Sulabh Sharma

ac6xw8@r.postjobfree.com 309-***-****(Cell)

Summary:

Certified Scrum Master with over 10+ years of experience working in Benefit Administration Domain for Large Market, Insurance, Medicare and Medicaid.

Experienced and broad understanding of Waterfall, RUP and Agile Methodologies.

Work with stakeholders to analyze feasibility, efforts and cost to implement requirement or for outsourcing the projects.

Manage scope, time and cost of the project.

Implement processes, policies and procedure for strategic business requirement.

Ability to flexibly accept dynamically changing priorities, organize information to manage tasks and project to support business needs.

Hand's on experience with writing requirement for business application, documenting the gap analysis by analyzing the current state and anticipating the future state needs.

Investigate potential future or discretion, perform root cause analysis outline possible solution

Propose improvement to further automate process to reduce time while improving accuracy.

Broad understanding of software development methodology, platform, tools and language.

Extensive knowledge of creating WBS, project plan, project schedule and leading, managing and coordinating the endeavor.

Gather business requirement and translate them into BRD, user stories, use cases and functional specification.

Eliciting, documenting and refining business requirements for the IT organization.

Manage work within cross functional environment and working experience with global team management.

Validate proposed solution and ensure they meet internal standard.

Manage security needs for several application and tools.

Create User manual, user guides, training document.

Good power point presentation and demonstration skills.

Earned Aon Star award for the excellent performance in three different projects within Aon for year 2015.

Technical Skills:

Gap Analysis, Process Improvement, Process Automation, Process Modelling, Documentation, Flowchart, Dataflow, Swimlane, Command Center for DB2 SQL, Work Force Management, Managing requirement, Requirement Gathering, MS Visio, MS Project, SharePoint, Maestro, MSWord, MS Excel, MS PowerPoint, Vlookup, Aldera, TFS, JIRA, Epics, Epic diagrams, User stories, Advanced Editor Tool DB2, Advance Query Tool, COBOL, Beyond Compare, Confluence, Lotus Notes, SPUFI, IOF, JES, Beyond, IBM-3270, Mainframe, File Aid for DB2, JAVA, JCL, SQL, VB, SAS, Microsoft VSS, RMS, Endeavor, DB2, MS-Access, ALLBASE, Oracle database, Workday, Waterfall, Agile, RUP

Education/Certifications:

Pune University India

Master’s in computers, 2000

Post Graduate Diploma in Computer Application, 1998

Certification

Certified Scrum Master

Professional Experience:

Employer : Insight Global

Job Type : Contract

Role : Business Analyst

Location : Chicago IL

Duration : March 2018 – Present

Client : Evolent Health Inc. IL

Evolent health care processes the Medicare and Medicaid Benefits for different states and counties. It processes eligibility and enrollment data, provider data and Claim data. Aldera is the main system that cater the need of Medicaid and Medicare Claims.

Responsibilities:

Read the contract document and update the policies and procedure related to enrollment and eligibility.

Analyze the current system and document the process flow, data flow.

Perform the process modeling and prepare gap analysis document.

Study the 834-enrollment file loading process and bridge the gaps that cause delays and impediments while loading process and cause 5-day SLA to miss, identifying and recording the delay in different client account that are looking for process improvements. Document that cause of delay in loading 834 eligibility file and impact cause due to delays, duplicate PCP assignment, PCP not assigned appropriately, program related to geographical assignment of PCP does not work as anticipated, PCP assignment rules are not working appropriately or team are not aware of specific business rules related to client, multiple ID card generation for same member, delay in the membership, incorrect ID card generation.

Document the process to help team understand their business rule related to Enrollment eligibility as when and how can participant will be enrolled and what are reason of PCP changes what are rules of assignment, what are rules of reinstatement and policy cancellation. Update documentation related business rule for new implementation and verify the the welcome packet content, disenrollment letter, Reinstatement letter format, termination of Eligibility.

Develop and maintain the processes, policy and procedure database.

Help Analyst with tweaking of SQL’s for the conditional statements.

Understanding the process, documenting the process and develop checklist for mailroom processes.

Suggest and include the approved process improvements, process automation area.

Help client team to streamline the process to reduce defects and delays for system.

Resolving issues and problem related to Enrollment, Eligibility and Claims.

Manage security needs of different team on different tools.

Read through new contract and prepare the client deliverable for new clients onboarding the system.

Resolve the issue related to Enrollment Eligibility, PCP assignments, duplicate eligibility, delay in the claim processing, related to loading of 834 file, missing eligibility, reinstated and cancelled accounts, issue with the process flow, issues related duplicate account, delay in id care generation through clarity, processing of appeals and grievances and other documentation.

Prepare power point presentation display the dataflow, process flow of existing clients, list down current processes.

Gap in the process, concern related to process execution, reason for delay in execution, area of automation and process improvement.

Employer: Aon Corporation Lincolnshire IL

Job Type : Full Time

Role : Business Technical Analyst

Location : Lincolnshire IL

Duration : May 2007 – June 2016

Total Benefits Administration is flagship application for administering benefits for various clients. It maintains Health & Welfare data (Payroll, HRIS, Status of Employee, (indicative data), Defined Benefits data (pension data), Define Contribution (401K data). Technology primarily used are SAS, SQL, COOL COBOL, J2EE, JAVA, DB2.

Project#: Benefit Implementation

Clients :

UBS: DB Benefit Implementation.

Philipps: HW Benefit Implementation

Greif: TBA lite Implementation

Amgen: TBA lite Implementation

Synchrony: TBA lite Implementation

Lineage: TBA lite Implementation

Responsibilities:

Worked as BA and PM for the Interface and Reports Account.

Read the business requirement contract and break down the requirement into different deliverable services.

Create work break down structure and work break down dictionary.

Prepare the cost and time estimate for each of the deliverable. Negotiate budget and time for each service.

Manage the work and resource using the project schedule.

Host daily standup call and business requirement meeting.

Gather requirement for each service from document analysis of contract or eliciting requirement from client.

Documenting business requirement document (BRD), gap analysis (for existing services), dataflow diagram, process flow diagram, user stories, defining scope of project and documenting it, documenting business case, constraints, assumption, documenting test cases for testing, documenting user manuals.

Decomposing high level requirement to lower level, refining the requirement using document analysis, brainstorming, interviewing SME or client, deal with change management, traceability matrix, prioritizing the requirement, managing the dependencies, defining and managing the scope of the project from beginning to end.

Document the requirement and scope of requirement, traceability matrix.

Work with cross functional team and remote team coordinating the construction of the deliverable.

Answer question and doubt of team member related to requirements and manage the scope of requirement.

Perform System, integration and user acceptance testing for each deliverable.

Document Project Plan, Transition plan and test plans on need basis.

Prepare the transition document and transition the service to ongoing team for routine processing.

Work with data transmission team to setup the data transmission channels.

Identify the area of process improvement and process automation and implement them.

Perform UAT on each service, signoff and transition to ongoing team

Experience hosting planning meeting for medium level project.

Work with remote development team, provide training and transition to team on the new application.

Project#: Provider Finder Implementation for YBR

Client : Internal Project.

Provider Finder Implementation in Aon s flagship YBR (Your Benefit Application) web application YBR is benefit administration web application which can be customized based on clients’ needs. This project was to add Provider Finder feature within YBR web application. This enables customers to search for doctors/facility by providing zip code and add to their profile. The feature was added by calling a third-party web service (API) to search, add and manage providers.

Participated in discussion with various vendors to discuss the features and requirement

Discussion with Business team in implementing the Provider Finder feature

Created Mockup flow and screens using Balsamiq and Marvell app to capture and solidify requirements.

Worked with internal design team to get HTML/CSS mockup pages

Work on Epics, Epic diagrams and User stories for Provider Finder feature to be implemented in Aon s flagship YBR (Your Total Benefits) Web (J2EE) application.

Provided feedback to update wireframes

Gathered requirement for Web Analytics feature (using Google Analytics) to measure web traffic.

Captured requirement for showing providers in online two-way map using Bing Maps.

Worked with vendor and team in customizing the third-party web services output based on needs.

Worked with internal team to define contracts for preloading providers from legacy system for certain clients.

Helped in documenting non-functional requirement by discussing with Architect and Operations team

Worked with Development and QA team to do the requirement handover.

Create Traceability Matrix to track the requirement till deployment.

Maintained a query log for tracking queries from various teams.

Helped UAT and QA team in writing test cases.

Project#: Ongoing Benefit Administration

Client : 3M, Rexam, Siemens, Boeing, Allstate State farm, Koch, Cardinal

Responsibilities

Supported HRIS /Payroll, other daily benefits files, issues, enhancement and defects related to it.

Analyze new requirement introduced with change in legislation and document requirement, implement the changes.

Work with cross functional team to resolve the issue and defect in ongoing system.

Manage scope, time, cost, resources and quality of deliverable.

Work with the metric data for the ongoing team and identify the reason and cause for delays and gaps and suggest how to bridge them.

Implemented project under ongoing team like Health Spending, Flexible Spending account, reports, re-amortization and Amortization of accounts, Medicare Part D Processing and run the reconciliation file to CMS and related vendors.

Retiree life implementation – Load data for the participants, run reports and analyze data, manipulate results,

Implementing and processing Medicare Part D business processes, Cobra Subsidy processing, Annual Enrollment

Process Improvement and Process Automation to increase efficiency of the project.

Document user stories, dataflow, process flow.

Decomposing requirement into lower level, represent in various ways to make the communication easy between business and technical teams.

Work on data modelling, data manipulation and data evaluation, process enhancement, gap analysis extensively and UAT.

Converting client on TBA system from different Vendor.

Perform root cause analysis of reoccurring problems. Document the proposed solution.

Document the policies, process and procedure.

Document checklist and check sheet for the smooth processing of the business process.

Validate the solution implemented.

Deal with data transmission issue, data security issues.

Document Project Schedule, WBS, WBS dictionary, manage task using Maestro Tool

Conduct Training, hands on or Workshop.

Lead the account for daily work.

Project#: Conversion Project

Client : PCA, AT&T

Responsibilities:

Project Managed the Interface & Eligibility Control Account.

Host planning meetings and create WBS and WBS dictionary.

Manage scope, time and cost of project.

Host daily standup call.

Update team and PMO with project progress.

Document the defect and open task for defect.

Open task for development work.

Monitor the progress of the work.

Employer: Cognizant Technology Solution

Job Type: Full Time

Duration: October 2005 – May 2007

Client : JP Morgan

Location: Chicago IL

Title : Senior Associate

Project # Migration of Wholesale Lockbox application

Manage internal and external client and vendors.

Analyzed the existing Lockbox system and documented the process.

Understanding the process and develop and maintain checklist for execution.

Prepare gap analysis for the project.

Suggest and include the approved process improvements to team.

Create and constantly update the checklist used by team to run the processes.

Liaison with various Business group to understand the business model/requirement and update the old requirements documents.

Liaison with “Receivables Edge” application team to understand the new requirement to support new formats.

Document the process flow diagram.

Coordinate the testing and share testing results with PMO.

Develop and maintain relationship with client

Lead Acceptance testing efforts.

Supported Onboarding of resource and training on the Receivable Edge application.

Analysis of existing code and text files to create a migration strategy specific to a user group.

Analysis of Risk and Issues and its resolution on time.

Employer : Patni Computers Solution ( Currently Capgemini)

Job Type : Full Time

Duration : February 2001 – November 2004

Location : Bloomington, IL

Title : Software Engineer (Project Lead/Coordinator )

Client : State farm Insurance

Project# PS Online is designed to handle all the types of fire claims. It is essentially a Client Server application that involves the multiple technologies and heterogeneous systems. MQ series is used to route the asynchronous data to vendor’s application. The data is securely transferred to system managing claim application using. The IMS transactions are extensively used to communicate with primary database and other dependent databases. This application is meant for a contractor to fix damages caused by certain loss type to the property of policyholder.

Responsibilities:

Participate on the planning meeting, database design meeting, requirement gathering session and requirement brain storming session.

Documented feasibility analysis coordinate efforts with other stake holders.

Participate in project planning meeting, requirement brain storming session.

Documenting and maintaining use-cases and process flows, dataflow diagram through development life cycle of the project. created work break down structure, and participated in creation of project plan, scope document, and estimation of project.

Liaison with service analyst in setting up the design standard for technical specification design, coding and test cases.

Work with UI leads to coordinate integration between backend and frontend.

Lead the development for technical specification documents, coding, unit test cases, unit testing of services and unit test results.

Conducted QA review meeting of the technical specification, codes with service analyst, DBA’s and tech leads. Ensure quality of each configuration item.

Coordinate creation and execution of Integration, System Test Cases and acceptance test cases.

Coordinated Unit Testing, Integration Testing, System Testing, Performance Testing, and Acceptance testing efforts.

Writing and Tuning SQL Queries for the integration, system and acceptance testing.

Manage configuration item and deliverable in configuration tool called Revision Management System

Resolving data communication problems in MQ or with external vendors.

System testing application with team of Business analyst and tech leads of mid-tier and UI team. Fixing bugs in the application, fixing code for any changed functionality. Implementing new functionality whenever required.

Service Support the application in production for 3months after production.

Transition & Documentation.

Creating user manual, training guides.

Project # : OFAC-Compliance – The application helps in restricting any person or organization listed under ‘OFAC-List Compliance’ from buying policy or paying for any claims. It tracks records of the policyholder and compares it against legislative database. In case of a match, the person or organization is listed on the report. This helps organization in deciding any kind of payment to such person and/or organization.

Responsibilities:

Participate in Database Modelling, data manipulation and data evaluation.

Participated in Planning session.

Documented WBS, WBS dictionary, schedule.

Manage scope, time and cost of the project.

Supported work for mapping 835 /837 files and testing of 835, 837 and imaging.

Documented gap analysis and system design document.

Developed system and integration test cases.

Document the transition to service analyst

Working with cross functional team.

Project#: ECS-Automate Medical Claim Processing – ECS was designing to cater need of electronic processing of Medical Claims. When claim was addressed late due to manual processing, SFI had to pay lots of fine on them. To speed up the process of addressing the claim payments and save the millions of dollars spent on fee the electronic processing of the claims was created.

Responsibilities:

Participated in the planning session.

Participated in WBS development, WBS dictionary development.

Read through the Business requirement contract and database structure and map 837 and 835 EDI transactions.

Perform the user acceptance testing.

Perform peer-to-peer review of UAT.

Supported system and integration test cases.

Contact this candidate