SUMMARY:

• Seven years of extensive experience in the field of Data Analysis, working with the technical staff to implement management and staff's business requirements into the software application in Healthcare Industry.
• Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross - platform environment.
• Experience in Medicaid Management Information System (MMIS). Expertise in various subsystems of MMIS- Claims, Provider, Recipient, Procedure Drug and Diagnosis (PDD), Explanation of Benefits (EOB).
• In-depth knowledge of creating use cases, functional design specifications, activity diagrams, logical, component and deployment views to extract business process flow.
• Used Query Analyzer, Execution Plan to optimize SQL Queries.
• Experience with SOX, Regulatory Compliance and Controls.
• Strong understanding of project life cycle and SDLC methodologies including RUP, RAD, Waterfall and Agile.
• Interviewed SMEs and Stakeholders to get a better understanding of client business processes and gather business requirements.
• Conducted JAD sessions, created Use Cases, work flows, screen shots and Power Point presentations for the Web Applications
• Familiar with HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278 etc
• In depth knowledge of SDLC and implementation of the Rational Unified Process (RUP) in all four phases of a project: Inception, Elaboration, Construction and Transition.
• Utilized a fusion of industry knowledge and technical programming to provide executive management the development and implementation of interactive business1s tools, and strategic analysis, vital for use in mission-critical decision-making
• Conducting requirement gathering sessions, feasibility studies and Impact Analysis and organizing the software requirements in a structured way using Rational RequisitePro to track development.
• Performed UAT and exposure to User Certification Testing (UCT) and Operational Readiness Testing (ORT)
• Expertise in understanding and supporting the client with Project Planning, Project Definition, Requirements Definition, Analysis, Design, Testing, System documentation and user training.
• Used Rational ClearQuest for tracking and prioritizing defects and for enhancements after base lining the requirements.
• Used Rational ClearCase for Version Control of requirement documents.
• Well versed in writing queries/Scripts for Data Analysis and QA reporting and testing.
• Good knowledge of Workflows and Content Management Tools.
• Experience in Change Management Process (Identify, Analyze, Evaluate, Plan, Implement, Review and Close).
• Expertise in Procurement and Management Services
• Experience in implementing Microsoft Office SharePoint.

TECHNICAL SKILLS:

Programming Languages: C, C++, HTML, XML, SQL.

Data Base: MS Access, Oracle (SQL Series), DB2

Reporting Tools: Crystal Reports

Operating Systems: MS-DOS, Windows95/98/NT/2000/XP, Apple McIntosh, Linux

Software: MS Office Suite(Word, Excel, Access, PowerPoint & Outlook), MS Visio, Rational Rose, Rational Requisite Pro, Adobe Acrobat, MS Office FrontPage, Lotus Notes

Performance Testing Tools: Virtual User Generator, Load Runner

Processes/Technologies: Rational Unified Process (RUP), Waterfall, UML & Microsoft Office SharePoint 2007

Automation Tools: Requisite Pro, Win runner, QTP, Test Director, Quality Center

PROFESSIONAL EXPERIENCE:

Confidential, Atlanta, GA

Sr. Data Analyst

Responsibilities:

• Authored business system analysis reports based on state regulations, HIPAA compliance and product business rules.
• Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing new sites.
• Worked with the SMEs (Subject Matter Experts), IT managers, software architects to identify the key changes pertaining to HIPAA, and participated in Health Management to communicate effectively with them.
• Performed the requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro.
• Develop MITA Maturity Model (MMM) & Business Capability Matrix (BCM) to identify the maturity level of SD Medicaid Enterprise.
• Worked on billing system a cash management module and enhanced the encrypting standards that are required for the application.
• Develop Conceptual Data Model & Logical Data Model in alignment with MITA Information Architecture.
• Followed a systematic approach to eliciting, organizing, and documenting requirements of the system.
• Reviewed the Joint Requirement Documents (JRD) with the cross functional team to analyze the High Level Requirements.
• Used Query Analyzer, Execution Plan to optimize SQL Queries.
• Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.
• Planned and documented procedures for data processing and prepared data flow diagrams for the application.
• Evaluating various open source architecture framework in the industry like TOGAF framework architecture, Zachman framework and other open source framework to come up with the architecture roadmap for the client.
• Expertise with supply chain strategies/vendor manufacturing process methods to determine level of procurement and strategic sourcing strategies/plans and worked with vendors/peers to determine lead times, schedules and cycle counts, established requirements needs.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Prepared and documented System Requirements and workflows for the Content Management Application tool.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Performed Unit Testing and User Acceptance Testing and documented detailed defects.
• Designed and developed project document templates based on SDLC methodology
• Designed workflows and allocated permissions within SharePoint.
• Performed Unit Testing and User Acceptance testing (UAT) and documented detailed results.
• Provided input (scope, goals, risks, constraints, timelines and interfaces) to PM for project planning and control.

Environment: Windows, Microsoft Office SharePoint, TOGAF, Rational Requisite Pro, MS Office, SQL Server, Agile, MS Project, MS FrontPage, MS Access, EDI,UML.

Confidential, MO

Data Analyst

Responsibilities:

• Responsible for defining the scope and implementing business rules of the project, gathering business requirements and documentation.
• Develop Technical Capability Matrix (TCM), Business Service & Technical Service in alignment with MITA Technical Architecture.
• Responsible for writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS).
• Analyzed Business Requirements and segregated them into high level and low level Use Cases, Activity Diagrams / State Chart Diagrams using Rational Rose according to UML methodology thus defining the Data Process Models.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278.
• Involved in applications analysis, which involves claims processing in NASCO.
• Defined Functional Test Cases, documented, Executed test script in Facets system.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Conducted presentations of the Q/A test results with analysis to the stakeholders and users and documented modifications and requirements.
• Coordinating and Developing QA activities.
• Assigned tasks among development team, monitored and tracked progress of project following Agile methodology.
• Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Wrote Test Cases and performed User Acceptance Testing (UAT), documented the in detail defects using the Defect Tracking report.
• Used Test Case distribution and development reports to track the progress of test case planning, implementation and execution results.
• Wrote PL/SQL statement and stored procedures in Oracle for extracting as well as writing data.
• Created Use cases, activity report, logical components and deployment views to extract business process flows and workflows involved in the project. Carried out defect tracking using Clear Quest
• Maintained proper communication with the developers ensuring that the modifications and requirements were addressed and also monitored these revisions.
• Involved in compatibility testing with other software programs, hardware, Operating systems and network environments.

Environment: Requisite Pro, Rational Rose, Agile, PL/SQL, HTML, MS Office, MS Visio, EDI, UML.

Confidential, NJ

Data Analyst

Responsibilities:

• Gathered, analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Performed Cost benefit, ROI and ROM studies
• Conducted user interviews and documented business and functional requirements.
• Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose
• Analyze and prepare specifications for the improved functionality of the Nasco.
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data
• Completed the documentation of Claims Scenario’s for the source system.
• Presented detail walk through of Functional Specifications, Detail Design and VISIO work flow process diagrams to Business, EDI, MQSI, HIPAA project managers and HIPAA project regulators.
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Exposed to Agile methodology.
• Created use case scenarios and documented work flow and business process using Rational Rose
• Involved in project management using MS Project
• Collaborated with External Auditors and documented SOX compliance requirements
• Documented requirements associated change requests with requirements and connected requirements with Use cases.
• Wrote test cases and test scripts for the User Acceptance Testing(UAT).
• Incorporated Rational Unified Process (RUP) to create Requirement Document Specifications using Visible Analyst.
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• Served as conduit for managing system requirements between the business and the software development team.

Environment: Windows, Oracle, MS Access, MS Excel, RUP, Oracle, UML, Rational Rose, Requisite Pro, Clear Case, Rational Clear Quest, MS Office suite, MS Visio.

Confidential, Washington DC

Data Analyst/Business Analyst

Responsibilities:

• Interacted with business heads to finalize the Business Requirements for the application.
• Performed the requirement analysis and documented the requirements using Rational Requisite Pro.
• Used the requirement attributes (priority, effort, and risk) as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Developed UML Use Cases using Rational Rose and developed a detailed project plan with emphasis on deliverables.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Managed changing requirements which included establishing a baseline, keeping track of the history, determining dependencies that are important to trace, tracing relationship between related requirements and maintaining version control.
• Prepared and documented System Requirements and workflows for the Content Management Application tool.
• Responsible for integrating with Facets .Designing test scripts for testing of Claims in Development, Integration and production environment.
• Checked Business Readiness and determined activities of flow.
• Developed & executed several Optimized queries in SQL on this data.
• Performed Unit Testing and User Acceptance Testing and documented detailed defects.
• Wrote Procedure Manuals and was responsible for continuity preparedness.
• Managed various tests, stored test information, reviewed and analyzed test results.
• Conducted presentations of the Q/A test results with analysis to the stakeholders and users and documented modifications and requirements.
• Helped in writing Training manuals and helped business with the Training on a one to one sessions.
• Employed Rational Clear Quest for effective Change Management (Requirements Creep) and bug tracking during the testing lifecycle.

Environment: Rational Rose and Requisite Pro, MS Visio, MS Project, UML, XML, HTML, Vignette Content management Tool, J2EE (JSP1.2), XML, XSL, XSLT, HTML, Oracle.