Project Health Insurance

Rama Raghavendran

**** ******** ***** *** # *** Corona, California - 92879

Email: ****.****@*****.*** Phone: 615-***-****

Professional Summary

Analytical, enthusiastic and innovative Business Analyst with over 8 years of Information

Technology experience in business analysis, defining business processes and system

solutions for Insurance/Health Care Applications.

Comprehensive knowledge of Software Development Life Cycle (SDLC), having thorough

understanding of various phases like Requirements, Analysis/Design, Development and

Testing.

Extensive experience in gathering, managing and documenting business and functional

requirements, communicating effectively with upper management, developers and QA

engineers.

Adept at creating and transforming business requirements into functional requirements

and designing business models using Use Case, MS Visio.

W ell versed in different management scenarios like Change Control, Quality Assurance,

Defect Tracking and System Integration

Excellent facilitation skills in conducting walkthroughs, questionnaires, interviews,

brainstorming and JAD sessions.

Exceptional problem solving and sound decision making capabilities coupled with

excellent communication and interpersonal skills. Excellent track record for meeting

deadlines and submitting deliverables on time.

Have exposure in educating internal customers on business systems and procedures and

working with other analysts and QA team to set priorities and schedules.

Successfully completed IT Architecture & Integration study for a Life Insurance Company

Successfully lead the Implementation team in the automation of Health Insurance System

for a General Insurance Company.

Gained extensive skills in the area of Security identity Management.

Successfully Completed Certified Public Accountant (CPA) exams in November 2008.

Skills

Microsoft Visio, Excel, Word and PowerPoint

SQL Queries

LDAP Queries(using Apache Directory Studio)

SDLC methodologies and Project Management

Extensive knowledge in developing Use Cases and Process flow Diagrams.

Education

AICPA, Certified Public Accountant (CPA), USA

Institute of Chartered Accountants of India, Chartered Accountant (CA), India

University of Madras, Bachelors in Physics, India

Professional Experience

June 2012 – Present: Business Analyst

Project Name: Identity Management(IdM) Provisioning Project

Client: Community Health Systems (Nashville, TN, USA)

Project Description

Identity Management (IdM) Provisioning Project involves centralization of control over users’ rights

and relationships within Community Health System’s network. This project involves:

User provisioning - create, modify, and remove access;

User authentication - user network validation through user name and password;

User authorization - Provide user-permissions to applications, files and functionalities.

Contribution

As a Business Analyst, was responsible for

Understanding the underlying constructs associated with each application (Clinical and

Financial systems) access control rules and creating Application Assessment Documents.

Create Requirement specifications document and Roles based matrix document for Roles

Based Access Control to enable driver development for each application

Used MS Visio to construct user creation/ user provisioning process flow diagrams

Prepare Requirement Traceability Matrix, test plan and test cases document

Perform business owner testing using Novell Validator (Novell Validator is a testing tool).

Document test results and obtain end user validation document sign off.

Run LDAP Queries on Apache Directory Studio to retrieve user data for data analysis.

Create requirement specifications and define data elements for key performance metrics.

Currently working on setting up the Identity Management solution for Cerner Millennium

Application at CHS.

M ay 2011 – M ay 2012 : Business Analyst

Project Name: Ameristudy.com

Client: Datasys Consulting & Software Inc. (Worked Remotely)

Project Description

Ameristudy.com is an educational product designed to focus on building robust Web solutions to

meet the diverse needs of educational organizations and professionals. It is designed to provide

teachers with the most up-to-date resources and information and makes it easy for them to

integrate the World Wide Web into the classroom.

Contribution

As a Business Analyst, was responsible for

Understanding client’s (internal and external) overall business and technical solution

needs and translate them into documented business requirements, then into functional

requirements using multiple, required methods of documentation - process flows, use

cases, business requirements, functional requirements, mapping documents, etc.

Translate business conversations into technology needs and vice versa.

Own, communicate and present functional requirements to the development and QA

teams

Risk Assessment/Prioritizing drafting, executing and documenting risk areas.

Preparing and executing SQL Queries for extracting information from the database.

April 2008 - October 2010: Business Analyst

Project Name: TennCare – VIP Project

Client: State of Tennessee (Nashville, TN, USA)

Project Description

TennCare is a Tennessee Government-operated health insurance program.

Vision Integration Platform (VIP) project focuses on implementation of VIP system which involves

replacement of the Existing ACCENT system. ACCENT is the primary system used by the

Department of Human Services to determine eligibility for the State and Federal programs for

Food Stamps, Medicaid/TennCare and Families First currently used by Tennessee State's publ ic

assistance programs.

Contribution

As a Business Analyst, was responsible for

Documenting High Level Design, Flow diagram, and technical specification documents in

an AGILE development environment.

Responsible for analysis of the current Eligibility System and Sub Systems like Claims,

Finance, and Enrollment. Worked extensively with the end users team in understanding

the business rules.

Created use cases and business scenarios that represented current systems as well as

documented the requirement specs, technical specs for the proposed changes. The

scenarios included screen mock -ups, functional, and technical requirements.

Created proposed Process Flow Diagrams with Visio, Report Mockups in the design

phase of the system.

Detailed Study of current Inbound/Outbound processes with other State Assistance

programs to generate a current and a proposed VIP Integration diagram.

Interpret the System requirements document and create Unit Test Plan and Unit Test

specifications

To ensure smooth transition to the proposed system - W as responsible for the analysis of

target and source databases to determine data mapping and documenting data mapping

rules for movement of data between internal applications.

June 2007 -August 2007: Business Analyst

Project Name: Group Immediate Annuity Product

Client: SBI Life Insurance Co. Ltd. (Mumbai, India)

Project Description

New Product launched for ‘Immediate Annuity for Group Customers’. Involved set up of necessary

features in Portal, which is the Policy Issuance System used in SBI Life Insurance Company

Limited

Contribution

As a Business Analyst, was responsible for

Carry out feasibility study in coordination with the development team, in regards to the

new features to be set up for the product. Discuss the identified cons traints with the

product manager to ensure documentation of the risks identified.

Analysis of product related physical documents to identify gaps that need to be resolved

to ensure facilitation of online processing.

Preparation of Functional Specification Document which involved preparation of ‘Use

Cases’ for Product Definition, Master Policy Proposal entry, Addition/Deletion of persons,

Financial Transactions and Endorsements etc.

July 2006 – June 2007: Business Analyst

Client: Birla Sunlife Insurance Co. Ltd., India (Mumbai, India)

Project Name: Anti Money Laundering

Project Description

To cater to the Guidelines issued by Insurance regulatory development authority to be

implemented to establish strong Anti Money Laundering detection with respect to Insurance

companies.

Contribution

Responsible for defining system requirements to ensure compliance to the guidelines

Preparation of test plans/scenarios

Carry out User acceptance tests

Project Name: Website Enhancements

Project Description

Enhancements in the Website based on the Online Survey Conducted on website

Contribution

Gathering User Requirements and documentation

Conducting Model Office Testing and coordinating User Acceptance Testing, Sign off and

Training to end-users.

Ensuring zero defect delivery within given timelines

Preparing and executing SQL Queries for extracting information from database.

Project Name: IT Architecture Study for BSLI

Project Description

To define the IT Architecture and the IT Strategy for the company

Contribu tion

Analysis of the As Is scenario of the IT Architecture

Defining the recommended IT Architecture based on the analysis of current systems and

the Business strategy

Documentation of the existing areas of system Integration with the definition of the curr ent

versions and future recommended areas of system Integration and possible version

changes.

Project Name: Outsourcing Pre Proposal Study for BSLI

Project Description

Analysis for decision making on the Outsourcing of System Development, Maintenance and

Production Support for Business Software Systems

Contribution

Creating a repository of currently existing system - System Portfolio Building

Coordination with vendors to provide clarifications about the Request for Proposal

Carry out Cost-Benefit analysis to facilitate decision-making based on the proposals

received.

M ay 2003 – July 2006: Business Analyst/Process Analyst

Client: ICICI Lombard General Insurance Co. Ltd., India (Mumbai, India)

Project Name: Health Insurance Policy Issuance - Central O perations

Project Description

Issuance of Health Insurance Policies and Creating processes to meet the Turnaround times

Contribution

Overall control and management of Health - Operations and evaluation of integrity of

management controls and effectiveness of business processes.

Process development, implementation and monitoring of Health Operations

Conducting process training, systems training & presentations

Designing and architecting business solutions and analysis of processes, data and

information

Project Name: Health Insurance Policy Issuance System

Project Description

Implementation of an Online Module for Health Insurance Policy issuance to allow issuance of

policies from the Module in a decentralized setup

Contribution

Defining the Business Requirements

Preparing the Functional Specifications

Conducting testing and releasing the final product and Training Users on the Application.

Project Name: Corporate Products - Detariff Phase I

Project Description

Enabling the Premia - Existing Corporate Policy issuance Module to handle the Detariff Scenario

Contribution

Analyzing the guidelines provided by the Insurance Regulatory Development Authority,

India with respect to Detariff.

Defining specifications for changes in the existing Premia system

Conducting Testing and providing User Acceptance Testing sign off

Conducting training for users on the system enhancements

Project Name: Product Setup for Loan Products

Project Description

Designing a system for Policy issuance of Loan related non-life products

Contribution

Defining Product specifications

Handling system testing and User acceptance testing

Project Name: Unified Customer View

Project Description

To create a single repository of customer database to enable efficient customer service, cro ss

selling and to comply with the guidelines issued by Insurance regulatory development authority for

Know your customer norms

Contribution

Analysis of guidelines issued by Insurance regulatory development authority for Know

your customer norms

Database analysis, DE duplication and Data Mining.

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