Project Data

Pravallika

972-***-**** x*** ***.******@*******.***

PROFESSIONAL SUMMARY

Professional experience of over 8 years working in various comprehensive projects in Health Insurance, Banking, IT, Pharmaceutical and Retail domains as a Sr. Business Analyst, Business System Analyst.

Experienced and in-depth knowledge of different phases of System Development Life Cycle (SDLC) and methodologies such as Waterfall, Agile-Scrum, and Waterfall-Scrum Hybrid.

Conducted various analysis like GAP Analysis, Feasibility Analysis, Impact Analysis, Cost Benefit Analysis, Risk Analysis, and SWOT Analysis.

Used different Elicitation Techniques for the Requirements Gathering like Brainstorming Sessions, Joint Application Development (JAD), Interview Sessions, Workshops, Focus Group, Surveys, Questionnaires, Document Analysis, and Observations with Subject Matter Expert (SME's), Business users and Business Owners.

Proficient in gathering and analyzing the Business Requirements and documenting them into Business Requirement Document (BRD), Functional Specification Document (FSD) and System Requirement specification (SRS), Request for Proposals (RFP), Statement of Work (SOW).

Experience in creating Test Plans, Test Scenarios and Test cases and documenting project processes and procedures.

Experienced in handling and implementing the change effectively by using change management process.

Experience with various tools for planning, tracking and managing projects such as Atlassian Jira, Team Foundation Server (TFS), HP Agile Manager and MS Project Professional.

Good knowledge in process modelling and created UML Diagrams (Use Cases, Sequence Diagrams, and Activity Diagrams) Workflow diagrams with the help of MS Visio, and Rational Rose.

Designed Prototype, Mock-up screen, and Wireframes using MS Visio while developing GUI applications

Expertise in facilitating UAT testing, Regression testing, Smoke testing, and SIT testing.

Experienced in writing the User Stories using the INVEST format and handling the requirement churn.

Recorded and maintained the artifacts like Sprint Burn down charts, Product Burn down charts, product backlog and impediments list. Efficient in facilitating estimation techniques such as Planning Poker, T-shirt sizing and prioritization techniques like Moscow and Kano techniques.

Developed and maintained all project related documentation needed for implementation of application.

Used SharePoint and Docstar for Content Management for managing documents.

Experience with database queries on various RDBMS like Oracle, SQL Server, My SQL, MS Access, Stored procedure writing and Online Analytical Processing (OLAP).

Knowledge in Data warehousing concepts- Data modelling, Data mapping, Conceptual, Logical & Physical Data Model, Star schema, Snowflake schema, and Normalization.

Experience with data analysis & data mapping.

Experience in designing dimensional modelling, star and snow flake schemas, Fact and dimension tables, physical and logical data modelling using Erwin modelling tool.

Working knowledge of XML including validation of Web Methods, Web Services, WSDL, SOAP, UDDI, HTML, AJAX and CSS

Developed systems complying with the rules defined by Health Insurance Portability & Accountability Act (HIPAA) and Health & Human Services (HHS): Privacy Rule, Security Rule, Transactions & Code Sets Rule, Unique Identifiers Rule (NPI)

Good understanding of Health Insurance Programs (Medicaid, Medicare Part A, Part B, Part C, Part D) and Managed Care Programs (HMO, PPO, POS), with expertise in HIPAA transactions and paper claim forms (CMS 1500, UB 04).

Experience in working on Step-Up/Step-Down solution during transition from 4010 to 5010 compliances.

Knowledge of File Formats used for EDI transactions ASC X12 837/276/277/834, 999 Functional Acknowledgement and TA1 Interchange Acknowledgement

Knowledge on Healthcare Claim Processing and HIPAA Standard Transactions X12-837 for Equivalent

status request and response, X12-270/271 Eligibility inquiry and response for a Health Plan,

Good Knowledge in Medicaid Management Information Systems (MMIS), Claims Process, Electronic Medical Records, Electronic Health Records and HL7 standards.

Assisted in converting ICD-9 codes to ICD-10 codes by General Equivalence Mapping (GEM).

ASSET OF EXPERTISE

Business development and business process, strategic planning and forecasting, reporting, documentation, work flow, market place, Scope Creep.

Key performance indicators, process improvements, project charter, team leadership and stakeholder approach, handling change requests

Finance and accounting, risk assessment, analysis and risk mitigation, enterprise supply chain management, Investment portfolios and finance data.

Enterprise Analysis: SWOT, Root cause analysis, GAP analysis, Market Analysis.

TECHNICAL AND DOMAIN SKILLS

Methodology

RUP, Extreme Programming (XP), Waterfall, Agile, Scrum

Data Bases

SQL Server, Oracle, DB2, MS-Access, Excel

Programming Languages

SQL, PL\SQL, Visual Basic, Java, JavaScript, HTML, dBase, Cobol, Fortran.

Operating Systems

Windows95/98/00/NT/XP, MS-DOS, UNIX, Mac

Project Management

Microsoft Project, Microsoft Office.

Quality Management

ISO 9000, PMBOK

Business Modeling Tools

Rational Rose, Enterprise Suite, MS Visio, MS Project

Healthcare

TRIZETTO, FACETS, COBRA, NASCO, HIPPA, FMLA, SUR, EPSDT, TPL, BPA, BIAR, Medicare-caid, Obama Care

Banking/ Finance

Laws of Banking, Types of Banking, Financial Assets,

Financial Market, Types of Payments, Bank’s balance sheet

Business Skills

BRD, FRD, SRD, Project Kick-off, MOM’s, Requirement gather & analyze, Mainframes, Modelling, & Analysis, Competitive Intelligence, Risk Management

Testing Tools

Test Director, Win Runner, Selenium JIRA, Rally, Swift ALM, HP Quality Center, IBM Rational Clear Quest.

PROFESSIONAL EXPERIENCE

Client: Cigna Healthcare April 2016- Till Date Location: Lafayette, Louisiana

Role: SR. Business Analyst

Project Description: The scope of the project is to develop a patient portal for the patients to connect with their doctor through a convenient, safe and secure environment. The portal should enable the patients to make payments, schedule appointments and access their personal health records.

Responsibilities:

Interviewed the end users, asked detailed questions and carefully recorded the requirements in a format that can be reviewed and understood by both business people and technical people.

Conducted GAP Analysis of current state (As-Is) and proposed state (To-Be) situations.

Conducted Requirement Workshop to gather requirements from various departments. Conducted Focus Groups and Interviews with physicians and to understand additional functionalities deemed critical.

Prepared a Questionnaire and conducted a survey to understand the user needs.

Created Business Requirement Documents (BRD), Functional Requirement Specification (FRS).

Assisted the project manager in Project Budgeting and Resource scheduling, in order to optimize the utilization of the project resources using MS project.

Worked with GUI development, designed the initial UI wireframes, and mock-ups.

Used MS VISIO to create Use Case diagrams, activity and Sequence diagrams so that the development team and other stake holders can understand the business process.

Performed duties of agile coach by educating the team on prioritization and estimation techniques.

Analysis for making system compliant with HIPAA. Involved in making the Medicare patient profiles being compliant with the HIPAA regulations. Management of patient profile transfer (PPT) reports created by data team by verifying the associated data.

Control Management Reporting and Security Systems: generation of daily, weekly, and monthly reports of hospital patients' activity. Medical Billing and Collection Systems: generation of daily billing activity based on patient records and establishment of collection protocols. Accounting Systems: Financial Statement generation and analysis according to government standards and protocols.

Coordinated and conducted system requirements walkthroughs/sessions (JRDs/JADs) with business Owner/stakeholders/SMEs as well as design/development teams. Worked with business area SMEs/analysts to develop and finalize test plans/scripts/use cases. Analysis of key business requirements and assisted in the development of Business Requirement (BRS), Functional Requirement (FRS), and System Requirement Specification (SRS).

Working knowledge of Epic Rx /Epic Lab/Epic Care Inpatient/Health Information Management and Chart Tracking

Experience with the use of clinical laboratory information systems within a medium to large clinical laboratory

Experience with Epic Resolute Professional and Hospital Billing system experience

Experience in a highly regulated environment (healthcare, financial, SOX, HIPPA etc.)

Member of the patient information reporting project team for analyzing and designing responsible for analyzing and designing a system that would improve reporting of patient data especially with relation to Medicare population.

Environment: Waterfall-Scrum, HP ALM, Balsamique, Visual Studio, Tableau, SQL SERVER 2012, AJAX, IIS Web Server, Java Script, HTML, CSS, SharePoint 2013

Client: Dish Networks May 2015 – Feb 2016

Location: Denver,

Role: SR. Business System Analyst

Project Description: The scope of the Project is to provide documentation of the business process by identifying data required in determining the satellite television, satellite Internet access, audio programming, and interactive television services to commercial and residential customers in the United States.

Responsibilities:

Performed extensive Document Reviews and GAP analysis to develop a thorough understanding of AS-IS business processes model and TO-BE business Process model.

Performed Impact Analysis to determine the impact of the enhancement on the business and organisation.

Performed Feasibility Study, Cost-Benefit Analysis and Return on Investment(ROI) in order to mitigate certain risks associated with the project.

Conducted JAD sessions, interviews and Brainstorming sessions with key stakeholders and SME’s to gather requirements.

Created Vision document and Business Glossary. Worked on business rules for the application.

As a scrum master, facilitated the Scrum meetings- Sprint Planning, Daily scrum, and Review, Retrospective and Product Backlog Refinement meetings with the Scrum development team.

Maintained Scrum artifacts like Sprint burn down chart, Product burn down chart and Impediment List.

Effectively Time boxed Daily Scrum meetings, maintained the record and analysed all the scrum activities in the Scrum Retrospective meeting along with scrum development team.

Used JIRA for drafting the User stories and managing the requirements.

Facilitated the estimation of efforts required using Planning poker technique along with Scrum team.

Analyzed the data in the database and presented reports to the client and the business team.

Interacted with the client managers and the business partners to validate the findings.

Maintained the Requirement Traceability Matrix (RTM) and worked with the Business Team to review UAT validation scenarios.

Performed User Acceptance Testing (UAT) in conjugation with the QA team. Also, created an error repository and managed the testing process with the QA team. Logged and tracked the defects using HP Quality Centre.

Improved collaboration in the scrum team as the team is new to the process and helped people understand the work dynamics within scrum.

Environment: Waterfall –Scrum, MS Office (Word, PowerPoint, Visio), Share point 2013, JIRA 6.0, HP Quality Centre, Visual Studio, Tableau, SQL SERVER 2012.

Client: Colonial Savings Bank July 2014 – March 2015

Location: FT. Worth, Texas.

Role: SR. Business Analyst

Project Description: The scope of the Project was to develop documentation of the business process by identifying data required in determining the Asset Based Lending loans that are eligible for financing and securitization from multiple sources and the method of obtaining and storing data.

Responsibilities:

Involved in gathering business requirements from end users and management

Analyzed requirements and created Use Cases, Use Case diagrams, sequence diagrams using Rose

Used Rational Requisite Pro for managing and configuring the requirement analysis effort

Extracted the business requirements for E-commerce from various sessions with business leads and maintained them using Requisite Pro, tracing them all the way to the system artifacts

Planned, coordinated, and monitored project levels of performance and activities to ensure project completion on-time

Prioritized requirements to be developed according to Agile methodology

Performed extensive requirement analysis and gap analysis

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

Used sessions, workforce for running and loading the data from source to target data warehouse

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

Extensively used SQL for accessing and manipulating database systems

Participated in design walk-through with SME's to baseline the business architecture

Worked closely with QA and developers to clarify/understand functionality, resolve issues and provide feedback to nail down the bugs

Effectively implemented defect management process using Clear Quest

Maintained a close and strong working relationship with teammates and management staff to achieve expected results for the project

Involved in writing manual test cases and test scripts for checking the application

Assisted the database modelers in preparing the logical and physical data models and ascertained that requirements have been met

Developed functional specifications and testing requirements using Test Director to conform to user needs

Was involved in UAT testing

Prepared user training manuals and successfully conducted user training sessions

Environment: MS office, MS Visio, Microsoft Windows 2008

Client: Anthem, Walling fort Feb 2013 - May 2014

Location: Connecticut,

Role: Facets Healthcare Business Analyst

Project Description: Part of company-wide design, development, testing, and implementation in transition from a legacy system to FACETS. In strict compliance to complex policies/regulations, configured FACETS modules such as Benefit Plans and Contracts as well as related modules such as Claims Finance, Configuration, Fee Tables and Carrier/Programs. Analyzed FACETS Benefit Plans and Contracts module as well as related modules in order to identify data requirements for script design developers.

Responsibilities:

Utilized Rational Unified Process (RUP) to configure and develop process, standards and procedures.

Conducted JAD sessions with business units and stakeholders to define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts.

Prepared the Business Requirement Document (BRD) and Functional Requirement Document (FRD) for the enhancement of the existing services.

Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance.

Requirements Gathering & Analysis to ensure HIPAA Compliance Auditing.

Created Test Scripts, Test Plans, and Validation Plans and Testing Metrics Reports.

Performed Functional, Integration and Regression Testing.

Analysis of inbound and outbound interfaces and extensions to Trizetto FACETS Claims Processing system.

Worked in FACETS Reconfiguration of member/subscriber, Data Element Definition and Usage with values and completed configuring FACETS Applications like Related Entity, Parent Group, Group, and Subgroup using IVSTech Data Toolset.

Configured the Billing Module that includes fee rate, premium rate, and invoices.

Analyzed data and created reports for all issued Action Items.

Completed Data Mapping for group and detailed product analysis and report writing.

Extensive backend testing using SQL queries, generating the reports to ensure the data integrity and validate the business rules.

Participated in solving Billing issues from the FACETS Problem Log for Trizetto and Billing Entities.

Analysis and Design of the Trizetto FACETS Data Model to ensure optimal system performance and tuning.

Involved in bug tracking and defect prevention activity, configuration management and UAT.

Involved in performing GAP analysis and highlighted related issues.

Involved in various phases of SDLC throughout the project life cycle in Rational Unified Process (RUP) environment and the creation of artefacts and managed various roles specified by RUP.

Environment: FACETS, Sybase, Java, T-SQL, Java Web logic Server, UNIX, Web Services Clear Quest, DB2, Oracle 10G, XML, HTML, DHTML, SQL, PL SQL, Windows NT

Client: Rajashekar Hospitals Sep 2012 – Nov 2013

Location: BANGALORE, INDIA

Role: Business Analyst

Project Description: The scope of the project was to generate reports for various departments on demand from the central database repository which stored data from the departments in the hospital.

Responsibilities:

Gathered requirements by conducting interviews, JAD sessions and Job shadowing.

Conducted GAP Analysis of current state (As-Is) and proposed state (To-Be) situations.

Created Use Case Diagrams, Activity Diagrams, and State Chart Diagrams using UML methodology.

Prepared workflow diagrams, analyzed AS-IS and TO-BE scenarios, designed new process flows and documented the business process and various business scenarios.

Involved in the calculations and documentation using MS Excel, MS word, and PowerPoint

As a Scrum Master, documented Sprint backlogs and facilitated all Scrum Ceremonies.

Created artifacts such as Sprint Burn down charts and Product/Release Backlogs.

Performed the User Acceptance Test (UAT) and suggested recommendations for the application.

Maintained complete documentation of the entire process along with all its activities.

Responsible for Data analysis, Data profiling, Data mapping and traceability matrix deliverables

Performed ad hoc statistical and data mining analyses

Experience with SQL queries and worked with the queries for data manipulation.

Created ER diagrams to establish different entities, relationships and different data mapping from various database into a single source.

Informatica was used to extrapolate the difference and results of data mapping.

Data validation, analysis and generating accurate reports using reporting tools.

Executed SQL queries to test data manipulations for data warehouse that detect functional acknowledgement.

Environment: Waterfall-Scrum, MS Excel, MS Word, Requisite Pro, MS Project, MS Visio, Outlook, Microsoft SQL Server, Microsoft Visual studio.

Client: Darwin Formulations May 2010 – Aug 2012

Location: Vijayawada, India,

Role: Business Analyst,

Responsibilities:

Participation in GxPs compliance assessments

Assess the different environment's Virtual Desktop Interface and Amazon Cloud Service for the requirements

Conduct gap analysis against available Cognos reports and mobile solution prototype

Work with the 3rd party vendors in getting the Publishing and Validation tools installed and test

Actively involved with users in analyzing the business process and converting them to functional requirements

Creating Project Charter, Requirement and Design document, Requirement Traceability Matrix,

Migration Plan, Deployment and Training Plan and Disaster Recovery/BCP Plan

Work closely with the Migration team to get business data moved to new file shares

Author Test cases in ALM for Qualification Testing, System Readiness Testing and execute qualification protocols

Maintained the RAID (Risks, Assumptions, Issues and Dependencies) log

Worked closely with the development team and supported Business users during UAT

Created and tracked deviations occurred during testing process

Support during Go-Live

Environment: Project Regulatory Affairs & Records Information Management - Applications Support.

Client: Emware Technologies,

Location: Hyderabad, India

Role: JR. Business Analyst Jun 2008 - Mar 2010

Responsibilities:

Conducted Requirement gathering sessions, interviews and Joint Application Development (JAD) sessions.

Worked on the different systems for Enrollment / Maintenance /Billing (payment credit industry)/Reporting for Direct, Small Group, Large Groups, Mid-Large Groups

Traced current system output results for the new enhancements. Reviewed the SQL with solutions and assumptions in IAD's. Reviewed data archiving code and ETL scripts (Data Extract- Transform and loading) Data Warehousing (DWH) process flow.

Modeled the business process flows using Rational Rose, the existing ER diagram and Data Flow Diagram (DFD) and developed UML Use case diagrams, Activity diagrams, Sequence Diagrams, Collaboration Diagrams and prototypes.

Studied the business and technical needs and modeled the AS-is and TO-be scenarios. Conducted GAP Analysis, Impact Analysis and Risk Analysis of the to-be model. Created the Business Requirements Document (BRD) from the requirements gathered. Generated the business process model to better understand the business workflows.

Identifying and documenting data standardizations to be performed, data enrichment operations, data validations, data security requirements, and data exception handling processes.

Interact with different groups of Infrastructure to have the Siebel environment co-exist with other application environments.

Identified and documented Issues, risks and gaps and their descriptions and impact, and provided recommendations and alternatives.

Created AS-IS and TO-BE business process flow diagrams, integrate process flow diagrams to show one end-to-end business model. Responsible for creating business flow diagrams (using MS-Visio).

Used MS Project to manage schedules, deadlines and resources and collaborate on the project.

Created initial Test plan, and test cases for acceptance test to provide the minimum requirements validation for the business process.

Used Rational Clear Quest to maintain and track the requested enhancements and changes.

Working on Oracle for data warehousing and data mining purposes.

Worked with Testers in User acceptance testing (UAT), System testing, Integration testing and build verification testing.

Environment: Rational Suite (RUP, UML with Rational Rose, Rational Requisite pro, Clear Quest, Rational Robot, Clear Case, Web Services, Share Point Server 2007, Lotus Notes, Siebel, MS-Visio, Oracle.

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