Project Analyst

Tanya Keyzman

*******.@*****.*** 201-***-****

*** ******* ***

Str.,

Gaithersburg, MD

20878

PROFILE:

. Senior business analyst with strong programming background and desire

to learn

. Extensive experience and proven ability in process redesign and

converting business

requirements into effective software.

. Successfully worked on multiple projects simultaneously through all

phases of SDLC

. Solid knowledge of health care products, medical policies, coverage

and diagnosis codes,

claims adjudication and EDI transactions.

. Collaborated effectively with stakeholders, developers, testers, and

management to deliver quality product on time, skilled in PM/BA

applications

. Was nominated for company Operational Excellence Award by 2 business

areas.

EXPERIENCE:

May 2011 - Present EmblemHealth

Senior Business Analyst, Consultant

Project: Medicaid Encounter Data Submission (MEDS II)

The health care organizations are required to submit Medicaid encounters to

the State Department of Health.

The institutional encounters submission is currently rejected by the State

Department of Health.

Worked with business and IT teams to identify process gaps and data

inconsistency. Analyzed the response files from SDOH, institutional

encounters data extracted from 837I transactions, and claims data stored in

the data warehouse. Ensured accurate documentation of the current process.

Identified the problems and proposed solution for enforcing data

consistency among the sources. Collected, documented and progressively

elaborated requirements using diagrams, use-cases and presentations.

Elicited requirements that lead to creation of business rules. Created BRD,

worked with IT on defining the future process and technical requirements,

created and maintained traceability matrix.

May 2003 - May 2011 Horizon Blue Cross Blue Shield

System Business Analyst III

Project: Redesign of pre-authorization process of medical procedures

Accomplishments: After implementation of the first phase of the project the

amount of calls per month dropped from 50,737 to 12,733. Daily inventory

totals of open service requests per workstation dropped from 1,486 to 93.

Evaluated information gathered from multiple sources, analyzed current

business process to identify challenges and gaps, redesigned the process to

ensure reliable and efficient end-to-end operation. Worked closely with pre-

authorization area business analysts, clinical staff, IT teams and

management during process redesign. Created flow diagrams, use cases,

metrics, and presentations to get stakeholders buy-in.

Throughout the project lifecycle acted as PM coordinating effort of pre-

authorization business team and IT teams: SOA/MOM development team,

phone/fax lines admin team, testing team, production release team. Reviewed

and approved BRD, wrote TRD, provided requirements traceability/success

matrix. Evaluated test plans and test cases, worked with testing team (on-

shore/off-shore) to ensure proper testing, communicated results to

business. Was responsible for costing and time estimates, sign-offs for all

projects stages.

Project: Central Product Library (CPL)

Project scope: $17 million budget, team of 50 people from 4 different

areas.

Accomplishments: reduced reports cost by 25% collaborating with

stakeholders and COGNOS team to combine reports by using COGNOS prompts and

web interface.

CPL is a single source of truth for products and benefit information across

the company.

The project objective is integration of all affected systems, elimination

of manual intervention and re-keying of information, providing ad-hoc and

scheduled reports.

Conducted JAD session, was responsible for evaluating approach for data

transfer to warehouse (db2) for reporting purpose. Gathered reporting

requirements, provided functional and not-functional technical

requirements, created reports mockups, performed data mapping and analysis,

specified transformation rules. Provided cost and time estimate, handled

project change requests, Worked with CPL and Informatica team on data

transfer, and with COGNOS team (off-shore) on reports.

Project: ICD-10 Conversion

Participated in sessions to create roadmap for the ICD-10 conversions,

collected and evaluated information, worked on comprehensive catalogue of

systems, interfaces, applications, middleware impacted by ICD-10 with a

description of the impact; performed feasibility studies and expense

analysis.

Additional Responsibilities:

. Was a part of warehouse team, created multiple ad-hoc

reports for different business areas including expense,

budget, inventory summary and key indicator reports.

. Analyzed business requirements and created TRDs for internal/external

feeds. Defined extract format and schedule, provided field mapping and

SQL joins, defined ETL rules, collaborated with developers. Worked

with admin team to create an FTP site between HBCBSNJ and vendor,

ensured that HIPAA and other mandates are not violated.

. Provided general user support, resolved access problems,

assisted with writing queries.

. Worked with governance team to resolve data integrity

problems, developed and enforced procedures and policies.

. Worked with data modeling team on creating data model for

Horizon HealthCare Innovations program.

. Created SharePoint workflow site to track BRD/TRD review process,

SharePoint documentation repository website to store project

documentation, provided support.

Senior Application Developer

. Worked on enterprise projects, Single Source Diagnosis Codes and

Medical Policies Repository, with different business areas throughout

the project lifecycle. Was responsible for costing and time estimates

of the project. Worked with business analysts on BRD, created TRD. Led

application development and supervised consultants working on the

project. Created test environment, worked with testing team to ensure

proper testing of the application. Monitored and communicated project

progress to stakeholders and PM.

. Worked with business analyst to provide solution for effective

communication of BCBSA committees' actions and their implications for

HBCBSNJ. Created application prototype using SharePoint, communicated

business and technical requirements to the consulting company, led

SharePoint application development.

. Worked with Legal department to develop business requirements for

compliance tracking, created technical requirements including

estimates and deadlines. Monitored the development progress against

the project deadlines.

. Worked on the enterprise single sign-on to the Lotus Notes

applications from the employee portal. Coordinated the efforts of

multiple groups, created test cases, supported testing and

implementation.

January - April 2003 The Globecon Group, NY

Senior Programmer/Analyst

Designed a new release of the eLearning web-based system that provided

unsurpassed learning support to bankers and finance professionals in

multiple countries. Analyzed transactional data and processes.

Developed functional specifications to meet the business requirements,

provided time and cost estimate, supervised team of 2 developers and

administrator.

October 2002 - January 2003 Department of Design and Constructions, NY

Senior Lead Programmer/Analyst, Consultant

. Was hired to improve budgetary system essential to DDC. The

system was used to charge project-related operating

expenses and to transmit data to NYC Office of Management

and Budget.

. Evaluated workflow and performed gap analysis, selected the most

efficient programming approach to improve performance. Worked out a

strategy that produced a considerable improvement in the existing

application.

. Acted as a key point of contact between IT and business

community. Developed productive relationships with business

stakeholders. Provided WBS, cost and time estimate,

supervised team of 3 developers.

November 2000- August 2002 HSBC Bank, NY

Senior Lead Programmer/Analyst

. Worked on global directory solutions, led the consolidation of mail

templates used in different international locations. Acted as

liaison between New York office and headquarters in London.

. Responsible for evaluation and implementation of new

technologies, reviewing and approving applications for

placing on production servers.

. Developed test procedures and documented test plan for

migration from Lotus Notes R4 to R5.

. Automated Intranet usage and statistics creation to measure

project success factors.

. Led the development and implementation of Intranet Content

Management suite.

. During the relocation of IS department to Buffalo acted as a

liaison between different developers groups, was responsible for

creating technical environment and smooth transition.

June 1999 - November 2000

Barnes & Noble College Bookstores, NY

Senior Application Developer

Specified technical requirements for online order system and provided

technical supervision for a consulting team working on this project.

Developed part of the system, which interfaced with DB2 on AS/400. Was

responsible for system testing and implementation.

December 1997-June 1999

American Express, NY

Programmer/Analyst, Consultant

Participated in formalizing of business rules, generating application

concept and data model. Was involved in migration from Lotus Notes R3

to R4. Designed and developed part of Lotus Notes Database System that

kept track of a variety of customer information (contacts, activities,

accounts). Integrated it into existing system; performed design

adjustment and functionality improvement. Created financial reports.

Before immigration to the United States worked at the Nuclear Power

Plant (Russia, Novovoronezh) as a liaison between Executive Management

Office and IT Center.

CERTIFICATION

IBM certified application developer

EDUCATION AND PROFESSIONAL DEVELOPEMENT

IBM Cognos 8.4 BI Report Studio: Professional Reports Fundamentals,

IBM NY

Hands-On Workshops for IBM Business Analytics (Cognos), IBM NY

Hands-On Crystal Report, Learning Tree, NY

Testing & QA Techniques, Advanced Information Technologies, NY

Technical Writing, Learning Tree, NY

Business Analysis Fundamentals, International Institute for Learning,

NY

Project Management Fundamentals,

XML: A Comprehensive Hands-On, Learning Tree, NY

Programming SharePoint Applications with .NET

Voronezh State University, Russia MA, Cum Laude

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