• Served as a QA architect Design, plan, execute, monitor, and improve testing process for a testing engagement.
• Lead coordinated of a team of four testers, created testing environment for P A, STAR and Master Medical on IBM Mainframe, and also kept track of all defects that was reported by team on a weekly basis. In addition, meet with the developer lead and business SME to classified defects by level and report project progress to upper management. Also worked with the oversea reports developers that were based out of Bangalore, India to test and report defects.
• Wrote test plan for HIPAA 837 professional and institutional.
• Mapped HIPAA 837 fields to Blue Cross Shield proprietary legacy fields for using Microsoft Excel and EC MAP.
• Created test cases for 835 Health Care Claim Payment/Advice institutional, dental, professional , 837 institutional, dental and professional HIPAA transactions on an IBM Mainframe.
• Tested Claims to verify that new Icd9 and Healthcare Common Procedure Coding System HCPCS are in sync and the provider taxonomy code is correct for this type of claim.
• Wrote test scripts for HIPAA transactions for online line and batch processing on an IBM Mainframe.
• Modified and create RTM for HIPAA transactions.
• Wrote multiple SQL statement for DB2 databases using SPUFI and QMF to view results.
• Used Claredi to verify that the incoming 837 claims and the outbound 835 Health Care Claim Payment/Advice transactions from EDI are HIPAA ANSI X12 compliance.
• Wrote functional test scripts and UAT test scripts.
• Created test grid for HIPAA transactions.
• Wrote script to test UB92 version H Medicare Part A national standard format from version 6.0 records.
• Modified RTM and create data map for Medicare Medicaid Services HCFA 1500 Medicare claims.
• Tested the Provider/Membership conversions from STAR application to TriZetto Facets 3.11 application.
• Mapped blue care network propriety legacy fields to TriZetto Facets for claims and membership processing using Microsoft Excel and EC MAP applications.

Confidential

Environment: Windows, JAVA, C , VB, ATM and Rational Clearquest.

Role: SQE Lead Team of 15

• Served as a SQA lead coordinated and defines testing requirements and testing strategy for Crevasse Software for Wireless and satellite Communications using ISO 9000 standard. Also lead a group of testers that were
• Wrote the test plans and scripts for WEB remote application. Execute test cases for ESA, and PSA Spectrum analyzers via the Web.
• Wrote C program to calculate Mean and standard deviation for FFT in an NT environment
• Wrote multiple VB Scripts using via COM API application.
• Coordinate meeting and steer team to follow testing methodology fundamentals.
• Created baseline scripts for testing PSA, VSA, ESA Spectrum analyzers and Infinium scope.
• Submit multiple defects using ATM and Rational Clearquest application.
• Wrote UAT test scripts
• Wrote functional test scripts

Confidential

Environment: Legacy, VSAM, DB2, UNIX, IBM MQseries, VB 6.0, Candle and IBM Rational suite

Role: SR. QA

• Served as a senior tester wrote rational robot scripts to monitor MQSERIES on the mainframe via Candle.
• Wrote project the requirement for automated environment monitor using Rational Robot REQ PRO 4.5.
• Wrote test scripts and test the availability of the WEB using rational team test 7.1.
• Wrote test scripts to connect to MQSERIES server via UNIX.

Confidential

Environment: UNIX, Vantage QA and NEON INTERFACE ENGINE

Role: SR QA/Analyst

• Served as a senior tester tested HL7 Logical Observation Identifiers Names and Codes LOINC for Laboratory interface via NEON INTERFACE ENGINE system in a UNIX environment.
• Tracked application defects and reported them using Vantage QA.
• Execute stored procedures using Oracle database.
• Wrote SQL query to access and update Oracle Laboratory database.
• Wrote UAT test scripts
• Wrote functional test scripts

Confidential

Environment: Legacy, Healthquest, medipac, PAS, CLOVERLEAF, HL7,CICS, ADS/PLUS, VSAM, IMS DB/DC and DAF

Role: Senior Prog/Analyst

• Served as a senior programmer analyst wrote extract programs to update DAF/VSAM FILES, Modified HealthQuest Medical Record Abstracting system, Modified interface programs to send EDI message to health care provider and Modified DCLS and CICS COBOL online programs that were running in CICS 2.1 and converted them to CICS 4.1.
• Tested the HBOC Products Patient management PM, Patient appointment.
• Modified HBOC Medipac Financial system using ASC X12N format for Medicare-A B, Medicaid, Champus
• Military Personnel and commercial insurance.
• Modified HealthQuest programs to send ADT interface to CLOVERLEAF
• Tested PAS and billing Medipac systems in a MVS mainframe environment.

Confidential

Environment: Legacy, UNIX, RISC6000, AS400, Healthquest, Medipac , CLOVERLEAF, DATAGATE, HL7, DB2, Powerscribe, file-aid, DATAGATE, ADS/PLUS, VSAM, IMS DB/DC,MODEL 204, Compuware QA Run, Winrunner and DAF.

Role: SR QA/Analyst

• Served as a senior software quality assurance tester wrote test plans, test approaches and test scripts for Health Quest 2000, Patient Transport, Transition II and PowerScribe Voice Recognition System.
• Executed compliance and integration testing on vendor applications incorporated into the network.
• Tested Health Quest 2000 patient management system in a MVS mainframe environment.
• Tested laboratory systems using DATAGATE and Cloverleaf interface engine.
• Tested mainframe applications using Compuware File-AID testing tool.
• Recorded application results in the QA test repository and created appropriate reports for the lead person for the project for him/her to understand in HL7 format and to ensure that the interface engine DATAGATE is receiving the correct ADT records.
• Tested interface for HBOC Medipac Financial system using ASC X12N format for Medicare-A B, Medicaid, Champus Military Personnel and commercial insurance.
• Wrote UAT test scripts
• Wrote functional test scripts

Confidential

Role: SR Prog/Analyst

• Served as a Programmed wrote and debugged batch and online COBOL programs.
• Updated CICS functions of the membership database using IMS/DLI database for Independent Blue Cross of Pennsylvania.
• Wrote ECI programs in MF COBOL to update DB2 via CICS queue processing for a major utility company using EDI standard.
• Wrote interface programs to send EDI messages to financial institution once bill are paid to PECO Energy
• Define data fields that are needed to send EDI payment to Philadelphia Gas work.
• Create trace ability module for Philadelphia Gas work.
• Uses EXPEDITER to debug both batch and online programs
• Uses ENDEVOR to check modules out from production to the test environment and promote them back into production. These modules include JCLS, screens and programs
• Submitted job streams in a MVS conversation from VSE using COBOL-II and VSAM file processing for the FIRSTUSA bank.

Role: SR Prog/Analyst

• Served as a SR Prog/Analyst wrote and debugged COBOL programs using VSAM, DB2 and sequential file processing.
• Modified out of stock recap reports and created test sales spreadsheets using MS Excel
• Wrote macro in MS Excel to calculate store revenues and sales promotion.
• Tested batch and online product inventory systems for Y2K compliance using Hyperstation and Hourglass data simulation tools.
• Uses EXPEDITER to debug both batch and online programs
• Wrote report product programs to extract data from DB2 databases.

Confidential

Environment: Legacy, COBOL, TSO, IMS DB/DC, EASYTRIEVE, ASSEMBLER, MS ACCESS, ITS and MS VB

Role:SR Programmer/Analyst

• Served as a SR Programmer/Analyst wrote and debugged COBOL EASYTRIEVE programs to access IMS/DLI databases in a DB/DC environment.
• Translated technical and medical documents from Spanish to English and vice-versa
• Tested Spanish Application for our South America office in Uruguay online and batch
• Travel to our South American office to test claims application via DLI/I IMS online application.
• Tested Claims to verify that new Icd9 and Healthcare Common Procedure Coding System HCPCS are in sync and the provider taxonomy code is correct for this type of claim.
• Created system for work-flow and translation them from English to Spanish and vice-versa
• Create process improvement and present it to our CEO in Montevideo, Uruguay
• Wrote interface programs to process EDI message received from health care provider
• Wrote extract program to capture ITS claims from the company proprietary system