Yamini Reddy Dontireddy Email: ade6bc@r.postjobfree.com

Sr. Business Analyst Phone: 978-***-****

PROFESSIONAL SUMMARY

Pursuing MS in Computer Science and Engineering from University of Missouri, Kansas City and graduating in Dec 2020

Over 7+ years’ experience in IT with focus on US Healthcare with experience in business analysis, requirements management, application development and testing.

Worked as developer, business analyst and scrum master leading 8-10 team members for a given project scope within planned schedule and cost meeting business expectations in terms of functional requirements and quality metrics.

Excellent understanding of US healthcare industry with specific focus on payer and provider businesses. Certified in Healthcare IT (AHM250 and AHM510) through Academy for Healthcare Management (AHIP)

Extensive experience in the full life cycle of software design approaches like SDLC (Waterfall model, V Model) as well as Agile.

Skilled/worked on projects leveraging technologies like Core JAVA, Tableau, Neo4j and Hadoop as well as on agile process tools like Rally, JIRA and RTC.

Experienced on Enrollment, ITS, Claims Processing, Reimbursements and Benefits on payer side and Patient Experience, CAQH on Provider side of business.

Hands on experience using Java, C++, Angular, XML and JSON.

Expertise in developing Web based Distributed and Front End applications in a three-tier architecture using J2EE, HTML5, bootstrap, AngularJS, Node.js and CSS.

Good exposure and experience in Web Services architecture using SOAP and REST APIs

Good Exposure in writing SQL queries for relational databases like Oracle 10g/9i/8i, DB2, SQL Server 2008, and NoSQL, MySQL etc.

Worked on Hadoop, Hive, Python for an academic project in UMKC.

EMPLOYMENT HISTORY

Accenture, India from June 2012 till Aug 2019 (Resigned from Accenture to pursue MS)

Joined as Associate Software Engineer in 2012 and promoted to Technical Team Lead in 2017 in 5 years; 3 level promotions since 2012.

TECHNICAL EXPERIENCE

Programming Languages: Java, HTML, SQL, C, C+

Java/J2EE Technologies: JDBC, Web Services, RESTFUL

Web Development: Angular, JavaScript, Node.JS, JQuery, HTML5

Development Approach: Waterfall and Agile

Web Service Protocols: SOAP, REST

Databases: Oracle, SQL Server, IBM DB2, MySQL, NoSQL, and Hadoop, HBase, Neo4J

Operating Systems: Linux, Windows XP/Vista/7

PM Tools: HP ALM, Rally, JIRA

Other Tools: MS-Office (Word, Excel, PowerPoint, Outlook, Access)

Healthcare Functional: EDI – HIPPA 277, 834, 835, 837I and 837P

ACADEMIC PROJECTS

Research paper and PoC leveraging Hadoop/Neo4J with use case of Location based pricing of Airline Reservation (Global Distribution Systems).

Social Media analytics on campaigns, sentiments, trends about Non Communicable Diseases (NCD) by leading institutions like WHO, Mayo Clinic, CMS, Anthem, Cigna and Aetna etc.

PROJET EXPERIENCE

Member Portal, BCBS, Tennessee Duration – Dec 2018 till Aug 2019 Team Size - 15

BlueCross BlueShield of Tennessee is the largest health benefit plan company in Tennessee. Working as offshore business analyst for Member Portal built using Availity.

Role – Business Analyst

Responsibilities:

•Solicit functional requirement from key stakeholders, provide impact analysis and solutions and document them in the Liaison between the IT Function and the Business.

•Understand, capture and document the business requirements across the business.

•Develop Use Cases as well as process mapping in line with detailed functional specifications for Sponsor validation

PressGaney Associates, nPGO – Analytics Platform Duration – Mar 2017 till Dec18 Team Size – 6

Project Description

Implementing a new, cloud-based architecture to improve the overall customer experience of PG’s analytics products that covers 26,000 hospitals across US that provide insights on Patient Experience, NDNQI, Safety and Employee Engagement. Scope also covers redesign of Press Ganey’s front end experience for the customer by moving all the products to a common interactive platform with role-based access for all the end users. Complex architecture involves Angular/Node JS interacting with Tableau with data layer on AzureSQL hosted on Azure platform. Authentication and roles are controlled by Azure AD tightly integrated with propitiatory products developed as part of this large SI program.

Role – Business Analyst

Responsibilities:

•Designed wireframes for Angular & Tableau dashboards.

•Solicit functional requirement from key stakeholders, provide impact analysis and solutions and document them in the Liaison between the IT Function and the Business.

•Develop Use Cases as well as process mapping in line with detailed functional specifications for Sponsor validation

•Provide knowledge transfer and Specification walkthrough for the Testing team and Support business user in UAT

Environment – Angular, NodeJS, Azure SQK, Redis and Azure Cloud

Highmark – Enrollment Duration – June 2015 till Mar 2017 Team Size – 4

Membership provides technical solutions to ensure the accuracy, availability and timeliness of the Member’s health coverage as well as making enrollment information protected, accurate and available to the other dependents to better serve our customers.

Other Party Information System is a software system that supports the Other Party Liability (OPL) Business. OPL staff review claims when member have other insurance and determine which insurance carrier has primary, secondary and tertiary responsibility for reimbursing the claims. OPIS with automate this process to ensure that Highmark does not pay for medical treatment first when other insurer has primary responsibility for the cost of that treatment.

Role - Business Analyst for Highmark

•Reviewed and analyzed business/functional requirements

•Supported the development of new requirements and enhancements to existing application features

Highmark – Claims /ITS Duration – August 2012 till June 2015 Team Size – 12

Claims Services Oscar System (CSOS) is the heart of the Claims system where OSCAR (Optimum System for Claims Adjudication and Reporting) is the engine for the Claims Adjudication and the Reporting. This System performs the critical tasks - Validation of the claim, determining the Eligibility and applying the appropriate Benefit rules and finalizing the Claims.

ITS is a set of common language data formats, software and procedures that allows Plans to access, send and receive data. It enables members to receive healthcare services while traveling or living in another BCBS Plan’s service area. RENO is the Reimbursement Notification system. The finalized Claims from OSCAR are sent to RENO so that it can produce subscriber, third party, provider, and facility Explanation of Benefits and checks.

Role – Developer & Business Analyst for Highmark

Responsibilities:

Reviewed and analyzed business/functional requirements

•Supported the development of new requirements and enhancements to existing application features

•Worked detailed design and coding in Java / JSP for front end and middleware changes

•Worked on DB2/Oracle DB changes based on the business requirements

EDUCATION

•Masters in Computer Science from University of Missouri – Kansas City, graduating in 2020 with GPA 4 in first semester (Dec 2019)

•Bachelors in Computer Science and Engineering from Jawaharlal Nehru Technology University, Hyderabad in June 2012 with 78.8 percentile.

AWARDS & COMMUNITY

•ISTQB Basic/Advanced – June 2013

•AHM-250 Certified – September 2014

•Awarded “Accenture Celebrates Excellence” twice in Accenture – June 2016 and Sept 2017

•Managed multiple CSR events to support NGOs through raising funds and organizing skill courses.

oHOPE Foundation – Nov 2014

oAshray Akruthi – Nov 2016

oHelpAge India – Sep 2017

oSai Seva Sangh – Dec 2017

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