Relevant job knowledge and expertise

*+ years of experience as a Business Analyst/Business System Analyst in industry domains including Financial, Healthcare, Property & Casualty Insurance, Retail Banking, e-Commerce, Pharmaceuticals, and Supply Chain.

Experienced within Individual Retirement Accounts (IRA), Employer Sponsored Retirement Plans (ESR), Fixed Income Investments, Capital Market, and Wealth Management domains.

Articulate, confident, and able to communicate comfortably with all levels of the company.

Experience with re-engineering and implementation projects.

Extensively involved in Data Governance process.

Worked in various technologies such as XSLT, XPATH, CSS, XML, and HTML.

Key contributor to projects by leading the analysis, design, and implementation of solutions.

Experience/understanding of business process re-engineering and business modeling concepts, business systems development and analysis.

Proven experience with end-to-end business process mapping, business and technical requirements analysis, business planning, modeling, verification and methodology and product development.

Ability to coordinate with user groups to provide training, resolve issues, assess user needs and recommend alternative solutions to meet their business requirement.

In-depth experience on migration of legacy applications using parallel and phased adoption methods, understanding the big picture, and ensure scope and requirements of projects are met through the implementation.

Experienced with Medicare, Medicaid, Medicaid Expansion, Duals, Marketplace, Healthcare Benefits Administration, Affordable Care Act/Health Care Reforms.

Experience in Medicaid Management Information System (MMIS). Expertise in various subsystems of MMIS- Claims, Provider, Recipient, Procedure Drug and Diagnosis (PDD), Explanation of Benefits (EOB).Experienced working on EDI file protocols and transactions in implementing eligibility, Confirmation, Claims and Remittance Advise systems.

Conversant with industry standards such as HL7, x12N, DICOM and NCPDP.

Capable of independently and proactively leading/facilitating efforts to identify opportunities to leverage technology to enable business success.

Experienced in IBM Security Identity and Access Management (IAM), and IBM Master Data Management (MDM) implementation.

Ability to effectively communicate across multiple levels (Executives to team members).

Ability to communicate technical issues to non-technical individuals.

Strong understanding of Retail Banking, including Credit Card, Mortgage, Account Transactions, Wire Transfers, Bill Payment.

Strong understanding of financial valuation concepts and various capital market instruments and processes including Equities, Fixed Income, Foreign Exchange, Derivative (OTC) & Back-Office operations.

Knowledge of Anti Money Laundering (AML) and Bank Secrecy Act (BSA). Working knowledge and understanding of Suspicious Activity Reporting (SAR),and OFAC reports.

Extensive hands-on experience in eliciting, defining, documenting, business, functional, non-functional requirements, decomposing high-level information into details and in critically evaluating information gathered from multiple sources.

Highly proficient in working with users and stakeholders to elicit, analyze, communicate and validate requirements using Joint Application Development (JAD), Rapid Application Development (RAD), and Brainstorming sessions, identify Functional, Non-Functional, and Business Rules, and then subsequently model them.

Skilled in business process analysis (use case, user experience design, storyboards, wireframes, user profiles and user stories) and mapping (gap analysis) techniques, conducting Joint Application Development Sessions, SWOT analysis, Cost Benefit analysis and ROI analysis.

Skilled in Analysis and Design with experience in creating Use Cases, Class Diagrams, Activity Diagrams, State Diagrams, Sequence Diagrams, Unified Modeling Language (UML) using MS Visio and Rational Rose.

Demonstrated ability to work actively with different Design Tools to create Use Cases and UML diagrams such as Use case diagrams, Work Flow Diagrams/Process Flow Diagrams; and Entity Relationship Diagrams, Swim Lanes, and Data Flow Diagrams.

Extensive database experience using Relational Database Management Systems (RDBMS) Oracle, PeopleSoft, MS Access and SQL with solid understanding of primary, foreign key constraints, strong and weak entities & attributes.

Strong SQL knowledge for querying the database and proficient in developing External Tables, Joins, Indexes, Data Modeling, Analysis, Verification, Cleansing, Transformation, Integration, Mapping, Extraction, Load Process from multiple Data Sources.

Proficient in executing Test Plans, providing Test Data, conducting unit test, documenting test cases and in Manual Testing - Functional, Database, Black Box, Positive-Negative, and Regression testing.

Experience in writing User manual, conducting functional walkthroughs, and in performing extensive User Acceptance Testing (UAT).

Proficient in understanding of the customer’s needs and defines a Product Backlog re-prioritizes the Product Backlog based on customer feedback, market changes and business priority.

Experience with various Software Development Life Cycle Methodologies such as AGILE (Scrum), Iterative & Incremental Development, RUP Iterative, and Waterfall Model etc.

Excellent ability to converse, negotiate and liaise between the business units, technology teams and support teams.

Knowledge of Business Intelligence and Data warehousing tools

Technical Skillset

Web Technologies HTML, DHTML, XML, CSS, XSLT, JavaScript

Software Applications MS Office, MS Project, MS Visio, MS FrontPage, Dreamweaver, Adobe PhotoShop

SDLC Methodologies Waterfall, RUP (Rational Unified Process), Agile (Scrum)

Requirements Management Rational ClearCase, Requisite Pro, Use Cases, User Stories,

QA/Testing Rational Clear Quest, Team Foundation Server, HP Quality Center 11, Quick Test Professional, LoadRunner

Project Management MS Project (PERT, Gantt charts), Excel spread sheets

Operating System Windows 95 & 2007, NT/2000/XP, LINUX, UNIX, DOS

Design Tools Rational Rose, MS Visio (UML)

Database Microsoft SQL Server, Oracle 10g & 11g, Lotus Notes, MS Access

Change Management Stakeholder Analysis, Change Classification, Prioritization, & Implementation

Education

Master of Commerce (P) Accounting and Finance, India 2004

Professional Experience

Commonwealth Care Alliance – Boston, MA Mar 2015 –

Business Analyst

Commonwealth Care Alliance (CCA) is a not-for-profit, consumer-governed organization and is a prepaid care delivery system for Medicare and Medicaid beneficiaries with complex medical needs. CCA was created to serve the many people covered by Medicaid or “dually eligible” for both Medicaid and Medicare. CCA has helped Massachusetts to become the first state in the nation to fulfill the promise of effective healthcare reform, a goal that is now enshrined in national law through the Affordable Care Act.

CCA transaction logs are tracked in the Talend system. Currently CCA has basic support for performance monitoring and auditing of log, allowing the users to individually track, view, and audit each log records in Talend DI and ESB and partially in BPM and MDM. My role as a Business Analyst is to help create a centralized transaction log repository. Other projects worked on ICD 9 to ICD 10 migration, JIRA production bug workflow and enhancement of existing SCION 837 FTP Provider Inbound (Weekly) Process.

Identify and document ICD-10 impact assessment and subsequent remediation planning

Work closely with developers to document and to identify HIPAA 5010 transactions (ASC X12N Version 5010) Data Element, Loop and Code sets that will be impacted by the change to ICD-10.

Create JIRA production bug workflow, conduct Gap Analysis by creating Swim lane diagrams and highlight the differences between the Current (AS IS) environments versus the Target (TO BE) environment

Analyze and document the Scion Enhancement process, review the exisiting process with developer in order to archive provider’s directory and to add recipients in mail component

Co-ordinate with Sql Developer, System Architect and Technical Architect about eCW production Echo process replication of files from MySQL to SQL Server

Identify and document transactions job and business processes for creation of centralized repository.

Elaborated, captured/updated static data structure table and dynamic data structure table for CCA transaction logs centralized repository logging table

Backlog grooming sessions with Talend developers to make sure that the Static data structure table and dynamic data structure table details were clear and understood

Consult and coordinate with System Architect to identify server and to design centralized repository

Coordinate with Talend developers and DB developer to understand Business Requirements, to create static and dynamic data table, and log view

Closely interact with developers and System Architect to understand log messages and to identify bottlenecks

Facilitate group meetings, one-on-one interviews, and correspondence through emails to manage change control process and to discuss the impact of change request on the project.

Collaborate, collect, support the IT interegration team, document workflows, build knowledge repository and create templates

Participate in knowledge transfer meetings about 837 (Dental Claims or Encounters), 278 (Health Care Service Review Response), 270/271 (Eligibility request/Response), and 834 ( Benefits Enrollment/Dis-enrollment to a health plan)

Extracted key progress metrics for entire IT integration team and development and production issues process

Create, update, prioritize and modify production and development issues in JIRA.

Coordinate/discuss the status in the regular status/blocker call

Work closely with IT offshore and onsite team members in building interfaces, automation, coordinating the development and production activities

Environment: Talend DI, MDM, ESB, BPM, EDI X12, MS Visio, MS SharePoint Services, MS SQL Server, JIRA, MS Project 2000, MS Office, Oracle 10g, Windows 2000,

Great West Financial – Greenwood Village, CO Nov 2013 – Dec 2014

Business System Analyst

Great West Financial is a leading provider of Life Insurance, Pensions, and Asset Management. They had multiple Web Applications for Life & Protection (L&P), Individual Savings & Retirement (IS&R), Individual Retirement Accounts (IRA), Employer Sponsored Retirement Plans (ESR), and Employee Savings & Pension (ES&P) divisions, and Customer Contracts/ Policy information is stored in multiple Policy Administration Systems. Great-West Financial is the nation’s fourth-largest defined contribution record keeper, based on total participant accounts. They provide 401(k), 401(a), 403(b) and 457 services to 30,000 plans representing 4.9 million participant accounts and $220 billion in assets.

Great-West Life & Annuity Insurance Company, with headquarters in Greenwood Village, Colorado, and regional offices around the country, has a long history of providing financial security for Americans and has consistently received strong ratings. The company’s yearly report highlights its business results and financial stability.

My role as a Business Analyst was to continue enhancing Great West's Client Portal. Every client had to log-in to different web applications to manage their Contracts/ Policies with Great West. So the management decided to build a new Client Portal integrating all these services under one web portal. Clients would be able to log-in to Great West's client portal and manage their accounts at one place and perform their transactions online through Single Sign on. A part of this is also to do with an IBM implementation of MDM (Master Data Management) by collapsing redundant user accounts. This would not only help Great West to create a great customer experience, but also make it easier for them to market additional products and add-on services to the existing clients. The project dealt with redesign of the Client Database, Digitize the Transactions and building new ESB (Enterprise Service Bus) which includes Web Services and Message Queues to communicate with all Policy Administration Systems and integrate with the Client Database through ETL process.

Responsibilities:

Gathering requirements from Business Line Mangers and SME’s for the redesigned Great West Client Portal, Client Database and to Digitize the Transactions

Perform system and document analysis to understand the current systems

Develop Process Model and detailed Business Policies and documenting the same in Business Requirement Document

Prepare High Level Process Flow Diagrams and Business Process Flow diagrams for Great West Client Portal functionalities in Visio

Develop Use Case diagrams, Use case Narratives and User Stories.

Administered Identity and Access Management (IAM), (including password management) controls for staff and vendors assigned to department-level projects.

Prepare Wireframes, Prototypes and Mock up screens for different web pages.

Develop Customer Database Mapping Document and Digital Transactions Mapping Document to map all Policy Administration Systems

Identify the required fields for Client Database from Client extracts and Contract extracts from different Policy Administration Systems

Participated in Backlog Grooming sessions, identified obstacles, planned releases and managed sprints, also created a Business Requirement Document for management.

Created and Managed User Stories in Epics, Themes and Sprints; also calculated velocity and Story-points in TFS. (I was also part of the team that assessed and analyzed TFS, HP Agile Manager and Green Hopper as Agile ALM tool)

Coordinate with offshore team in documenting the gathered Requirements in to BRD’s and FRD’s

Interact with SOA architects for developing Integration Service Bus(ISB) & Enterprise Service(ESB)

Worked closely with System Architect to implement Service Oriented Architecture (SOA), Client side Validations, Server side Validations, Web Method definitions and data modeling.

Extensively involved in Data Governance process. Assisted in data grouping and defined relationship among the different tables.

Develop Service Mapping Documents to map UI Literals to Administration Systems

Help developers understand Business Requirements and design for Graphical User Interface (GUI), Client Database and Digitize Transactions

Coordinate with QA team to determine and develop Test Plans, Test Cases and methods for Unit Testing, Integration and Functional Testing based on testing requirements

Participate in User Acceptance Testing (UAT) and developed Training Manuals

Developed Multidimensional Models in Power-Play Transformer and generated Power Cubes for OLAP comprising of dimensions, hierarchies, levels, categories, and measures in Cognos.

Modified Power Cubes by adding new Dimensions, Levels, Categories and Measures.

Created different Dashboards in report studio using combination of List, Crosstab, and Graph and Map reports.

Worked on Performance tuning of report with huge queries using concurrent query execution for better performance of Reports.

As part of MDM implementation, involved with validating and testing user accounts; validating the suspect and collapsed data; created dummy accounts to validate against the back-end and the front-end data.

Created new ETL process to extract, transform and load data from different sources to data ware house.

Participated in Data Mapping, Data Conversion, creation of the Data model and used SQL and Toad to extract, filter and validate data.

Created T-SQL objects such as tables, views, joins and store procedures to meet client requirements.

Perform data validation using SQL queries and run ad-hoc queries to show data to the business users

Environment: Business Objects, Cognos 8.4, Informatica, Rational Requisite, Rational Rose, Rational Clear Case, UML 2.0, MS Project 2000, MS Office, Oracle 10g, Windows 2000, XML, Power Designer, IBM Master Data Management (MDM)

Care More/Well Point – Cerritos, CA Feb 2013 – Nov 2013

Business System Analyst

The new Claims Processing MMIS (Medicaid Management Information System) was initiated by the Care More to replace their 20 yrs old legacy system with a new SOA based system that will be based on the Microsoft .NET Platform. The new system would automate all the business areas with minimum human inter-vention. I was the Business Systems Analyst for the all the Claims Processing data which needed to be migrated from the Mainframe to the SQL Server environment. I had to constantly interface with the legacy team & the new MMIS design team for data & design related issues. As a Business Analyst, I was involved in all aspects from beginning to end of the entire legacy migration project.

Worked on Duals, Medicare, Business Operations, Case Management, Claims, Clinical Analytics, Clinical Operations, Compliance, EDI Validations, Finance and Accounting, Healthcare Code, Member Services, Membership and Eligibility, Network Operations Management (OM), OPMR, SOX Auditing, ICD10, Pharmacy, Pharmacy Benefits & Claims, Practice Management, Regional Performance Management, Sales, Terms and Conditions, Trainings and Utilization management, Revenue Cycle, EPIC Implementation & EMR Reporting. Project included technical and professional services related to analysis and assessment of the current MMIS and EDI claims, documentation of business and technical requirements, preparation of cost analysis and implementation of new MMIS automation system.

Responsibilities:

End to End working experience of Medicare, Medicaid, Duals, Hospice, LTSS, Vision, Dental, Pharmacy and behavioral health benefits projects from Patient/Member Eligibility, Patient/Member Registration to Patient/Member departure.

Experience with Patient Billing, Payer Compliance, Payer Reporting and Analytics.

Worked with HIPAA 4010 implementation in designing EDI X12 (837,834,278,270) transaction to the newly implemented Duals System.

Propose strategies to implement HIPAA 4010 in the new MMIS system and eventually move to HIPAA 5010

Interviewed the stakeholders to gather high level requirements.

Responsible for gap analysis in changing old MMIS to new MMIS.

Performed workflow analysis toward automated disability claims process.

Experience with Clinical, HL7, CCDs, EMR and EHR projects.

Assisted in re-engineering the company's core claims adjudication processing following BABOK standards and extensive use of the BABOK guidelines and practices as commissioned

Implemented Healthcare Enterprise Core Administration Platforms such as FACETS and Electronic Health Record & Practice Management applications such as NEXTGEN. Also involved in migrations and customizations of these systems.

Experience in migration of clinical data from ICD 9 to ICD10.

Designed and Developed various Business Intelligence reports against ODS, Claims systems such as Facets, HER systems such as NEXTGEN and Care Management systems, Network Management systems, Revenue Cycle Management systems.

Involved in SSAS Cubes design by creating KPI, Actions and Perspective from huge dataset using SQL Server 2008 Analysis Services (SSAS).

Designed and developed matrix and tabular reports with drill down, drill through and drop down menu and used gauge reports with KPI’s in SSRS.

Developed solutions in compliance with the industry models / standards and implementation of Quality Management Systems and HIPPA regulation.

Converted the logical request and response documents into the physical XML schema, compile a Data Dictionary and convert the logical data model into a physical data model that will be implemented within SQL Server RDBMS.

Develop interfaces to third party system and create business rules and data transfer mappings using XPath, XSLT,and XML.

Designing and Implementation of XSD schemas using XML Spy Tool keeping reusability in view across the systems.

Responsible for Change Management Processes (Identify, Analyze, Evaluate, Plan, Implement, Review and Close).

Analyzed customer needs and existing functions in the area of HIPPA transactions to determine feasibility, consistency with the established scope of work.

Clearly understood coding standards required for all Medicare Part D Users transactions involving electronic data interchange as provided by department of health and human services and incorporated at every stages of the project wherever found necessary.

Aided management in standardizing web applications by preparing GUI standards and recommending alternatives for incorporation in a phased, iterative manner.

Performed Requirement Analysis and developed Use Cases and Activity Diagrams.

Prepared user stories using JIRA. User stories are dissolved to the granular level and are supported by acceptance criteria which are in turn used by both development and QA team for both development and testing throughout the iterations. Also was involved in writing test cases for checking the functionality of the processing system constructed.

Used teamcenter to track the deadlines of different versions.

Uploaded all the sign off documents on teamcenter so it can be accessed by any team when required.

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.

Created SSRS reports from raw data to answer executive management questions on many topics.

Developed Test Strategy and Test Plan to ensure that test cases reflect user needs for functional, performance, and usability and security requirements.

Performed Functional Testing, System Testing and Regression Testing by executing all the prepared Test Cases.

JIRA has been thoroughly used for maintaining the Test Plans, Test Cases repositories along with the Defects.

Understood the business logic, user requirements, and test-objectives to develop test plans, test cases, use-case scenarios. Tracked and assigned defects to the associated teams.

Involved in writing SQL queries to test the mappings and to track the requirements as per the user requirements.

Co-authored functional specifications, business requirements specification (BRS), use-case specifications, and systems requirement specification (SRS) with the business group, and the IT team members.

Performed defect tracking and bug reporting using Quality Center and coordinated defect fixes in specific build releases with the Development and Project Management teams.

Created the Requirements Traceability Matrix (RTM) by mapping the Test Cases to ensure all the Business Requirements are fully covered by the Test Cases

Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.

Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to a health plan).

Involved in creating requirements that comply with HIPAA and HL7 regulations to protect the privacy of the employee insured under any policy and also regulations for claim submission that is required by Medicare and Medicaid policies.

Used SDLC (System Development Life Cycle) methodologies such as the Agile (Scrum) and the waterfall.

Environment: Sybase Power Designer, MS Visio, MS SQL Server, Team Foundation Server, C#, Visual Studio, Biz talk Server, MS Office Suite,MS Project Professional, MS SharePoint Services, Visual C#, Web Services, XML, XSD, XPATH, Spy 2010, XSLT, EDI X12, Trizzetto FACETS, Mainframe, DB2

Silvercrest Asset Management Boston, MA May 2012 – Jan 2013

Business System Analyst

Silvercrest Asset Management Group is an independent registered investment advisor which provides asset management and family office services to families and select institutional investors. Silvercrest currently advises on $16.7 billion for a clientele comprised primarily of families, as well as endowments, foundations and other institutional investors. Silvercrest's family office, advisory and investment capabilities are available to clients interested in investing substantial assets.

Wealth Management:

Worked extensively in wealth management activities (Value, Growth, Dividend Investing, Fixed Income investing, Portfolio Diversification (Asset Class, Geographical, investment style and type), Draw Down, System Back Testing, Technical Analysis, Option Strategies, Hedging, Pairs Trading, Futures, Indexes, ETFs etc.).

Fixed Income Investments:

Fixed income asset management, investment/Fund Accounting, Fixed income derivatives, Standard Settlement Procedures (Trade Confirmation, Cash Settlements, Foreign Exchange settlements), Fund Accounting, Reconciliation, Posting etc. Familiarity with collateral management, performance measurement, Swift, ISITC, FIX messaging. The application allowed traders and portfolio managers to trade multiple derivative instruments (exchange traded and OTC) with a common front end execution platform. The application interfaced with Reuters and Market for real time data, the accounting system and multiple VBA applications. System captures all market data needed to price & trade these products, including Recovery Curves, Default Probabilities & Correlations. It also generated credit-related risk reports – P&L, Industry Exposure, Counterparty Exposure and Issuer Exposure.

Responsibilities:

Liaison between stakeholder’s system users, clients and managers, software development team and the QA team to gather requirements.

Created targeted Questionnaires for SMEs to gather requirements.

Facilitated (JAD) Joint application Development sessions to identify the business rules and requirements and then documented them in a format that can be reviewed and understood by both business people and technical people.

Involved in Requirement Scoping and analyzing high priority requirement for implementation.

Studied and analyzed competitor’s applications and brainstormed to gather effective requirements for a quality product.

Extensively used MS Visio to create Mockups, screenshots and Wireframes based on the requirements elicited for the mobile application

Created Business Requirements Document and converted them into System Requirement specifications Document.

Followed the RUP methodology right from inception to the projects transition.

Participated in Design walk-throughs with SMEs to baseline the business architecture.

Implemented business modeling, data modeling, and object modeling using MS Visio to develop the business architecture for the application. Created reports using formulas such as Vlookup, goal seek and pivot tables

Analyzed Requirements and created Use cases, Use Case diagrams, Activity Diagrams using Enterprise Architect

Created and managed project templates, use case project templates, requirement types and traceability relationship in RequisitePro.

Coordinated with the development team, database team, data warehousing team and QA team throughout all phases in the RUP methodology.

Assisted QA Team in writing test cases, test plans and tested the final application for usability testing to verify whether all the user requirements were catered to by the application.

Coordinated with test team with Data Mapping to articulate better transfer of data and performed backend testing using SQL queries for data validation.

Made detailed research analysis & prepared a diagrammatic investment and trading process for derivatives instruments including CDS, CDS Index, CDS Options, Equity Swaps, Interest Rate Swaps, Exotic Options.

Coordinated with various data feeds (Reuters, Bloomberg, Markit) for market data, reference data, counterparty data, and credit data; mapped them to the oracle database for credit derivatives pricing, corporate bonds, municipal bonds and analytics

Performed detailed analysis and work – flow diagrams for derivatives trading which included - preparation of market & reference data, analysis & decision support, modeling a contract, preliminary instrument setup on the application

Archived all project documents and implemented the UCM model for activity-based configuration management using Used Rational Clear Quest for defect tracking and change management request and reported them.

Involved in preparing a simple and detailed User manual for the application, for an intended novice user.

Environment: Rational Rose, Requisite Pro, MS-Visio, MS-Excel, Microsoft Project, Oracle10g

Astoria Financial Corporation – Lake Success, NY Feb 2011 – Mar 2012

Business Analyst

Astoria Financial Corporation is the holding company formed in 1993 to facilitate the conversion of Astoria Federal Savings and Loan Association from a mutual form of ownership to stock ownership. Astoria Financial Corporation, with assets of $16.5 billion, is the holding company for Astoria Federal Savings and Loan Association. Established in 1888, Astoria Federal, with deposits in New York totaling $10.4 billion, is the largest thrift depository in New York.

Project 1:

The project involved enhancement and re-engineering of the base product for the peer-to-peer Network Expansion. Although Online Mobile Banking service activity has existed in the past, it has been largely reactive and untargeted approach. Astoria Financial needed product changes to ensure that compelling features are enabled for its customers. I worked closely with Marketing, Customer Service Center, Operations, Legal and Compliance to help analyze, document business requirements, process flows, and data needs to leverage a smarter way which allows

Contact this candidate