Project Data
Resume:
Ramya
*****.****@*****.***
SUMMARY:
. Over 7+ years of experience as a Business Analyst and Systems Analyst
in Healthcare Industry concentrating on Health Insurance and Hospital
System Management.
. SixSigma White and Yellow belt holder.
. Excellent working knowledge of HIPAA Compliance Life Cycle, HIPAA
Insurance Regulations and Claims Processing.
. Immense knowledge in EDI Transaction sets including 270, 271, 276,
277, 278, 834, 835, 837(P, I, D).
. Worked in ICD-9 to ICD-10 transition and EDI ANSI 4010 to 5010
transition.
. Experience in creating Business Requirement Documents (BRD), Use
Cases, Business Systems Designs (BSD), Project Plans, Requirements
Traceability Matrix (RTM), conducting GAP Analysis, SWOT analysis,
Cost benefit analysis, Risk Analysis, modeling Businesses Processes,
and preparing Training manuals and Knowledge Transfer manuals.
. Excellent Business writing skills in writing Business Requirements
Document (BRD), Use Case Specifications, Functional Specifications,
Systems Design Specification (SDS), Systems Requirements Specification
(SRS), Data Dictionary, Workflows.
. Adept at creating and transforming business requirements into
functional requirements and designing business models using UML
diagrams - Context, Use Case, Sequence, Activity diagrams in MS Visio
and Rational Rose
. In-depth knowledge of complete software development life cycle (SDLC)
and various Software Methodologies such as Rational Unified Process
(RUP), Agile and Waterfall Methodology; Gap analysis; Risk
Engineering; Data Modeling and Mapping /process mapping
. Strong aptitude for analyzing, excellent communication, good project
documentation skills, adaptability to time bound projects, managing
multiple projects simultaneously, a good team player and quick
learner.
. Expert level skills in MS Office products like MS Word, MS Excel, MS
PowerPoint, and MS Visio.
. .
TECHNICAL SKILLS:
Programming Languages : C,C++,C#,VC++,VB,VB.NET,C#.NET,
ASP.NET, Java, SQL, PLSQ
Development Methodologies : RUP, AGILE, Waterfall, ESDM, STV
Databases : MS-Access, MySQL, SQL Server, Oracle, Teradata, DB2,
Sybase
Application Servers : IBM Websphere, ATG Dynamo, BEA
WebLogic.
Internet : HTML, XML, VBScript, ASP, JavaScript, JSP, J2EE.
Automation Tools : MS Visio, Rational Rose, Rational ClearCase, Rational
RequisitePro, Documentum
Bug Tracking Tools : Mercury TestDirector, Rational ClearQuest
Utility Tools : MS Office Suite, MS Project, TOAD, Adobe Photoshop
Reporting Tools : Crystal Reports, SQL Server Reports (SSRS)
Data warehousing Tools : Informatica, Business Objects, Cognos, Erwin
Testing Tools : Quick TestPro (QTP), TestDirector, WinRunner,
LoadRunner,
Niku Project WorkBench
Experience:
Verizon Business, Boston MA
Mar 12 - jan 13
Sr. Business Analyst
Verizon business is the owner of VZT VZW and affiliates of Verizon. The SMP
program is to develop and delivery ITIL compliant CMDB, Service Catalog,
Ordering and Billing capabilities. Responsible for development of
architectural, functional and detailed design through thorough
understanding and analysis of business requirements.
Responsibilities:
. Drive the completion and complete alignment of system design from
business requirements and architectural design.
. Track, drive and coordinate program development activities, per
requirements and design, with Business owners, IT PMO, and IT
Development teams across US and EMEA.
. Document and analyze business requirements, functional requirements,
system capabilities, and detailed design.
. Ensure consistent and effective communication among all parties.
. Proactively identify and resolve issues by working with all portfolio
teams.
. Create and publish periodic executive reports.
HealthMarkets, Irvine, TX
Jan 11 - Feb 12
Sr. Business Analyst
The HealthMarkets group of Insurance Companies is one of America's leading
providers of affordable health insurance for the self-employed, individuals
and families, as well as small businesses. It's underwriting companies -
The MEGA Life and Health Insurance Company, Mid-West National Life
Insurance Company of Tennessee and The Chesapeake Life Insurance Company,
They Provide business support for benefit accumulator and Claims processing
system NASCO. The purpose of BARS (Benefit Accumulator and Remediation
Support) has been to improve usability constraints from the members and
providers accessing their associated portals.
Responsibilities:
. Gathered and documented business requirements for existing and future
business systems.
. Acted as a liaison between business staff and technical staff to
articulate needs, issues and concerns.
. Lead multiple project teams of technical professionals through all
phases of the SDLC using technologies including Oracle, Erwin, Data
Stage, Data Warehousing, Websphere and Cognos.
. Performed extensive data modelling to differentiate between the OLTP
and Data Warehouse data models
. Defined Functional Test Cases, documented, Executed test script in
Facets system.
. Identified/documented data sources and transformation rules required
populating and maintaining data warehouse content.
. Performed Front end and Back end System Integration Testing
. Analyzed trading partner specifications and created EDI mapping
guidelines.
. Healthcare system implementation including enterprise Electronic
Medical Records (EMR) software.
. Created Data Stage jobs to extract, transform and load data into data
warehouses from various sources like relational databases, application
systems, temp tables, flat files etc.
. Designed and developed use cases, activity diagrams, and sequence
diagrams using UML.
. Used the DataStage Designer to develop processes for extracting,
cleansing, transforms, integrating and loading data into data
warehouse database.
. Troubleshooted file transmission problems and assisted customers in a
call center environment with EDI and Medicaid Insurance claim related
inquiries explained and enforced guidelines in the X12 Implementation
guides (837P, 837I, 837D, 270/271).
. Converted various SQL statements into stored procedures thereby
reducing the Number of database accesses.
. Created surrogate key tables to map the required dimensions.
. Data transfers from text files and Access databases using BCP and DTS;
Data mapping and transformations while loading data using VBScript
. Created hash tables used for referential integrity and/or otherwise
while transforming the data representing valid information.
. Developed estimates, project plans (Microsoft project), training
material, BI reports using Microstrategy
. Used Query Analyzer, Execution Plan to optimize SQL Queries
. Ensured that all Lines of Business specifications were consistent in
form and function to the Diamond Base System.
. Ensured that project requirements are properly tracked and documented.
. Used MS-Visio for flow-charting, Use- Case process model and
architectural design of the application.
. Assisted in monitoring ancillary data transactions and addressed
problems with HL7 messages.
. 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.
. Captured business requirements for reconciliation reports and designed
metrics in Microstrategy
. Rational ClearCase was used to manage all the changes and change
requests in the projects. Worked with QA team with the aid of
ClearQuest for the bug tracking and Mercury Test Director for Test
Case Management and created Front end and Back end System Integration
Testing test cases .
. Created requirements analysis and design phase artifacts using,
Rational Software Modeler and MS Visio to create DFDs, ER diagrams,
Use Case, Activity/State chart, Sequence, Collaboration and Deployment
Diagrams.
. Employed Rational Clear Quest for effective Change Management
(Requirements Creep) and bug tracking during the testing lifecycle.
. Used Rational Clear case for version control.
. Monitored test scripts developed by QA team to check the integrity of
the test plans.
. Dedicated a good portion of time with the QA team in front-end, back-
end and Regression testing.
. Drafted business Use Cases such that any future changes could be
easily managed.
Environment:
Microsoft Office 2003 Professional (Outlook, Word, Excel, Visio, Access,
etc.), Microsoft SharePoint 2003,UML, RUP, UAT, db2, Peoplesoft GL,Mercury
Test Director, SQL, .NET, Clear Case
Group Health Insurance, Chicago, IL
aug 07 - Dec 10
Sr. Business Analyst
GHI contracted with the Medicare Centers and Medicaid Services (CMS) to
provide quick, easy, and affordable access to the health care service of
their choice. Market Prominence is the only system that provides management
with the ability to tailor each step of the regulatory process based on the
health plan's interactions with each of its beneficiaries. Project involves
integrating Market Prominence and the Claims processing System with the
data warehouse to support the reporting requirements. My duties were
included designing the model of ODS to automate and maintain the ETL
process
Responsibilities:
. Played key role in System Development Life Cycle Process consisting
of: Design and Gap Analysis, Business Requirements, Systems
Requirements, Test
Criteria, and Implementation to have the outputs of project dealt with
the automation of correspondence directed to Insurance policy owners.
. Led the development of a training program to train users on a custom
web application and a Cognos ad-hoc reporting environment.
. Correspondence included solicitation letters, financial transaction
confirmations, and quarterly and annual policy statements.
. Coordinated participation and sign-off of various business partners
and customers.
. Created business requirement documents and integrated the requirements
and underlying platform functionality.
. Used knowledge of Health Care Information Systems EMR model to develop
proposed workflow in MS Visio.
. Designed High level design, for New process, integrating with legacy
and Facets
. Responsible for integrating with Facets .Designing test scripts for
testing of Claims in Development, Integration and production
environment.
. Conduct complex documentation and user needs analysis. Interface with
team and staff to develop HL7 integration.
. Developed HL7 messaging for bi-directional case and disease report
exchange, in text and XML formats, in accordance with HL7
specifications;
. Conducted Functional Walkthroughs, User Acceptance Testing (UAT), and
supervised the development of User Manuals for customers.
. Interfaced between Business new product builders and System platform
builders.
. Worked with systems area to translate business needs into system
requirements.
. Made sure the test cases and test process guarantee accountability to
business and systems requirements.
. Rational ClearCase was used to manage all the changes and change
requests in the projects. Worked with QA team with the aid of
ClearQuest for the bug tracking and Mercury Test Director for Test
Case Management and created Front end and Back end System Integration
Testing test cases .
. Created SAS programs that are used for data validation, statistical
report generation and program validation and automated the Edit Check
programs using Macros.
. Extensively involved in data modeling
. Data mapping, logical data modeling, created class diagrams and ER
diagrams and used SQL queries to filter data within the Oracle
database
. Gathered requirements and modeled the data warehouse and the
underlying transactional database
. Perform Gap Analysis of the processes to identify and validate
requirements.
. Identified/documented data sources and transformation rules required
populating and maintaining data warehouse content.
. Involved in the testing phase right from the Unit testing to the User
Acceptance testing.
. Used SDLC (System Development Life Cycle) methodologies like the RUP
and the waterfall.
. 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.
. Use Cases and other Process Flow Models were designed using Visio and
Rational Rose.
. Involved in jobs and analyzing scope of application, defining
relationship within & between groups of data, Star Schema etc
. Followed the UML based methods using Rational Software Modeler/MS
Visio to create: Use Cases, Activity Diagrams / State Chart Diagrams,
Sequence Diagrams, and Collaboration Diagrams.
. Tuned the batch programs and online transactions to alleviate
performance problems.
. Developed & executed several Optimized queries in SQL on this data.
Environment:
RUP, UAT, GAD (Gap Analysis Document), Microsoft Office 2003 Professional
(Outlook, Word, Excel, Visio, Access), Microsoft SharePoint 2003.
Presbyterian Health Care System, Washington DC
Jan 06 - july07
Sr. Business Analyst
Uniprise Technologies is a part of Presbyterian healthcare System, a
Fortune 500 company and a leading player in the Health Insurance and
services market. UHCI specializes in Network based care co-ordination
health care services for small groups, government and specialized groups
and commercial employers. The system streamlined patient registration,
patient scheduling, medical insurance checking, claims processing, and
reporting. The purpose of this project involves population of the
Enterprise Data Warehouse (EDW) which is used in critical reporting and
analysis. The data is pulled together from multiple, disparate systems. I
was also involved in certain modifications to the claims processing system.
Responsibilities:
. Involved in Inception Phase and prepared vision statement and initial
data models that contain Business Requirement Documents and supporting
a document that contains the essential business elements and detailed
definitions.
. Working with clients to better understand their needs and present
solutions using structured SDLC approach.
. Accurate processing of Medicare claims using the Diamond system
. Gathered user and business requirements through open-ended
discussions, brainstorming sessions and role-playing.
. Troubleshot the designed jobs using the DataStage Debugger.
. Tuned DataStage transformations and jobs to enhance their performance.
. Wrote PL/SQL statement and stored procedures in Oracle for extracting
as well as writing data.
. Used the DataStage Director and its run-time engine to schedule
running the solution, testing and debugging its components, and
monitoring the resulting executable versions on an ad hoc or scheduled
basis.
. Designed DataStage ETL jobs for extracting data from heterogeneous
source systems, transform and finally load into the Data Marts.
. Rational ClearCase was used to manage all the changes and change
requests in the projects. Worked with QA team with the aid of
ClearQuest for the bug tracking and Mercury Test Director for Test
Case Management and created Front end and Back end System Integration
Testing test cases .
. Documented the user requirements Analyzed and prioritized them and
converted them as system requirements that must be included while
developing the software.
. Worked with Cognos and micro strategy reporting systems to extract the
data for analysis using filters based on the analysis.
. Wrote detailed specifications for various reports generated using
Cognos
. Analyzed data and created class diagrams and ER diagrams for designing
databases.
. Performed felid-by-field mapping of interface between parent EMR
system and downstream system.
. Suggested web security using encryption and authentication
technologies for reporting and complaint filing procedures.
. Planned and defined Use Cases created Use Case diagrams, Scenarios and
Use Case Narratives using the UML methodologies.
. Query optimization using SQL Profiler and performance monitors to
enhance the performance of database servers.
. Converted various SQL statements into stored procedures thereby
reducing the Number of database accesses (since Stored Procedures
passes the whole block at one time.)
. Created Activity Diagrams, Sequence Diagrams and ER Diagrams.
. Created Mock-up forms in MS word for better visualization and
understanding of the software solution.
. Identifying and modeling Use case diagrams, Sequence diagrams,
Activity diagrams, Collaboration diagrams using UML.
. Used SDLC (System Development Life Cycle) methodologies like the RUP
and the waterfall.
. Tracked change requests and monitored workload and schedule.
. Facilitated JAD sessions with management, development team, users and
other stakeholders to refine functional requirements.
. Scheduled meetings with developers, System Analysts and testers to
collaborate resource allocation and project completion.
. Created and managed project templates, use case templates, requirement
types and tractability matrix in Requisite Pro.
. Managed workload, schedules and coordinated status review meetings
with project managers, business managers and team members.
. Authored progress and completion reports which were then submitted to
project management on a weekly basis in MS project.
. Identified various frequently used modules with in the application as
well as the peak user volume for load testing purposes.
. Analyzed the test results from QA teams using Performance Studio
Analysis to create various scenarios.
. Developed strategies with Quality Assurance group to implement Test
Cases in Test manager for User Acceptance Testing.
. Collaborated with Quality Assurance Analyst in Automated and Manual
Black box testing.
. Helped in creating end user manuals and procedure manuals.
Environment:
Java, J2EE technology, Windows 2000 Advanced Server, Liberty,UNIX / Oracle
Platform, MS Visio, RUP, UAT, Rational Rose 2002, Rational Clear Quest,
Rational ClearCase, Rational requisite pro, rational test manager, Rational
Robot.
Nationwide Insurance, Columbus, OH
Aug 6- jan6
Sr. Business Analyst
Nationwide is one of the largest insurance and financial services companies
in the world, focusing on domestic property and casualty insurance, life
insurance and retirement savings, asset management, and strategic
investments. Nationwide currently has about 35,000 employees, and is ranked
#98 in the most recent Fortune 100. The Data Warehouse was developed to
integrate nationwide operational systems into one central database
structure. Informational queries can be obtained from the Data Warehouse
that identifies customer behavior patterns. This customer data helps
Nationwide to better understand and respond to customer's needs.
Responsibilities:
. Interviewed Business Users to gather Requirements and analyzed the
feasibility of their needs by coordinating with the project manager
and technical lead.
. Collects requirements from department managers and users for
enhancements. Acts as liason between clients and development.
Facilitates sessions to bring business requirements and functionality
into SAP system development and enhancement.
. Prepared Business Requirement Documents (BRD's) after the collection
of Functional Requirements from System Users that provided appropriate
scope of work for technical team to develop prototype and overall
system.
. Used IBM WebSphere Business Modeler to fully visualize, comprehend,
and document the business processes. To model and optimize the
business-critical processes. Define and refine process models through
the company's best practices.
. Interacted with users for verifying User Requirements, managing Change
Control Process, updating existing Documentation
. Created reports from SAP modules using Business Objects / Crystal
Reports based upon business requirements.
. Developed straightforward DBMS queries, knowledge of HL7 and xml
interface messaging.
. Identified/documented data sources and transformation rules required
to populate and maintain data warehouse content.
. Was responsible for indexing of the tables in that data warehouse.
. Reverse Engineered the existing ODS in to Erwin.
. Develop Logical and Physical data models that capture current
state/future state data elements and data flows using Erwin.
. Involved in data migration design so that the data can be exchanged
from other systems in standard ACORD XMLife standards.
. Created job schedules to automate the ETL process.
. Worked on data modeling and produced data mapping and data definition
documentation
. Configured the Data mapping between Oracle and SQL Server 2005.
. Tested Performance & Accuracy related queries under SQL Server
. Designed and implemented basic SQL queries for testing and report/data
validation
. Created relationships in Requirement Traceability Matrix linking
Business Requirements to Functional requirements and Functional
Requirements to Systems Requirements.
. Conducted Joint Application Development (JAD) sessions with IT groups.
Identified the Key Changes, and participated in Stakeholder Management
to communicate effectively with them
. Developed and Documented timelines for Project Delivery, and managed
Projects and Resources to successful completion.
. Used Data warehousing for Data Profiling to examine the data available
in an existing database.
. Prepared graphical depictions of Use Cases, Use Case Diagrams, State
Diagrams, Activity Diagrams, Sequence Diagrams, Component Based
Diagrams, and Collateral Diagrams and creation of technical design (UI
screen) using Microsoft Visio.
. Worked on Documentum for Version Controlling, to maintain up to date
changes in the Documents.
. Assisted to develop the Test Plan, Test Cases and Test Scenarios to be
used in testing based on Business Requirements, technical
specifications and/or product knowledge.
. Conducted User Acceptance Testing, gathered and documented User
Manuals and Business Rules
Environment: Microsoft Office Suite, Microsoft Visio, Documentum, Windows
NT/XP, Oracle, SQL, SQL Server, Sybase, EVPN, IBM Websphere Business
Process Modeller, ACORD, XML,Business Objects, TestDirector, LoadRunner,
Medical Mutual of Ohio
Jun 05 - Aug 06
Sr. Business Analyst
Medical Mutual of Ohio, is a Health Insurance Provider established in 1934,
serves over 1.5 million members, and has 2,500 employees that live and work
in Ohio. The system make it simple for customers, brokers, consumers and
physicians, And make it easier to understand and navigate the complex
health care system- while helping to manage the effects of rising health
care costs. Medical Mutual offers plans like SuperMed One (for ages 6 weeks
to 64 years). It contains five comprehensive plans including health savings
accounts (HSA), dental, vision, life, Medicare Supplement insurance plans,
short-term and permanent health insurance plans. The National Committee for
Quality Assurance (NCQA) awarded the company the Quality Plus Distinction
in Member Connections. Data about insurance requests and Claims would be
collected from users and processing would be done to calculate premium and
claim amounts.
Responsibilities:
. Served as a liaison between mortgage specialists and the project team.
. Responsible for gathering user requirements and specifications for
designing a mortgage based loan system using and documenting the same.
. Extensively involved in maintaining requirements traceability and
communicating any changes to these requirements to different business
groups and programmers.
. Worked on HL7 and xml interface messaging.
. Led and conducted JAD sessions for requirements gathering, analysis
and design of the system.
. Designed DataStage ETL jobs for extracting data from heterogeneous
source systems, transform and finally load into the Data Marts.
. Created context and workflow models, information and business rule
models, Use Case and Object Models during the analysis using Rational
tools.
. Provide implementation assessment, strategy, and mentoring services
for Rational Rose, UML and RUP.
. Designed the system, prepared UML and sequence diagrams using Rational
Rose.
. Responsible for writing detailed descriptions of user needs, program
functions, and steps required for developing or modifying software
programs using Rational Rose (UML).
. Prepared Functional Specification Documentation (FSD) and communicated
these to the stakeholders.
. Actively interacted with different business groups to perform Gap
analysis to identify the deficiencies in the system by comparing the
actual objectives with the system objectives desired.
. Conducted Business Requirements, Functional and Technical meetings
with Business groups.
. Used MS Visio for Process modelling and Business Process flow
diagrams.
. Extensively involved in regression testing during various phases of
the application.
. Used Aggregator stages to sum the key performance indicators used in
decision support systems.
. Troubleshot the designed jobs using the DataStage Debugger.
. Tuned DataStage transformations and jobs to enhance their performance.
. Wrote PL/SQL statement and stored procedures in Oracle for extracting
as well as writing data.
Environment:
Rational Enterprise Suite (Rose, RequisitePro, ClearCase, ClearQuest) UAT,
RUP, WinRunner, LoadRunner, MSOffice2000
Education: Bachelor of Technology,JNTU, Hyderabad, India.
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