Tamkanath Ali

(***) ***- ****

Email: acrvns@r.postjobfree.com

Professional Summary:

SIX plus years of diverse progressive experience in Information Technology, with emphasis on Business Analysis, DATA Analysis and Software Development life cycle.

Functional experience in Health care, E-commerce and other Hi-Tech Industries.

Thorough understanding of Software Methodologies.

Strong knowledge of Business Process modeling (BPM) using Swim lane, Unified

Modeling language (UML), JAD sessions, and Gap Analysis.

Excellent interpersonal, presentation skills, oral and written experience to communicate on different levels of management.

Experience working with business users and the senior management.

Experience working with Offshore and On-shore teams.

Key Skills

In depth knowledge of Software Development Life Cycle (SDLC), with thorough understanding of various phases such as Requirements, Analysis/Design, Development, Testing, UAT and Implementation.

Expertise in Business Analysis, System Analysis, Data Migration, Data Analysis and Business process flows.

Strong knowledge on Federal Exchange projects, implemented as part of Affordable Care Act.

Experienced in working with Trizetto Facets on Provider Life cycle, Members Enrollment and Claims modules.

Experienced in working on SAP ECC system with various Transaction codes for Master Data, Procurement data and Transactional data loads.

Experienced in using Siebel CRM system to provide business with capability to view, track and maintained consumer information.

Experienced in proposing ETL methods, Data Conversion, OLAP designing for reporting purpose.

Good working knowledge in Enrollment, Billing, Claims, CMS regulation, HIPAA regulations, ACA regulations, 834 enrollment and 837 claims transactions for health care industries.

Expert in using various requirements gathering techniques including White boarding, Brainstorming, JAD, Focus Analysis, Reverse Engineering, Survey, Document Analysis, Interviewing and Observations.

Experience in writing documents including Software Requirement Specifications (SRS), Business requirements document (BRD), Use Case Specifications, Functional Specifications (FSD), Systems Design Specification (SDS), Requirement Traceability Matrix (RTM) and testing documents.

Experienced in detailed analysis that requires identifying Data Sources, impacted areas, downstream systems and proposing solutions.

Experienced in performing Gap Analysis to capture system gaps.

Proficient in translating business requirements, user stories into detailed System requirements and technical requirements.

Solid background in Software Development Life Cycle methodologies including Water Fall, RUP, and Agile Methodologies.

Experienced in creating User Stories and product backlog using scrum methodology.

Experienced in conducting Joint Application Development (JAD) sessions with end-users, Business system analysts, software developers and quality assurance teams.

Experience in Change Management Process (Identify, Analyze, Evaluate, Plan Implement, Review and Close).

Ability to work in high pace environment and a quick learner.

Innovative, versatile Business Analyst having experience in understanding of Business Process Flows, Project Management, Case Tools and Business Analysis.

Experienced in using MS Access 03/07/10 version for Data conversion/Data Cleansing and Reporting purpose.

Proficient in using business knowledge, technical skills, and strategic analysis to design solutions and provide creative insights to critical business problems.

Proficient in requirement analysis and creating Use Cases, Sequence Diagrams, Activity Diagrams, Class Diagrams etc.

Strong experience in Microsoft Office Tools (Excel, Word, Access and PowerPoint)

Experience in the use of tools like Rational Rose, Rational Requisite Pro, Rational Clear Case, and MS Visio.

Involved in reviewing test procedures, defining test cases, reviewing and maintaining test scripts, analyzing bugs and User Acceptance Testing (UAT).

Reputation for dedicated teamwork, high energy, work ethics and commitment with capability to handle new technologies and situations.

Technical Skills

Operating Systems: Windows 98/NT/2000/XP/7, Citrix, VSE Mainframe.

Languages: C, C++, Visual Basic, SQL/PLSQL

Databases: MS-Access03/07/10, SQL Server, Oracle, DB2.

Tools: MS Visio, Rational Rose, Rational Clear Case, Rational RequisitePro.

Bug Tracking Tools: Mercury Test Director, Rational Clear Quest

Testing Tools: Test Director, Load Runner, Quality Center

Client: Blue Cross Blue Shield June 2013 – Aug 2015

Role: Sr. System Analyst

Affordable Care Act/Exchange-SHOP implementation projects

Worked on countless exchange scopes implemented as part of ACA Act.

Worked with vendors as a representative from Florida Blue on integration projects.

Worked with IT and Business areas closely to understand business needs and implementation approach and have coordinated with enterprise architects to ensure seamless deliveries.

Worked on FB gateway and Data integration services (HUB AND SPOKE) to coordinate impacts, interfaces, enhancements, and other ad-hoc request.

Worked as a lead to provide sizing for work (Scope) items.

Worked on projects following Waterfall/Agile methodologies for exchange items and exchange related postproduction issues.

Worked on 834 inbound and outbound files using Hub and Spoke model.

Used detailed knowledge of the application, features and functionalities to assess the scope and impacts

Performed Gap Analysis to check the compatibility of the existing system with the new business design using the “As is” and “To be” phase analysis.

Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and AODs using Visio.

Interact with development/review BRD's to identify system Impacts and Process impacts

Organize JAR and JAD sessions to document system requirements

Documented Functional Requirements Specifications (FRS), Created Process flows/activity diagrams using Visio for projects following water fall methodologies.

Gathered reporting information from businesses for various reporting needs.

Worked closely with the IM team to generate reports using crystal reports.

Worked with developers to design and develop SSRS to generate BI reports.

Organized and participated in status call/meetings for project status tracking, BTIs and other issues.

Documented and tagged requirements using Rational Requisite Pro.

Identified features, Prioritized features, Identified Requirements by features and Developed Traceability Matrix using Rational Requisite Pro.

Involved in UAT testing, UAT Regression and Implementation phase for releases.

Environment: RUP, Siebel, PEGA, Sales Force, Diamond, JAVA services, Mainframes, RBMS, MS Office 2010, MS Visio, QC, Rational Requisite Pro.

Client: Fidelis care, NY Dec 2012 – May 2013

Business Analyst

Responsibilities:

Gathering requirements from business users based on new market rules and Desk level procedures.

Worked with Architects to Create Data flow model for Government owned Facilities, and for new oncoming ROSTERS.

Created business requirements document (BRD) & functional requirements document (FRD) to map the business rules as documented.

Built databases in Microsoft Access07/10 as per new market guideline based on business rules and Desk level procedures, to asses Data Cleansing.

Created Test data and test cases in MS Excel to test numerous scenarios, for setting up Providers in FACETS.

Worked on Excel to create Pivot chart for reporting purpose.

Worked with Facets Architects to get in-depth knowledge on Providers life cycle and how can Members and Claims get affected with Providers Network setups.

Did Reconciliation of Data on Providers back-end table to gauge the quality and enhance quality of existing entities.

Worked with Facilities to get the correct count on number of Members/ Eligibility and Demographic information to set Groups/Subgroups/Subscribers/Members accurately in facets

Reconciled the Relation tables to ensure the dependencies does match with Health products selected.

Built Automated system to Add, Terminate and update existing data based on incoming weekly ACT files from existing Rosters.

Created Audit Ad-hoc update system to capture any changes that were skipped.

Worked with Operational and Implementation team to build a system where loading Providers and Eligibility checks can be made successfully which overcomes efforts of keying records through GUI.

Did Post load Check through GUI to make sure provided updates/Demographic information is loaded accurately.

Manually created records through GUI to create Network rows for existing TIN/NPI combinations.

Reported Vendors about the data issues and Data Quality that is actually required.

Created a Mapping document to map Codes provided by Vendor/Roster/Government owned Facilities to match the codes that are acceptable in Facets.

Worked with business users during self service reporting training using crystal reports application.

Created Pivot tables to show the oncoming New add’s vs Terms from new vendors.

Worked with Operational team and End users to ensure the quality of data to help them get agreements from new providers.

Worked with Users to make sure Claims get Adjudicated correctly for the new providers added into the Network.

Set Flags for Government run Facilities to process claims with different rules.

Environment: Facets 4.71, RUP, MS Office suite, MS Access 07, MS Excel, SQL Server 08, TOAD, VB script, Quality center 9.0.

Client: Amerigroup, VA Aug 2011– Oct 2012

Role: Business Analyst

Amerigroup is one of the Fortune 500 Company serving more than 2.7 million members in 12 states. The project was to expand its services in the 13th state, Kansas by 2013. Amerigroup has to rent provider network from vendors in Kansas market. And also to build the Enrollment process for members based on new market rules.

Responsibilities:

Gathered requirements from business users based on new market rules and Desk level procedures.

Worked with Architects to create Data flow model for Government owned Facilities and for new oncoming ROSTERS.

Created business requirements document (BRD) & functional requirements document (FRD) to map the business rules as documented.

Built databases in Microsoft Access 07/10 as per new market guideline based on business rules and Desk level procedures, to assess Data Cleansing.

Created Test data and test cases in MS Excel to test numerous scenarios, for setting up Providers in FACETS.

Worked on Excel to create Pivot chart for reporting purpose.

Worked with Facets systems Architects to document new rules for Kansas market.

Performed data reconciliation on Providers back-end tables to gauge the quality and enhance quality of existing entities.

Worked with Facilities to get the correct count on number of Members/ Eligibility and Demographic information to set Groups/Subgroups/Subscribers/Members accurately in facets

Reconciled the Relation tables to ensure the dependencies match with Health products selected.

Built Automated system to maintain existing data based on incoming weekly ACT files from Rosters.

Built triggers to capture any data mismatches or inconstancies.

Worked with Operational and Implementation team to built a system where loading Providers and Eligibility checks can be made successfully which overcomes efforts of keying records through GUI.

Performed post load validation through GUI to make sure Provider information is reflected accurately.

Manually created records through GUI to create Network rows for existing TIN/NPI combinations.

Created a Mapping document to map Codes provided by Vendor/Roster/Government owned Facilities to match the codes that are acceptable in Facets.

Created Pivot tables to show the oncoming new Adds vs Terms from new vendors.

Worked with Users to make sure Claims get adjudicated correctly for the new providers added into the Network.

Set Flags for Government run Facilities to process claims with different rules.

Environment: Facets 4.71, Waterfall, MS Office suite, MS-Access 07, MS Excel, SQL Server 08, TOAD, VB script, Quality center 9.0.

Client: Airgas (Off-Shore) Dec 2009 – July 2011

Role: Business Analyst

Airgas, Inc. is one of the largest distributor of industrial, medical, and specialty gases and related Hardgoods, such as welding supplies. Airgas was in a process of deploying SAP Business suite for all future Transactions for each Airgas region. The project was CS3 Development and Data Conversion. Company wanted to migrate their data from legacy system to SAP ECC without compromising quality of data.

Responsibilities:

Gathered, analysed, and documented requirements from 8 different Regional Airgas Companies.

Database designing and developing queries in Microsoft Access03/07, Sql server 08 to Asses Quality of data.

Worked with the core team to design Regional Go-Live plan, Cut over plan and their ITC test schedules.

Touched point with Regional companies on a weekly basis to review the status of the GO-LIVE plan and also conducted weekly Data test loads in various Instances of SAP system for data Quality assurance.

Worked on Excel for Analysis and reporting purpose.

Facilitated joint application development (JAD) sessions acting as a facilitator between various teams.

Created workflow diagrams, SAP Transport diagrams, GO-Live Plan using MS Visio.

Developed Audit reports for each region for their Data purge and reported them as per the schedule to the Process team for data issues

Documented Query logics, execution process and export process in MS Word for future use.

Owned the entire reporting process. Interacted with the SAP Deployment team, ABAP developers, SCM and OM teams to get the requirements, templates, Configuration for deployment purpose

Possess good knowledge on SCM, CRM strategies, Vendor master, Material Master, FI/CO for determining levels of procurement, strategic source planning and allocations determine dependencies of data in SAP

Worked with reporting team to get them reporting requirements and help them setup Universes for various teams

Designed new database for tables to meet changes required as per mapping documents and data conversion process.

Conducted multiple test loads in ECC to determine dependencies of data.

Migrated Data from MS Access to SAP ECC for ITC Test loads and GO-LIVE loads for each regional company.

Assisted in developing test scenarios, test scripts and test data to support unit and system integration testing.

Involved in UAT testing, UAT Regression and Implementation phase for each data loads.

Experience in managing the changes in requirements by Unified Change Management Tools (UCM) like Rational Clear Quest.

Environment: SAP ECC 6.0/BW7.0, Oracle10g, Citrix, CU, Oracle Financials, Windows, MS Access 03/07, SQL server, MS Excel, MS PowerPoint, SQL/VB script, ABAP.

Client: Airgas, OH May 2007 – Aug 2007

Role: Intern Business Analyst

Worked with regional business areas and Corporate office to document SAP Implantation plan

Gathered requirements, organized meetings with Off-shore development teams to document the development strategy and Resource Planning.

Created business process flows in Visio.

Created business requirements document for 4 regions.

Created a reporting database in MS Access for ad-hoc reporting purpose.

Worked with System Architect and SAP Engineers for drafting design and specifications.

Documented risk factors and pain points.

Documented testing requirements for each core component.

Education: Bachelor in computer science

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