SUMMARY:

ISO, CMMI and Six Sigma process SDLC methodologies Waterfall, RUP, AUP, Agile/XP, CARA IBM's classes on Top down Business Requirement Analysis Problem Identification and Resolution Defect Tracking, Status reporting, Risk Analysis, Data Mining/Warehousing, Extract Transformation and Loading ETL , Oracle 10g, PL/SQL, UNIX, .Net, SSIS, SSRS, SSAS, IVR, VIOP, ICM, Visio, SharePoint Java, .Net, Web Based Testing, HTML/XML/XSL, XMLSpy, Ms Project, Ms Office

Mainframe TSO ISPF, JCL, DB2, IMS DB/DC, VSAM, AIX and MOVE4DB2, Platinum products, DB2 Administration Tool, SPUFI, QMF, SAS, Easytrieve, CA Easytrieve, SQL, Comparex, Hyperstation, Assembler, CICS, XPEDITER, MVS/XA, CICS, SQL Store Procedures, File Aid, IBM Utilities, QMF, Web Sphere, SAS, Microsoft SQL Server 2005, and Visual Basic Web Sphere, Cold Fusion eCommerce, eBusiness, Informatics, FTP, PL/SQL, TOAD, MTS and IIS, The Agency Manager TAM , AQS and Mecca, BizTalk, Platinum products , Compliance 360 IBM Rational Suite of Tools, HP Quality Center of Tools Quick Test Pro QTP , Mercury Quality Center of tools Business Process Testing BTP , SharePoint, Ms Office, UDB, TOAD, TICTOC BTS, ViaSoft testing tools

Summary of Systems

Healthcare - EDI Editing and Validation process, Data identification and Trading Partner Relationship Validation TA1 Interchange Acknowledgement and X12N syntax validation, determining whether the data is ANSI ASC X12N The 997 Functional Acknowledgement containing ACCEPTED or REJECTED information, syntactical errors segment s and element s where the error s occurred The X12N syntax validation, and payer business edits performed and the transformed ANSI ASC X12N transactions returned for submitter pickup Healthcare HIPAA HL7, TriZetto's QNXT and Facets Claims Processing, 4010 CDI-9 expansion, 5010 CDI-10 conversion, ASC X12N 837, 834, 270/271, 835, 820, 276/277, 977 and 278 Transactions Ingenix Claims Edit System iCES , SOA, EMR and EHR

Insurance - Commercial Lines of Business - automobile, business owners, property and liability combined for smaller commercial customers , crime and fidelity, electronic commerce, employment-related practices liability, equipment breakdown, farm , general liability, inland marine diverse commercial goods and properties , medical-professional liability, package policies property and liability combined , property, umbrella, workers compensation Personal Lines of Business Property - Personal, Flood, Earthquake, Dwelling Fire/Personal Liability, Homeowners, Medical Malpractice, Workers' Compensation Insurance, Other Lines of Business, Interline Filings, Fidelity, Insurety, Commercial Auto Liability, etc . and the Telecommunication Industry

Summary of Experiences

20 Years as a Developer on the Mainframe, eBusiness, web-based applications, Client Server and a strong Financial Industry experience, which Include xchange Insurance Industry experience includes Cigna, Hawaii Medical Service Association, Caremark Rx, WellPoint, Eli Lily, Liberty Mutual of Indiana, State Farm of Illinois, Allstate of Illinois, Blue Cross Blue Shield of Minnesota and Lincoln National Insurance Telephony Industry experiences includes Comcast, SBC, AT T Ameritech of Wisconsin, Cincinnati Bell and MCI WorldCom

QA Lead/Analyst

Stress, Load, Performance automated and manual testing Tested in the Mainframe, Client/Server, ecommerce, eBusiness web-based environments Created the Master Detail Test Plans and Uses Cases, Test scenarios, Test Cases, and deliverables using SharePoint, Rational, Quality Center suite of tools under the SDLC of Waterfall, RUP, AUP, Agile/XP, TTD methodology and as the Testing DB2 Oracle DBA Coordinated the Master and Daily SCRUM sessions,

07 Years as a Business Analyst

Agile/XP, Master Spiral and Waterfall methodologies creating and publishing the Business Requirements Document BRD Function Requirements Document FRD and Supplemental Requirements Document SRD , Tracking, Coverage, Change Impact, Use Cases, Requirements Traceability Matrix, User Acceptance Testing, Integration Test Plan, Integration Test Strategies Approaches, Test Cases Assigned Testing Tasks assessed Skill Levels, Roles and Responsibilities Participated in assigned work groups, JAD sessions and supported the development and maintenance of required documentation

Assignments

Confidential

QA Lead/Analyst

• Responsibilities were to manage, mentor, develop and motivate a team three, Participated in the preparation for implementation and operational enhancement of the Medicaid Management Information Systems MMIS Performed all interviews creating and publishing the Business Requirements Document BRD Function Requirements Document FRD and Supplemental Requirements Document SRD for the 4010/ICD-9 expansion and the 4010/ICD-9 5010/ICD-10 conversion Systems responsible for were Medical Claims Processing System, Eligibility Processing System, Pharmacy Claims Processing, 270/271 Eligibility Transaction Processing, 276/277 Claims Inquiry Transaction Processing, 837I/837P Claims Submission Processing, 278 Service Authorization Processing, 835 Remittance Advice Processing NCPDP standard transactions NCPDP D.0 Retail Pharmacy and Interactive NCPDP 1.2 Retail Pharmacy, SOA, EMR and EHR
• Created the Master and Detail Test Plans and Uses Cases using SharePoint, Rational, Quality Center suite of tools and the Agile/XP Unified Process SDLC/PDLC methodology Maintained all documents in SharePoint, Rational and Quality Center Testing suite of tools for the conversion from the mainframe legacy system to the 4010/ICD-9 expansion, the 4010/ICD-9 5010/ICD-10 conversion in the Mainframe and Web Based environments Maintained Defect Tracking Status reporting, Traceability Metrics JAD Sessions and Weekly Status, Risk Analysis and held Master/Daily SCRUM sessions
• Lead QA Test Team in the ETL Data Warehousing/Mining STM Creation experience STM - Source To Target Mapping testing efforts Development of specific testing scenarios, execution and to validate that the system is functioning appropriately assigned to a specific electronic transaction and related system areas and adhere to Medicaid/Medicare regulations/standards and industry standards and best practices Systems responsible were Medical Claims Processing System, Eligibility Processing System, Pharmacy Claims Processing, 270/271 Eligibility Transaction Processing, 276/277 Claims Inquiry Transaction Processing, 837I/837P Claims Submission Processing, 278 Service Authorization Processing, 835 Remittance Advice Processing NCPDP standard transactions NCPDP D.0 Retail Pharmacy and Interactive NCPDP 1.2 Retail Pharmacy

Confidential

BA/QA Lead

• As BA QA Lead the responsibilities were to manage, mentor, develop and motivate a team of 2 QA's and Testers Define, Develop and Document Business Requirements, Functional Requirements Master Test Plans, Detail Test Plans, UML Uses Cases, using a home grown solution, using the Agile/XP Unified Process SDLC/PDLC methodology Maintained all documents in SharePoint, Ms Office suite of tools, within the Call Center Technology CCTE group, for the Eastern Region Unified Contact Center Expansion Project.
• Worked with CCTE's Vice president, Director and Manager's group to design a Standardized Document for Business Requirements, Functional Requirements, the Master Test Plan, Test Approach, Test Strategy, Use Cases and Tests Case Worked with CCTE's Vice president, Director and Manager's group to develop an Approval Process for Business Requirements, Functional Requirements, the Master Test Plan, Test Approach, Test Strategy, Use Cases and Tests.
• Worked with CCTE's Manager, CISCO's Sr. Telecom Analyst's and QA Analyst group, to Design an in-house Automated Testing Tool, using Ms Office Ms PowerPoint, Ms Word, Ms Excel to function as a repository for all Use Cases and Test Cases, replication of Use Cases and Test Cases, control the execution of tests, the comparison of actual outcomes to predicted outcomes, the setting up of test preconditions, test reporting functions, Defect Tracking for the and Graphical Analysis.
• Worked with CCTE's Manager, CISCO's Sr. Telecom Analyst's and QA Testers, to create all of the Eastern Region Unified Contact Center Expansion ICM Scripts, VXML/Java, WEB Admin, SQL/Stored Procedures and FTP Pickup/Dialer , IVR and VIOP Platform's Use Cases and Test Cases documents Log and track Defects, held daily Scrums, a weekly status meeting and provided weekly status and Defect Tracking reports.

QA Lead/Analyst

• Gathered the Business Requirements and created the master test plan for the conversion from the claims payment check along with a Provider Claims Register or a Provider Claims Remit PCR The Register was converted from the old EDI claims processing system LRSP , CSRP to the new system QNXT , TriZetto's Claims Processing, Ingenix Claims Edit System iCES and TriZetto Facets working with all modules and functional areas of Facets including: Benefits Contracts, Subscriber, Member, Prior Authorization ,Provider, Plan / Products , Medical Management, Accounting, Billing Commissions, Capitation, Business Rules and Workflow, Claims, Customer Service, ITS Subsystem / Claims, SOA, EMR and EHR
• Created for QNXT and Facets the Business, Functional, Supplemental Document requirements, Master and Detail Test Plans for all Service and Change Packs for the Trizetto Facet Claims Process Application Group which includes recording, processing, tracking and running inquires on hospital and medical claims, Claims Inquiry, Dental Claim Line-Item History, Dental Claims Electronic Log, Dental Claims Logging, Dental Claims Processing, External Claims Editing, Hospital Claims Electronic Logging, Hospital Claims Logging, Hospital Claims Pre-Pricing, Hospital Claims Processing, Medical Claims Electronic Logging, Medical Claims Logging, Medical Claims Pre-Pricing, Medical Claims Processing, Payment Drag Override Processing, Pended Claims Release Parameters
• Developed the data plan that required hybrid conversion strategies for using the QCSI EDI tools, as well as, developing SQL tools and/or utilizing third-party applications e.g. Informatica to transform and convert data into the testing environment
• Selected regression test plan data for claims and claims history providers, affiliations, members, enrollments, benefit plans, and benefits , provider demographics, credentialing, provider affiliations, memos and alerts Managed Risk by performing Risk Analysis that outlined the testing risks and escalated them to upper management

QA Lead Testing

Data-warehousing DBA

• Performed as the test DBA for the TSO DB2 to UNIX Oracle conversion process Managed twenty-one 21 mainframe and nine 9 Unix Test database environments DB2 and Oracle, TSO and AIX ETL Data Warehousing/Mining STM Creation experience STM - Source To Target Mapping testing efforts Successfully trained end-users, regarding new system functionalities Acted as a liaison for MIS and end-users Analyzed and tested new functionalities and software upgrades Created the master test plan, test strategy and test scenarios from Business Requirement
• Identified data sources and constructed data decomposition diagrams provided data flow diagrams and documented all processes wrote the code for all database accesses, modified and constructed stored procedures maintained all documentation of the positions expertise, concepts, practices, and procedures
• Conducted Systems Acceptance Testing and User Acceptance Testing, monitored changes and enhancements Wrote complex SQL/SQR programs within an aggressive schedule Adhered to the change control processes, when implementing test plans and project plans, utilizing the change control process Worked with both end users and technical teams, to ensure changes are documented correctly Maintained all system, security and QA documentation per department policies

BA/QA Lead Data-warehousing Analyst

• Maintained all testing databases, ETL Data Warehousing/Mining STM Creation experience STM - Source To Target Mapping testing efforts Successfully trained end-users, regarding new system functionalities Acted as a liaison for MIS and end-users Analyzed and tested new functionalities and software upgrades Researched and resolved any referred help desk issues
• Data-mining/warehousing specialist for the Samples Allocation Tool forecasting system Responsibilities included defect tracking, test coverage, validation plan, use cases, system integration, test plan, test strategy and approach, traceability matrix, test cases, assigning testing tasks and maintaining the project plan Coordinated, created manual and automated test cases using the Rational and Quality Center Test Suite of tools.
• The Sample Quantity forecasting system, uses the linear regression formulas, forecast and monitors the distribution of drugs nationally regional divisional and via its Sales Representative for each quarter. The system makes a forecast based on the samples consumption within the past two quarters, and the current inventory level.
• Performed as Business Analyst gathering requirements for the Repetitive Transcranial Magnetic Stimulation rTMS project
• Performed system testing of new modules and enhancements Collected, analyzed data and troubleshot system issues Relied heavenly on knowledge of the functions for which the application was designed to assist end users Conducted testing of systems and applications, monitors changes and enhancements
• Documented system procedures Created tree structures, using hierarchies to address query security requirements Configure combination edit rules Wrote complex SQL/SQR programs within an aggressive schedule Adhered to the change control processes, when implementing test plans and project plans, utilizing the change control process Worked with both end users and technical teams, to ensure changes are documented correctly Maintained all system documentation, security and QA per department policies.

WellPoint Family of Companies

The Health Insurance Portability and Accountability Act of 1996 HIPAA National Standard Health Care Identifier defines the Department of Health and Human Services requirements for the format and use of a National Provider ID NPI throughout the health care industry. The NPI uniquely identifies every provider and user in any electronic HIPAA transactions by all health plans, health care clearinghouses and health care providers on or before May 23, 2007.

• Responsibilities involved writing Business Requirements, Tracking, Coverage, Change Impact, Use Cases, Corporate Integration Test Plan, the 17 company's Integration Test Plan, Test Approach, Traceability Matrix, Test Cases, assigning Testing Tasks, assessing Skills Levels, Roles, responsibilities managing, mentoring, developing, motivating and leading a team of six analysts for the Claims processing team and the Enterprise wide Solution Integration Testing Team
• Served as a leader/ mentor Sought out as an expert Reviewed the work of others Developed innovative approaches Analyzed and dissected system requirements and technical specifications to create and execute test cases for large business initiatives
• Assisted business users in defining UAT test cases and plans Established and maintained test cases and test data Created automated manual Test Scripts and Test Cases using Quality Center, Test Director and QTP Actively participated in walk-through, inspections, reviews and user group meetings for Quality Assurance
• Worked with business users, system analysts, designers and programmers to create and analyze various required project documents Participated in production implementation verification and being accountable for validating system quality
• Planned, documented, evaluated and tracked testing results to ensure system applications are free from defects Communicate and interacted with the appropriate areas on problems, changes and enhancements that may impact data, workflow and /or functionality within Clinical IT software

Commercial Line/Property and Casualty Web Routing Service: The goal of the eCommerce Web Routing Services, through the B2B Gateway, is to provide a single point of access, for authorized and authenticate external agents to access back end services. Many agencies use a common agency management system, TAM The Agency Manager and TS Transformation Station . As an Internet based Value Added Network VAN , these products enables near real-time throughput as it retrieves information from the current AQS, Mecca and A1 legacy systems. Based on the customer information system, it can generate a quote to issue a policy and evaluate the risks involved

• Extensive QA testing ECommerce Internet based services including websites, web applications, back-end databases and web sites built in an n-tier model.
• Responsibilities involved Functional, Integration, QA Testing and UAT Testing, using XMLSpy, Rational TestManager, Rational Robot, and Rational ClearQuest. Business Requirements, Master Test Plans, Test Strategies and Approaches, Use Cases and created automated manual Test Scripts and Test Cases using Automated Manual Testing Tools from Use Cases and linked automated manual Test Scripts and Test Cases Test Cases to Use Cases creating a Traceability Matrix Worked with Rational Test Suites and Quality Center to perform and write Manual and Automated test scripts and generate the Reports.
• State Farm Insurance of Illino
• Functioned as Business Analyst and QA Team Lead for Commercial Line/Property and Casualty group writing Business Requirements and System Integration Test and User Acceptance Test Plans.
• Performed Automated and Manual Testing for the Mainframe, Workstations, Servers and Internet based applications, Client/Server Setup and Software Installations, including Upgrading Testing Operating System, MS Office and other proprietary products.
• Prepared and executed Quality Assurance Standards, Defect densities and defect counts, Test Plans, Automated Manual Test Scripts and Test Cases using Automated Manual Testing Tools Hyperstation, RAMBA, Ms Access, FTP, Rational RequisitePro, ClearQuest, TestDirector, WinRunner, LoadRunner and Defect Reporting
• Provided 1st line technical support 24x7 for production and testing environments First line of problem solving for the project team State Farm and its offshore team , relying on extensive experience and judgment to plan and accomplish goals while performing a variety of tasks.
• Allstate Insurance of Illinois
• Prepared Business Requirements and System Integration Test Plans, all appropriate Method/1 deliverables including Testing Approach Memo, T910, Test Cases Expected Results, ZZ109, and Inspection Forms and AA534.
• Responsibilities for the Personal Lines of Business Property - Personal, Flood, Earthquake, Dwelling Fire/Personal Liability, Homeowners, Medical Malpractice, Workers' Compensation Insurance, Other Lines of Business, Interline Filings, Fidelity, Insurety, Commercial Auto Liability, etc To work closely with the software developer s to preparing and executing the master test plan Created and maintained testing work plans for large projects in MS Project and completed all testing related activities by establishing target dates and maintaining testing related documentation in Test Director, the Project log or Project folder, including Upgrading Testing OS, MS Office products and other proprietary products
• Performed Automated and Manual testing using Test Director, WinRunner and Hyperstation Participated in all phases of the SDLC, Configuration Management, Version Control, QA Testing through Defect Tracking, kick-off, status and inspection meetings

Sr. Systems Analyst/Lead Developer

• Responsibilities included developing the Function and Implementation Test Strategies, Writing Test plans, Test Case Design, Test Data, and Test Execution throughout the SDLC process Created Automated Manual Test Scripts and Test Cases for eCommerce applications using FTP, Test Director, WinRunner and Load Runner Assisted in all development application phases from Requirements, Analysis and Design Specifications, Structured Walk-through, System Testing and Production Implementation.

• Tested the functionality of all GUI, Business Objects, and Peer-to-Peer processing, Data Retrieval and DB2 rules as they apply to the GUI requests for the Merchant Information Warehouse MIW database. Task included Configuration Management and Version Control of merchant software application credit card transactions, settlements, equipment and inventories throughout the US and Canada conversions from C , OS/2 - OS/390 to Java, Windows N2 - OS/390 , Data Warehousing from DB2 and Oracle

Sr. Systems Analyst/Lead Developer

• Responsibility of managing the Y2K Claims processing team of 12 Configuration Management and Version Control for COBOL and COBOL II applications Developed detailed Test Plans and Test Cases/Points Developed all queries, using SQL, SAS, COBOL II, JCL/Procs, Sort utilities, Clist, ViaSoft Utilities, FileAid, TICTOC, BTS, and Hyperstation. Transmitting data from Mainframe to PC between Servers Worked with the Business Analyst, customer service reps, and technical groups to build Application Knowledge Repositories, Y2K Remediation and approaches, such as Inline, Windowing and FastPath