Atif Mir

860-***-****

adavf7@r.postjobfree.com

adavf7@r.postjobfree.com

Visa GC

Looking for Atlanta, GA

Professional Summary

More than 10+ years of in-depth knowledge and diverse Business and Systems Analysis experience dealing varied business processes in Healthcare Insurance, Hospital and Finance domain.

Proficient in different software development life cycle (SDLC) methodologies such as Waterfall, RUP, AGILE/Scrum and Prototype models.

Experience in gathering requirements and writing specifications like Business Requirements Document (BRD), Use Case Realization Document, Functional and Non-Functional Requirements Specifications.

Experienced working with agile methodology, creating user stories, participating in iterations for completion of projects and conducted daily Scrum/Stand-up meetings to track the progress of the team on a day to day basis.

Broad knowledge in healthcare insurance domain including system conversions (Mapping, Migrating, Enhancement) such as HIPAA X12 4010 codes to X12 5010 codes and ICD-9-CM codes to ICD-10-CM & PCS codes in Medicaid, Medicare, Procedural and Diagnostic codes and Claims processes.

Expertise in HIPAA ANSI X12 EDI transaction codes such as 270/271(inquire/response health care benefits), 276/277,278,834,835(payment/remittance/enrollment advice), 837(Health care claim) and version 5010 of this transaction.

Hands on experience with UAT testing in preparing UAT Test plan and assisted in UAT testing.

Hands on experience in leading JAD sessions in development of business requirements, along with leading Triage sessions with business users to identify and determine priorities for any work to be performed.

Strong experience in Data Analysis, data warehousing and Quality Assurance testing to fulfill requirements for product and service.

Excellent analytical skills in understanding business process (AS-IS) and (TO-BE), understanding functional requirements and translating them to system requirement specifications.

Experienced in writing SQL queries, Stored Procedures & ETL to extract and load data from multiple source on to data mart. Designed complex dataflow tasks to integrate, transform and load the data from different sources.

Technical Skills

Project Management: MS-Project, Primavera, MS-SharePoint, Jama

Project Methodologies: SDLC, Agile, Rational Unified Process (RUP), Waterfall, UML

Business Modeling Tools: MS Visio, MS PowerPoint, Enterprise Architect, Rational Rose

Requirement Management Tools: Rational Requisite Pro, Rally, CA Service Desk Manager, Jama

Defect Tracking Tools: Rational Clear Quest, Quality Center, Test Director, Jira

Education

Master of Business Administration (GPA 3.95) Aug’09-Apr’12

King Graduate School at Monroe College, NY, USA

Major Courses - Finance & Management

Master of Business Administration (GPA 3.30) Sep’01-Dec’03

Pak Lawrence Institute, Lahore, Pakistan

Major Courses - Marketing & Management

Bachelor of Commerce Sep’97-Jan’00

Punjab University, Lahore, Pakistan

Major Courses – Accountancy, Auditing and Economics

Certification

Certified SFC (Scrum Fundamentals Certified)

Certified SMC (Scrum Master Certified)

EXPERIENCE

IBM Watson Health

Smyrna, GA

Senior Business System Analyst/Requirements

Feb 2019- Present

IBM WH was contracted to design, implement, and maintain an Enterprise Data Solution that enables The Georgia Department Of Community Health to provide better member, patient and user experience, generate better health outcomes, lower costs, create Department-wide efficiencies and continue technological advancements with an emphasis on improved data analytics, and implement an enterprise-wide solution which will integrate multiple healthcare and non-healthcare data sources to support enterprise decision-making.

The objective of the project is to replace legacy Medicaid\Medicare information system (GAMMIS) to (Enterprise Data Warehouse) EDWH as per MITA 3.0 framework. The project offers integrations to around 85 different data sources.

Project contains different solution components including Cognos BI Analytics, Informatica (ETL), MDM (Master data management), Data Warehouse and Data marts.

Responsibilities:

Involved in business requirement updates while working with different user groups to define priorities concerning project development.

Documented business requirements and communicated these requirements to the development team for the design and implementation of business solutions.

Serve as a liaison between the business community and the technical development team.

Work actively in all requirement analysis sessions, to identify clarified requirements and assign work products and contractual deliverable to them.

Analyze business and user needs, document use cases that conclude with approved functional requirements, also prepares mange’s and communicates project activities with team participants as required.

Understands and document existing applications including (Advantage Suite, Data Probe) used to store data from different data sources (DXC, Optum, WellCare etc.).

Reverse engineer existing ETL processes to map to current reports to existing data sources.

Analyzes requirements and studies system processes and data flows; creates detail specifications to map, translation and standardizes data for data transformation development.

Understand processes for different financial models including Capitation and Fee for service.

Understand different subject areas including Members, Providers, Claims.

Understand different EDI formats including 837,835 etc.

Executes scripts for data analysis, testing, ranging from unit to integration testing.

Creates and maintains supporting documentation, such as data flows, entity relationships, business and process flow.

Works to ensure accurate data mapping and data transformation between source systems, data warehouses, and data marts.

Facilitates daily scrum, sprint planning, sprint demo and retrospective meetings.

Arranged daily stand-up meetings, facilitate meetings, schedule meetings, demo and decision-making processes in order to ensure quick inspection and proper use of adaptation process.

Involved with product owners in product back log grooming.

Responsible to remove the impediments for the scrum team

Involved in requirement gap reviews discussions and prioritize and update product back log items by adding new stories or improvements.

Work with Development teams, QA teams and different product managers and systems analysts to do impact analysis of new stories and features in product.

Work with development and QA teams to fill up understanding gaps and provide understanding of business processes.

Part of test case review sessions to fill up gaps in QA teams understanding and make sure that all business scenarios are covered.

Environment: MS Project, MS-SharePoint, Jama, CA Agile Central, MS Access, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio.

State of Massachusetts Department of Health

Quincy, MA

Senior Business System Analyst/Scrum Master

Feb 2013- Feb 2019

Medical Assistance for the 21st century (MA21) is a computer system that determines eligibility for MassHealth, Commonwealth Care and Health Safety Net. Also manages workflow and does automated case reviews. As a Senior Business Analyst, I am responsible to work on MA21 functionalities along with State Supplement Program (SSP) This State Data Exchange (SDX) Broker application is supporting the University of Massachusetts Medical School (UMMS) State Supplement Program (SSP) project which has replaced the Federal Administration of Commonwealth of Massachusetts’ State Supplement Program.

Working as a lead analyst for service desk production issues, I am currently leading a group of 6 analysts. My job is to administer and triage all the service desk production issues, and to assign those incidents to my group. I am also responsible for generating weekly triage reports identifying open requirements in JIRA and identifying business priorities

Worked on Massachusetts Health Insurance Exchange Project, representing State of MA this project was contracted to Optum Healthcare, to repair and implement the State's Medicaid system which was formerly contracted by CGI. During the year 2014, no resident of the State of MA was able to apply for Medicaid via the Health Connecter until November 15th which was the Go-Live date. My role was to work on eligibility from Application Intake, Program Determination, Notices and connectivity and data verification to the MMIS database. Once the eligibility process was complete, work was done to initiate the 834-enrollment process in the claims domain which was partnered with Dell. Project was implemented successfully, and defect work related to implementation was done post Go-Live.

Worked for the team that is responsible for receiving, documenting, processing the 837 transactions upgraded as per with EDI X12; ICD 9- ICD 10 and 4010 to 5010 version of HIPAA.4010A to 5010A and the new 277 Claims Acknowledge transaction into the Medicaid Management Information System (MMIS). The design includes the documentations of the Paper Claim Entry, Electronic Claim Entry, Daily ECA Reporting, Electronic Claim Acknowledgement, Weekly ECA Reporting and Data Mapping from ICD9 – ICD 10.

Responsibilities:

Serve as a liaison between the business community and the technical development team.

Work as an active member in all phases of the Software Development life Cycle (SDLC) including post production verification.

Primary responsibility is to ensure that the implemented project, maintenance enhancement or defect fix meets the requirements of the business community.

Analyze business and user needs, document use cases that conclude with approved functional requirements, also prepares mange’s and communicates project activities with team participants as required.

Worked on the claims domain and oversaw communicating between State of MA and the UMMS and its vendors that UMMS worked with.

Specified in EDI 837/835 transactions, which EDI 837 transaction was used either as a one-way transaction, or as a two-way “inquiry/response” type of transaction.

Worked with business users, and MA21 development group via JAD sessions to gather and document Scope, Business Rules, Business Requirements, Use Cases, Functional Requirements and technical specifications.

Prepared mockups using Balsamiq to develop new UI screens and enhance existing screens in MA21 system for end users

Responsible for generating weekly triage reports identifying open requirements in JIRA and gaging business priorities

Heavily involved in system analysis, data analysis and generation of test data for unit testing and assisted in system testing for data being transmitted to downstream agencies

Responsible to manage Production control Triage for all production related incident for the team.

Diagnosed and resolved production data incidents identified by Production Control, MMIS and MA21 users or management.

Worked with Senior management and SSP Team; participated in all phases of project life cycle including business requirements gathering and documentation, definition, design, development, testing and deployment following Agile

Acted as Scrum Master for Product teams with a focus on guiding the teams towards improving the way they work

Facilitating daily standup meetings, update product backlog

Facilitating sprint meetings, removing or guiding team for removing impediments

Assisting Product owner with product backlog

Maintaining sprint matrix to show team progress to project lead

Developed user stories to document application requirements, created process flow diagrams using Visio software

Performed existing system analysis, gap analysis and cost benefit analysis as needed

Worked on automating the file exchange process using SFTP and facilitated the B2B communication to improvise process management

Executed Mainframe Queries from Mainframe Server Database to retrieve data

Used JIRA, and Clear Quest to store all the requirements and to trace completeness of requirements

Identified and analyzed the data used by the SSP and SDX using Flat Files, Mapped the data using existing online screens and assisted in the integration of the SSP and SDX data without affection the legacy system

Prepared Functional Specification Document (FSD) and Developed Test Plan and Test Cases for Integration, System, UAT and End to End Test for Users

Supported the development of artifacts required for operational support

Environment: Mainframe, SQL Server, SSIS, SSRS, Virtual Gateway, MS Project, MS Access, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio, Rational Clear Quest, Rational Clear Case, Rational requisite pro, Jira, CA Service Desk Manager

Boston Medical Center HealthNet Plan

Boston, MA

Business Analyst

Aug 10- Feb 13

Boston Medical Center HealthNet Plan is a health maintenance organization managing healthcare coverage for Massachusetts residents participating in Mass Health (Medicaid), and Commonwealth Care. The project involved regular optimization and standardizing of the claims process such as maintain historical data, Ad hoc request/reports, tracking and addressing the problems on timely manner encountered by the providers, billers as well as vendor companies, health plan groups. The team is also responsible for making the system changes if there are any changes need to be made in the current policies, rules & regulations due to the business necessities. I worked for the team that was responsible for converting the programs from 4010 to 5010 version for HIPPA standards involving transactions such as 837, 835, 276, 277.This resulted in incorporating the business rules to increase automation, enhance interfaces for seamless integration with claims tracking system.

Responsibilities:

Involved in business requirement updates while working with different user groups to define priorities concerning project development.

Documented business requirements and communicated these requirements to the development team for the design and implementation of business solutions.

Collaboration in daily Scrum/stand up, readiness meetings and sprint planning meetings to establish wish list, a sprint backlog, and decides how to implement those pieces.

Expertise in rally software extensively to write user stories, assign tasks to individual team members, analyzing the Iteration Burn Down charts and Cumulative flow charts, logging and reviewing defects.

Working knowledge of agile development methodology to adapt the change for simple clean implementation and designs.

Worked on Burn-up and Burn-down charts to measures the status of remaining work and project deadline

Used agile methodology for Claim intake process and contributed in daily standups, user stories in each agile sprint.

Conducted brainstorming and JAD sessions with stakeholders and end-users for requirement analysis and documented the same.

Associated with full HIPAA Compliance life-cycle from gap analysis, mapping, implementation and testing for processing of Medicare, Medicaid and Tri-care claims.

Worked with various Claims’ upstream domains such as Plan, Member and HMO domains.

Analyzed the premium data files/claims files which is coming to accounting applications for various reporting and auditing purposes.

Used UML during requirements gathering and created Use Case Models and Use Case Diagrams for the purpose of stakeholders in the project to help them understand the workflow of the system associated with the requirements.

Involved in UAT Testing of claims applications and created several artifacts such as Application Mapping, Data Masking, Cross Function dependencies, and UAT files timelines.

Developed, implemented and executed test methodologies and plans to ensure software product quality as per the RATIONAL UNIFIED PROCESS (RUP) methodology.

Used JAVA as Request tool for Re-engineering purpose.

Used SQL Server Reporting Services (SSRS) for maintaining ad hoc request/reports for the clients as per their requirements

Analyzed, coordinated, documented and managed project requirements, project processes and procedures and its changes throughout the software development lifecycle.

Performed Requirements Analysis and traceability using Requisite Pro.

Involved in writing test plans, defining test cases, test scenarios and data sets; developed and maintained test scripts, analyzed bugs and interacted with development team in fixing the errors.

Worked with Subject Matter Experts (SME), project team members (business and technical), to define technology application for the business and system requirements. Also worked with the QA Team Lead to develop QA standards and ensured compliance with all regulatory requirements.

Developed several MS Excel spreadsheets and applications to automate manual calculations and optimize reporting structure.

Created and segregated SQL views and stored procedures for obtaining meaningful set of data.

Created Gantt charts and project charters and followed the Software Development Life Cycle (SDLC) methodology to complete projects on time and within budget.

Extensively used MS Project 2007 for status reporting and planning throughout the project lifecycle.

Environment: SQL Server, SSRS, MS Project, MS Access, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio, Rational Clear Quest, Rational ClearCase, Rational requisite pro.

New York State Department of Health

Albany, NY

Business Analyst

Aug 09 –June 10

Computer Science Corp. has supported the Department of Health, NY for Health and Dental Insurance Claims and Eligibility efforts and provides business support for claims processing system, MMIS. The core data is in MMIS Legacy system and can handle the processing of different Claims within POS in MVS Site D. The MMIS can handle the HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278. The Inbound and Outbound is run through JCL in batch mode.

Responsibilities:

Conducted weekly meetings for deciding the Policies and Procedures to be followed while constructing

New sites and performed the requirement analysis, impact analysis and documented the requirements using Rational Requisite Pro.

Responsible for architecting integrated HIPAA and Medicare solutions

Adopt agile methodology for respective domain’s implementation and contributed in overall project process.

Documented the server farm requirements and requirements related to security within Share Point and using Windows Active Directory.

Performed Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.

Used Query Analyzer, Execution Plan to optimize SQL Queries.

Interacted with client and the Technical Team for requirement gathering and translation of Business Requirement to Technical specifications.

Conducted interviews, meetings and JAD sessions during the process of Requirement Gathering.

Planned and documented procedures for data processing and prepared data flow diagrams for the application.

Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology

Expertise with supply chain strategies/vendor manufacturing process methods to determine level of procurement and strategic sourcing strategies/plans and worked with vendors/peers to determine lead times, schedules and cycle counts, established requirements needs.

Interacted with line of business managers and coordinated the transition into the security database to assure business compliance with SOX.

Analyzed trading partner specifications and created EDI mapping guidelines

Environment: MS Office, SQL Server, Agile, MS Project, MS FrontPage 2003, MS Access, EDI, Documentum 2.0., Lotus Notes, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio.

Group Health Insurance

Chicago, IL

Business Analyst

Aug 08- Aug 09

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:

Involved in Inception Phase and prepared vision statement and initial data models that contain Business Requirement Documents and supporting documents that contain the essential business elements and detailed definitions.

Accurate processing of Medicare claims using the Diamond system.

Gathered user and business requirements through open-ended discussions, brainstorming sessions and role-playing.

Used Waterfall and Agile for Claims processing system implementation.

Documented the user requirements Analyzed and prioritized them and converted them as system requirements that must be included while developing the software.

Analyzed data and created class diagrams and Activity Diagrams, Sequence Diagrams, ER diagrams for designing databases.

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 Mock-up forms in MS word for better visualization and understanding of the software solution.

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 along with creating and managing project templates, use case templates, requirement types and tractability matrix in Requisite Pro.

Authored progress and completion report which were then submitted to project management on a weekly basis in MS project.

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.

Prudential Financial

Newark, NJ

Business Analyst / Systems Analyst

Oct 07- Jul 08

Prudential financial is a company whose subsidiaries provide insurance, investment management, and other financial products and services to both retail and institutional customers throughout US. Worked on Retirement Savings, 401K claims for Life Insurance and involved in analysis and testing of online account services which included Quotes, Bill Pay, billing history and changing customer profile and modifying the provider details.

The new systems were designed to increase productivity and reduce costs.

Responsibilities:

Involved in framing the Business Requirements Specification and preparing BRD of the Enterprise structure, interacting closely with the end users & take repeated documented feedback.

Collected case analysis and documented business processes as well as business rules. Participated in the identification, understanding, and documentation of business requirements, including the applications capable of supporting those requirements.

Documented the current process, suggested future state process improvement, identified bottlenecks and modeled current and future state processes using Rational Rose.

Assisted in documenting the detailed Technical Specification for future reference.

Developed and executed real world lending scenarios based on client’s business requirements to ensure functional/non functional integrity.

Implemented the entire Rational Unified Process (RUP) methodology of application development with its various workflows, artifacts and activities.

Developed Use Cases using UML based on the needs of Business Users.

Used MS Office suite (Word, Excel, Access, Visio, Power Point, Outlook, and Project) for project tracking, documentation, and presentation.

Identified, organized, and documented the changing requirements of the project

Developed and executed test plans and test scripts for testing and UAT (User Acceptance Testing).

Conducted end user training sessions (125 + users) for exercising full use of the application.

Environment: Windows 2000, IBM Rational Suite (IBM Rational Requisite Pro, IBM Clear Case) Oracle 9i, Test Director.

HSBC Bank

Karachi, PK

Junior Analyst

Mar 05- Sept 07

The HSBC technology Group develops and applies advanced technology to the efficient and convenient delivery of banking and related financial services. Worked on HSBC Net Access, which is a free service (web-based interface) that provides 24-hour access to an individual’s credit card account information in a safe, highly secured environment. Facilitated the creation of a database for storing the customer details and their credit card information and eliminated the traditional method of maintaining ledgers/accounting books and generates monthly statements with different primary keys like card holder name his\her id, last name, date (issue n expiration) of the card. This system also facilitated printing of the statements on a monthly basis. Suggested Programming Methodology to streamline the process, effective management of time, money for the company

Responsibilities:

Collected and analyzed financial reports from the Banks of the entire state and resolved reporting problems directly with senior bank officials like Regional Managers, Branch Heads, Credit Card specialists and IT group heads.

Created trend variances to determined validity of banks mandated data

Contributed to the development of an automated processing system by writing user specifications and performing system testing.

Analyzed Business Requirement Documents, Functional Specification Documents to prepare Test Cases based on Test Plans.

Involved in verification process on a regular basis using checklists.

Utilized existing internal processes and improved those same processes for software problem identification, escalation, and resolution and facilitated project team meetings. Continually reviewed and revised project processes to ensure accurate and timely results.

Gained extensive Business Objects experience and the ability to spec, build and test reports

Prepared software test plan and test cases based on business requirements documents.

Performed positive and negative testing manually of the website to determine ease of website usability.

Manually performed Functionality and Security Testing during the various phases of the development of the online application.

Manually performed GUI testing to check for functionality and appearance of the website.

Performed software compatibility tests on various hardware platforms.

Provided feedback concerning completeness and accuracy of the Online Web application.

Coordinated with the developers on Defects Status on a regular basis.

Environment: Windows 98, Oracle, SQL, Microsoft Office suite (Visio, Power Point, Excel, Project), Business Objects, Load runner, Test director, Win runner.

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