Project Manager Quality Assurance

S SINGH

Business Analyst

SKILLS SUMMARY

Skilled professional with proven track record of over 6 years as a Business Analyst.

Proficiency with Rational Enterprise Suite (RequisitePro, Rational Rose, ClearCase, ClearQuest) in support of

the RUP methodology.

Solid Experience in documentation of User Requirements, as well as organizing interviews, User meetings,

workshops, JAD sessions and requirement elicitation sessions

Possess strong knowledge of healthcare terminology and extensive experience working on healthcare projects.

Specialized experience in healthcare insurance domain. Profound understanding of insurance policies like HMO

and PPO and proven experience with HIPPA 4010 EDI transaction codes such as 270/271(inquire/response

health care benefits),276/277(Claim status), 834(Benefit enrollment), 835(Payment/remittance advice),837(Health

care claim) and 470 benefit codes

Working knowledge of Cognos, COBOL, Sybase ECMap, and X12 EDI Standards

Good knowledge of SOX, EDI/HIPAA and Facets 4.51

Technical experience extracting Medicaid data directly from the database for analytical and/or reporting needs.

Experience with healthcare billing, collection and patient financial information and management applications.

Experience in developing scope/vision documentation and project plan, tracking project progress, and managing

resources to ensure successful project delivery

Experience with identifying business and technical impacts in production & non-production systems as would be

caused by the transition from ICD-9 to ICD-10.

Experienced in testing applications developed using PL/SQL, Java, J2EE, HTML, XML, ASP, Visual basic and

C/C++.

Knowledge of relational data models, data modeling, database programming, and SQL

An accomplished liaison between management and development team for requirements and QA. Conducted

walkthroughs with stakeholders and end-users.

Designed and documented Operators Guides Minutes of the meeting, Flow charts, Installation Guides- Standard

operating procedures, Training Manuals and Management Presentations.

Involved in backend testing of reports generated using Crystal reports from ODS (DB2) and FACET database

(Sybase).

Good knowledge of Business Process Modeling and Business Re-Engineering

Experienced in conducting training sessions for users

Experienced in conducting GAP analysis, User Acceptance Testing (UAT), SWOT analysis, Cost benefit

analysis and ROI analysis

Experienced in testing applications developed using PL/SQL, Java, J2EE, HTML, XML, ASP, Visual basic and

C/C++.

Experienced in writing test queries/scripts for data analysis and QA report testing

Experienced in conducting Joint Application Development (JAD) sessions for requirements gathering, analysis,

design and Rapid Application Development (RAD)

Experienced in Business Analysis, Object Oriented Analysis, Data Analysis, Requirement Analysis, Business

Modeling and Use Case development using UML methodology

Expertise in developing QA Test Plan, Test Conditions, and Test Cases; ensuring adequate testing of software both

before and after completion; conducting and documenting UAT.

Expertise in the management of User Request Change, and handle User Conflicts

Ability to organize, document and track changes and defects by Traceability Matrix, using Rational Requisite

Pro, Clear Quest, Clear Case

EDUCATION

Business Administration, Bachelor of Science

Management Information System

North Dakota State University

SOFTWARE SKILL SETS

Database : Oracle 9i, MS SQL Server

Operating Systems : Windows 95/98/00/XP and NT

Languages : SQL, Informatica

Web Technologies : Microsoft Frontpage,

Multimedia : Adobe InDesign, RoboHelp, FrameMaker, SnagIt, Epic Editor

Change Management Tools : Rational Clear Quest, Test Director, PVCS

Methodologies : RUP, CMM, UML

Testing Tools : Mercury Test Director

Version Control Tools : PVCS, Rational Clear Case

Project Management Tools : Microsoft Office (Microsoft Word, Microsoft PowerPoint, Microsoft Excel), Microsoft

P Project, MS Visio, Microsoft Publisher

PROFESSIONAL EXPERIENCE

United Health Group (Hartford, CT) Apr 2008- Present

Business System Analyst

For more than 10 years United Health Group has ranked among the most admired health care companies in America in the

annual survey by Fortune magazine. Since its inception, United Health Group and its affiliated companies have led the

marketplace by introducing key innovations that make health care services more accessible and affordable for customers,

improve the quality and coordination of health care services, and help individuals and their physicians make more informed

health care decisions. My part is to work on a claims processing system and carefully analyze the requirement, created and

participate in risk session and drive the requirement to the product release. It was a new healthcare product to the small

business. Enrollment, decision tool and Administration are three kinds of online portal, validated for data integrity as well

as data integration. I was involved in data integrity as well as data integration analysis. Performed User Acceptance testing

to make sure the final expected reports is in the required format.

Responsibilities:

Conducted user interviews, gathered requirements, and analyzed the requirements for the new health insurance

product.

Evaluate and planned to collect and report clinical performance using CRS tool.

Data management and metadata reporting done using Informatica ETL tool

Gathered requirements to include Dental Insurance into the new product for small business.

Created and revised Business Requirement document (BRD) and Functional requirement Document (FRD) using

the Scope and Interview with stakeholders.

Worked on Claims, Customer services, Members, Enrolment, Billing interfaces and extensions for FACETS as

a part of FACETS 4. 51 implementation team.

Developed data modeling, mapping and business process flow diagram.

Extensive HIPAA EDI transactions knowledge - 835, 837, 277, 278, 270, 271, etc current 4010 and

new 5010 formats.

Data mapping experience from X12 to canonical business object

Researched the existing client processes and guided the Vendors in aligning the HIPAA 4010 compliance output

with the client systems.

Assisted in integrating Facets FXI web services components into the claims workflow process

Assisted project manager in the implementation of ITS, and facilitated and participated in the ITS Host detail

design discussions to address business requirements

Worked with different functional groups to arrive at the common business and technical specifications.

Worked as the primary liaison between the business user and the developers throughout the project cycle

Works closely with internal auditors, public accountants, federal tax examiners and others as required in

performing assigned investment accounting functions.

Used SharePoint to store document and version control.

Lead as well participated in JAD sessions and interacted with various functional leads and analysts.

Responsible for preparing Software Requirement Specifications (SRS), Functional Specification Document (FSD)

and final Design Document as per SEI CMM standards.

Created and managed project templates, Use Case project templates, requirement types and trace-ability

relationships in RequisitePro.

Well versed with Claim processing from point

Participated in risk sessions to address the risks and addressed of entry to finalizing, claim review, identifying

claims processing problems, their source and providing alternative solutions project impacts to bring to light the

possible workaround.

Conducted workflow analysis to bring out the identified gaps and documented it.

Traced Requirements using Requirement Traceability Matrix.

Assisted in database design, development and enhancement with MS SQL Server DBMS

Used SQL statements for Back-end testing

Performed User Acceptance Testing, developed Test logs and opened/closed as and when the issue is fixed and

Quality checked with the assumed company data with all the possible Test Scenarios.

Trained Implementation managers to work on the new application.

Environment: J2EE, SQL, XML, SharePoint 2003, MS Visio, MS Office, MS Project, Filenet.

Cardinal Health, Inc. (Dublin, Ohio) Aug 2006- Feb 2008

Business Analyst

Responsibilities:

Performed stakeholder analysis to identify key players for project success

Identified and involved all key stakeholders, contributors, business, operations and technical resources that must

participate in a project and ensured that contributors are motivated to complete assigned tasks within the

parameters of the project plan

Involved extensively in testing of the application both manually as well as using the required tools

Involved in creating the business case and project plan

Created product documentation, including online help, printed user manual, and training materials

Participated in the design of the 276/277 Claims Status transaction, create EDI map(s), and added some project

leadership thru-out the project by working closely with other Business Analysts and Project Manager.

Used FrameMaker to document material in both print and online formats

Assisted in designing policies and procedures to protect the privacy of Electronic Protected Health Information

(ePHI) to ensure data integrity as per HIPAA

Analyzed existing processes, Extracted XML/COBOL files, for successful FACETS implementation and

integration with other proprietary tools/application.

Worked with developers in maintaining system configuration to ensure that claims process in accordance with

Medicare, Medicaid and Local policy

Designed and delivered HIPAA training material regarding information security and best practices

Supervised the work of junior technical writers and worked in collaboration with them

Reviewed and edited the TO BE documents

Developed Test Cases, test plans and strategies with Quality Assurance group to implement them. Efficiently

responded to client inquiries and resolved discrepancies. Identified, prioritized, tested and proved essential

business functions to assure compliance with vendor and internal auditing.

Wrote test cases/test scripts to execute functionality of the system

Performed black box, regression, performance, and UAT testing

Scheduled meetings with developers, systems analyst and testers to collaborate resource allocation and project

completion using MS Project

Experience with Microsoft SQL Server database writing stored procedures

Conducted interviews with client to ensure developed functionality complied with user requirements

Played an active role in making sure that at every point of the project the PM team and users were in compliance

with HIPAA’s privacy and security rules

Wrote application help files, user’s guide, and reference manuals as needed by the clients.

Facilitated JAD sessions for communicating and managing expectations with Cardinal Health

Played an active and lead role in gathering, analyzing, and writing business requirements.

Collected and documented business processes as well as business rules.

Provided key input in working with users in defining project and system requirements.

Translated the business needs into system requirements and communicated with the business on a non-

technical level

Assisted in building a business analysis process model using Visio.

Documented the Functional Specifications Document using UML.

Created use cases using UML and managed the entire functional requirements life cycle using Rational Unified

Process, Requisite Pro

Experience using SQL queries to test the Backend applications and database

Created and managed project templates, use case project templates, requirement types and traceability

relationships in Requisite Pro

Responsible for creating business flow diagrams using MS-Visio

Used test director for defect management and defect rectification

Experience with User Acceptance Testing (UAT), System testing

Collaborated with Quality Assurance Analyst in Rational Clear Quest to track defects and used Rational Clear

Case to maintain consistency in the builds.

Environment: Rational Rose, Rational Requisite Pro, MS Office, Rational Clear Case, Rational Clear Quest, J2EE,

HTML, Microsoft SQL Server, Test Director,

Anthem Inc. (Indianapolis, IN) Mar 2004-Jul 2006

Business Analyst

Responsibilities

Analyzed system specifications and business requirements

Involved in creating detailed Test Plan development

Planned, coordinated, and monitored project levels for performance and activities to ensure project completion

Created user requirements document for company wide reports by communicating with end users and developers

Managed a multilevel responsibility matrix providing senior leaders with a thoroughly operative report

management and problem-solving platform for the creation of crucial financial reports.

Involved in gathering business requirements from the end users and management

Worked directly with developers, Project Manager and Business contacts to produce Test Scripts and Test

Conditions

Followed established formats and procedures, created new formats, as well as researched, created, edited technical

and business data documents

Reviewed test cases written by team and made modification for better execution of test cases.

Responsible for providing primary leadership in designing, leading, and directing all aspects of UAT Testing

Reviewed success of functional, regression and end-to-end testing done by the team.

Prepared DFDs, data modeling and extensive use of PL/SQL procedures and SQL queries for interacting with the

Oracle database.

Assisted in the training effort for educating the end users with the new system and how it affects the report format

and structured

Utilized Microsoft Project and Visio

Responsible for setting up weekly meeting and walkthroughs for project updates and to detect bottlenecks and

devise a plan to handling the bottlenecks.

Assigned groups with weekly/monthly tasks needed to ensure completion of project.

Performed Gap analysis by identifying existing technologies, documenting the enhancements to meet the end state

requirements

Interacted with development team to ensure efficient database operations and provided value that assures effective

use of SQLServer Databases.

Assisted with user testing of systems (User Acceptance Testing, UAT), developing and maintaining quality

procedures, and ensuring that appropriate documentation is in place

Worked with development and testing teams to accomplish timely release objectives

Provided superior client interaction to ensure all needs are met

Environment: Rational Rose, Test Director, RUP, UML, Oracle 9i, MS Office, MS-Project, MS Visio, Windows 2003

server, UNIX, VBScript, Crystal Reports.

United Insurance, (India) May 2002- Feb 2004

Business Analyst

United India Insurance is one of the largest Insurance Companies in its class with approximately 4000 contractor agents.

The requirement was to integrate and upgrade the claims processing system and various disparate systems on a common

environment to enhance CRM by providing real time monitoring and services for their Life Insurance division. The

project covered the integrating of all the disparate systems into one synchronized system, providing remote access through

a web interface and maintaining the infrastructure required for these systems.

Responsibilities:

Studied and assessed the clients systems and business processes. Developed project plans and managed scope

Established a business Analysis methodology around the Rational Unified Process.

Assisted in building a business analysis process model using Rational Rose and Visio.

Conducted JAD sessions for communicating with Stakeholders and Project directors.

Linked business processes to organizational objectives, perform critical path analysis, and identify opportunities

for business process improvement

Communicated extensively with the clients and with different levels of management to identify requirements, use

cases and to develop functional specifications.

Created Use-Cases and Business Use-Case Model after accessing the status and scope of the project and

understanding the business processes

Integrated RequisitePro with ClearQuest and Rose to provide all teams visibility and maintain tractability among

requirements, use cases and change requests

Managed all the requirements in RequisitePro, making requirements available to all team members.

Used the Unified Change Management from Rational to track changes to multiple artifacts by versioning

artifacts, associating requirements to specific change request/defects to streamline the defect/change tracking

process.

Used SQL Plus and Toad to create, query and verify test data for backend testing.

Assured that all Artifacts are in compliance with corporate SDLC Policies and guidelines.

Coordinated and prioritized outstanding defects and enhancement/system requests based on business requirements,

allowing sufficient time frame to ensure accuracy and consider deadlines

Monitored client expectations and conducted user interviews.

Performed requirement analysis, went through all the use cases and workflows.

Modeling the As - Is system and doing the complete Gap Analysis for the existing system in order to map it to the

To-Be system.

Addressed all aspects of the claim processing lifecycle, starting from identifying a claim right up to closure.

Researched the various steps in the lifecycle and then constructed the system in such a way that the riskier claims

could be easily identified and monitored.

Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOD using UML

Experience using SQL queries to test the Backend applications and database

Played a key role in the planning, User Accepted Testing (UAT), and implementation of system enhancements

and conversions

Provided key input in working with users in defining project and system requirements.

Functioned as the primary liaison between the business line, operations, and the technical areas throughout the

project cycle.

Used Date warehousing for the arrangement of customer data.

Implemented Traceability Matrix and User Requirement Specification Document (URS) verified the

functionality coverage.

Environment: SQL, Rational Requisite Pro, Rational Rose, UML, SQL, MS-Office, MS Project, MS Visio, Test Director.

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