Project Data
Resume:
SUMMARY
o * + years of experience in diversified Health care domain facilitating
business requirements, Business Process Modeling, Business Process
Documentation, Client relationship Management, Documenting Request For
Proposal (RFP) - Mapping end-state Organizational goals, Data
Management & Integration, Strategic Analysis, Feasibility Analysis,
Focused Group Discussion, Use case scenario, Business flowcharts, User
interface and Quality management of web-based and standalone
applications, SDLC Practices and Enterprise QA.
o Expertise at Organizing Joint Application Development (JAD) with
diversified stakeholders and working with cross-functional domains
across the operational units to gather business requirements which can
be successfully translated as data models, architecture - design,
development and testing at various phases of the Software Development
Life Cycle (SDLC) with thorough understanding of requirements to
discuss open issues and resolve them
o Expertise in UML Modeling
o Expertise in performing Feasibility, Adaptability and Risk Analysis to
identify the areas of risk to business users and IT
o Knowledged in reviewing and mapping existing (AS-IS) Process Flows and
Data Models to improvise workflow methodology
o Experienced at developing test plans, deployment plans, monitoring
User Acceptance Testing (UAT), Integration testing and performance
Analysis
o Expertise in creating traceability matrix to illustrate the
relationships between different requirements across domains to
facilitate Gap analysis
o Experienced in Health care Domain
o Expertise in business modeling tools like Rational Pro, MS PROJECT and
MS Visio to visualize High level business work flow
o Understanding of Interactive Dashboards with drill-down & drill-across
capabilities on reporting tools
o Knowledge on Oracle BI / Siebel Analytics Environment, Siebel
Analytics Web / Presentation Services & Interactive Dashboards
o Knowledge in Oracle PL/SQL and database Performance Tuning by
implementing Parallel Execution, Table Partition, Mat views, Indexing
and re-building indexes.
o Effective communication/ written skills, Ethical behavior and charisma
which had facilitated a high level of collaboration among cross
Functional Teams (Both IT and Business).
o Strengths include problem solving, analytical thinking, designing and
handling complex business solutions, writing design documents (both
user requirements and functional), writing user manuals and guides for
functional testing.
CERTIFICATION
o Brain Bench Certification RDBMS,PL/SQL data Modeling
o Inquestra Certified Business system Analyst - III
o Certified Analyst - Best Business practices and Negotiation techniques
o Member RQNG, IIBA, IEEE
*Inquestra is an Endorsed Education Provider and Charter member of
IIBA
TRAINING
o Object Oriented Analysis and Design (OOAD), Diploma from NIIT, India
o UNIX, C Diploma from Aptech, India
o Visual Basic 5.0, Oracle 7i Database Administration
o Effective business analysis - Practices and Approach (3 day work shop)
o HIPAA Training, PA compliance best practices, Participated URAC audits
TECHNICAL SKILLS
o Rational Unified Process (RUP), Agile, Six Sigma, ISO, Total Quality
Management (TQM), IEEE Standards
o Requisite Pro, Clear Case, MS Visio, MS Outlook
o Test Manager, Rational Clear Quest, Mercury Load Runner.
o SQL Reports, Seibel Analytics 7.x, Oracle Business Intelligence EE
o SQL*Plus, SQL Assistant 7.1
o Oracle, MS SQL Server, MS Access
o SQL, PL/SQL, C++, C, XML, .Net frame work 3.0
o MS Office Suite, MS SMS server, MS Exchange Server, MS Project, MS
Visio
o Windows 95/98/2000/XP, UNIX, Linux, Mac OS & DOS
Work Experience
Tech Point solutions Inc., Milpitas, CA
Feb'08 - Aug'10
UST Global Inc., Aug'10 -
till date
Client: WellPoint Next Rx, CA
Oct '08 - till Date
Role: Senior Business Analyst (Contractor)
WellPoint is the nation's leading health benefits company serving the needs
of approximately 35 million medical members nationwide. WellPoint is a Blue
Cross or Blue Cross Blue Shield licensee in 14 states: California,
Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada,
New Hampshire, New York, Ohio, Virginia, and Wisconsin.
CFM Reporting
Oct'08 - Dec'08
Clinical Formulary Management is the active entity of Pharmacy clinical
operations inside Next Rx enterprise. The team is committed to maintain
formulary updates for different customers/Clients(close to 110 accounting
Pro PBM and Pro Serv) using Medi-Span and First Data Bank Drug data on DMS.
The team works to maintain updates on diversified data sources such as MS
Access, DB2 and Oracle data bases where the NDC and GPI values are
maintained as mandated per the perusal of the Pharmacists to specific
health plans.
Well PATH - Prior authorization compliance
Jan '09 - Till Date
Project Well PATH is a vision application for WellPoint to unify business
process and data from two different systems Pro Serv (Next Rx) and Pro PBM
(Anthem) onto one Prior Auth system.
The Letters team was involved in Migrating and modifying letters for
different Line of business on the unified system to address state mandates
and compliance practices. Letter design and behavior were controlled by
Letter Generation Module where letters are docked. PA Letters were
identified the end product of the end to end application design where
multiple systems and data sources exchanged information.
Responsibilities
o Worked closely with IT and Business Stake-Holders, key Business/Super
users and Subject Matter Experts (SME's) to gather requirements for
development/reporting to regulate process behavior and account
compliance mandates
o Analyzed source systems (LGM/Well PATH/ULTERA) and related data sets
to ensure that business requirements can be successfully translated
for appropriate work flow and letter development.
o Defined the structure and validate content of letters to ensure best
compliance practices and Mandates for on-going business need.
o Documented Business Requirements, Functional specifications and
created ensured effective analysis approach before development (We
follow Water flow model at WellPoint).
o Created business requirement document (BRD), functional (FRS)
specification for letters and associated changes to be updated onto
other systems (Well PATH, LGM or BG Processes).
o Effective escalation practices and communication techniques were
followed in addressing requirement conflicts via Change requirements
by sizing their effort and need.
o Involved in creating Impact estimates for Small Scale Change requests
(SSCR) in working closely with senior business and compliance team.
o Facilitated JAD/ Focused group sessions with business users and other
SME's to refine functional requirements.
o Performed Ad hoc business reporting for Enterprise compliance, URAC
and MEDD Audits.
o Extensive knowledge on lines of business and drug maintenance in
cohesion with PA sheet maintenance team for drug administration
practices.
o Conducted iterations in requirements design and communicated results
and milestone achievements to the stake owners while keeping the IT
closely updated on all documented refinements.
o Conducted walkthroughs with the end users and stakeholders to gather
the modification requests from the user to upgrade or change the
specifications for letters.
o Actively involved in Production Validation and feature testing on
behalf of business during implementations.
o Validated Test Plans, test cases, and test input data for test
procedures to ensure Quality of test artifacts being delivered to
address issues during UAT.
o Diplomatic in addressing conflict of interests to reach a solution.
o Highly motivated Team player and values business ethics.
Environment: MS Visio, Oracle, DB2, MS Access, Business objects, LGM, Well
PATH, Clear Quest, MS Project, XML, MS Excel, MS outlook, Power
Point Presentation.
Client: Department Of Health, PA
Jul '08 - Sept'08
Role: Business Analyst (Contractor)
Department of health is one of the Important functional body of Common
wealth of Pennsylvania State Services. The Department of health controls
the various IT administration tasks associated with the Bureau of Emergency
services which contains over 50,000 medical practitioners throughout the
state providing a variety of medical services.
EMSREG System Design
The existing architecture had the records of diversified practitioners
which come into the system through various different resources such as
manual entry, scanned forms and LCD data. A new web application was
developed to translate existing manual methods in to online resources that
can facilitate business users. The project involved migration of data from
3 different resources, creating new SQL database models, and multiple
validations of the data at screen level, database level and screen level.
The new model re-engineered the existing model for record maintenance.
Responsibilities
o Interviewed Stake-Holders, key Business/Super users and Subject
Matter Experts (SME's) to conceptualize business objectives, new
process flow methodology and address challenges.
o Analyzed source systems (CWOPA - HS) and related data sets to ensure
that business requirements can be successfully translated for Data
design, development and QC.
o Defined the Business Process Model by creating UML & ER Diagrams.
o Documented Business Requirements, Functional Requirements and created
Requirement Traceability Matrix (RTM) as a roadmap to the To-Be
system.
o Created business requirement document (BRD), functional (FRS)
specification for application development.
o Facilitated JAD sessions with business users and other SME's have to
refine functional requirements.
o Adopted agile model for efficient development during unit test and
regression test.
o Conducted iterations and communicated results and milestone
achievements to the stake owners while keeping the IT closely updated
on all documented refinements.
o Designed Application module (Logic) to handle Service claims and
billing purchases for Practitioners for the CWOPA.
o Conducted walkthroughs with the end users and stakeholders to gather
the modification requests from the user to upgrade or change the
specifications for the product.
o Analyzed the Functional/Business requirements and validated Test
Plans, test cases, and test input data for test procedures.
o Created Project Plans, Conducted Weekly Design reviews, Status
reporting and participated in system and Regression testing.
o Efficient Client management, Requirement management skills to meet
deadlines and skilled in addressing process issues.
o Highly motivated Team player
Environment: MS Visio, Oracle 10g, Requisite PRO, Clear Quest, MS
Project, MS visual studio 1.1, MS Excel, MS outlook, Power Point
Presentation.
Client: UNICARE, Texas health insurance system
March '08 - Jun '08
Role: Business System Analyst (Contractor)
They offer health plans that are unavailable elsewhere, with unlimited
prescription drug coverage, hospital cost coverage, low out of pocket
premiums and worldwide coverage, all without the complexity of most other
health plans. The package designed as to support various health Insurances
(HMOS and PPOS, Medicare, Medicaid, Medical, Medigap) to process claims
without any hassle and effective tool for the end users for renewal and
status on their application and to provide WEBMD health online source for
well being.
Unicare Health benefits sale forecast/Reporting
In addition the tools were designed to create timely reports for the
management for strategic planning and to implement decisions for changes in
the existing system. To create timely reports on the client or patients
transactions with any health care providers made available online, to
improve data quality and as well as increase the audit ability of the
entire system, to span the chain of healthcare decision-making and ensure
that the right people have the right information in real time.
Responsibilities:
o Interviewed Stake-Owners/ key Business/Super users and Subject Matter
Experts (SME's) to understand business need/ Objective and address
challenging issues.
o Analyzed source systems and related data sets to ensure that business
requirements can be successfully translated for development and QC.
o Documented Business Requirements, Functional Requirements and created
Requirement Traceability Matrix (RTM) as a roadmap to the To-Be
system.
o Closely validated Logical Data Model to conform entities, check
dependencies and consistency to ensure that the database and
application built around the LDM would support Functional
Requirements, Metrics, performed Business Reporting which addressed
process and business forecasts
o Studied and assessed the clients/Group/Member systems and streamlined
business processes.(HIPAA and SOX Mandates)
o Performed analysis on the billing and insurance claims for various
plans promoted and enhanced precise reporting for the same
o Overviewed the Acceptance/Unit testing scenarios and liaised with the
clients and involved vendor groups.
o Developed Project Status Metrics for weekly evaluation of
Service/repair Status and analyzed the impact of deliverables and
Changes on the Project Plan
o Liaised the Seibel reporting team in development areas and organized
appropriate structure to facilitate reports development with
Dimensions, Hierarchies, Measures, Aggregation and Time Series
o Developed User guides and Manuals for business user group for
effective user training and knowledge transition.
Environment: MS Visio, Siebel Analytics7.8, Oracle 9i, .Net frame work
3.0, Clear quest, Load runner, MS Project, MS Excel, MS outlook, Power
Point Presentation.
Final semester Project (Paid Internship/ Interim work opportunity)
Jan'06 - Jul'06
Client: KC Precision, India
Role: Paid Intern Associate
Worked with KC Precision group of companies for developing computerized
calibrators to provide precision manufacturing/ quality test equipment. The
Project involved Instrumentation physics and IT back ground to develop an
automated application which shall understand controls run by a PCB
controlled by a User interface developed on VB.
Responsibilities:
o Interviewed key faculty to understand the system model and expected
behavior to identify key performance features and precision of the
output.
o The UI design was developed on an iterative approach to optimize the
system interface for back end automation.
o Maintained a high level requirement/scope document and traced defects/
enhancements via the RTM.
o Weekly reporting on Project status and presentations.
o Hands on Development and testing
o Created manuals for the end application
Environment: VB 5.0, SQL database, Windows OS, MS office suite and applied
electro- Mechanical Instruments.
"There really is no success or failure. JUST DO IT"
Email: ****************.********@*****.***
Phone: 001-408-***-****
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