SANKET S. BINIWALE,CMS

Sr. Business System Analyst

adfw95@r.postjobfree.com

mailto:adfw95@r.postjobfree.com

OBJECTIVE: To transcend in the field I am, to be marked as a leader in the company's growth, and to be an asset to the company. To work in a professionally stimulating environment and strive for excellence in all my endeavors, be profitable to organization, with integrity in thought and action, and concern for the organizational values.

CORE COMPETENCIES

A disciplined and self-motivated leader with 10 plus years of dynamic experience as Business Requirement Analysis, Release Management, operations Management, Quality and Team Management Operations in the Health Care, Insurance and Hospitality industry.

A top-performing, results-driven Business Systems Analyst who possesses strong analytical and problem-solving & organizational abilities. Possess a flexible & detail-oriented attitude. Highly proficient in working with clients and analyzing the business needs of Customers.

Expertise in all global solution. delivery activities of creating Business requirement documents, Effort estimations, Developing Test Case Scenarios and Test Plan and proving the same to testing team.

Expertly utilizes Project Planning and Management skills to successfully handle multiple projects at a time. Well-versed in all aspects of Software development life cycles SDLC such as Waterfall, Agile, RUP, UML etc.

Proficient at managing & leading teams for running successful process operations & experience of developing procedures, service standards for business excellence.

Created multiple deliverables such as BRD, SRS, FSD, Project Charter, Project plans, Feasibility studies.

Intense knowledge of Agile (Scrum) framework and efficient in solving all the impediments dealing with internal and external stakeholders.

Extensive working experience and knowledge about concepts of Healthcare domain such as HIPAA and FDA guidelines, Health Insurance coverage, Claim payment processing, Healthcare claim and Healthcare eligibility, Patient monitoring devices, Healthcare Clearing House etc.

Highly proficient in creating Unified Modelling Language (UML) diagrams like Use Cases, Use Case diagrams, ERD diagrams, Swim lanes, Sequence diagrams and activity diagrams using MS Visio, and Lucid Chart.

Thorough knowledge and working experience of SQL queries which includes Inner and Outer joins, SELECT statements, Adept in XML, JSON, loosely coupled Web Services (SOAP).

Meticulously created Test plan, Test cases, Test data, Test Scenarios, Test scripts, User Acceptance Testing (UAT), Manual and Automated Testing, GUI Testing, and familiar with Smoke and Sanity Testing and end-to-end Regression Testing.

Experienced in Defect tracking, Defect analysis and ability to organize, document and track changes using tools such as Atlassian JIRA.

Experience of conceptualizing & implementing various Quality Improvements projects and conducting audits for continual improvements in the services.

Experience in the Systems Development Life Cycle (SDLC), Rational Unified Process Methodology (RUP), RAD, SWOT, and CRM

Highly motivated team player and effective communicator with excellent relationship building & interpersonal skills.

Multinational and multicultural working experience with great internet and computer skills.

SKILL SET

IBM Rational ClearQuest, JIRA, Clear Case Web- Configuration Management, Requirement Gathering & Analysis, User Acceptance Testing (UAT), Enterprise Implementation, Project Management, Agile portfolio Management, Data Analytics, SQL,

Functional Modules: Central Product Library- FJA's Product Configuration Tool,

Methodology: Waterfall, AGILE

Software: MS Office Suite (Word, Excel, PowerPoint & Outlook), MS Visio, Adobe Acrobat, Lotus Notes. Sharepoint, MS Project tool, IBM Blueworks, Beyond Compare, JIRA, Trello

Operating Systems: MS-DOS, fWindows95/98/NT/2000/XP, Apple McIntosh

EDUCATION:

Master of Science in Project Management Harrisburg University, USA

CERTIFICATION:

Certified ScrumMaster® (CSM®)

Badge ID: 1244826,

Expiration Date: 07/14/2022

URL Evidence: 1244826-csm

PROFESSIONAL EXPERIENCE:

Horizon Blue Cross Blue Shield of New Jersey Jun 13 – Present

Sr. Business System Analyst / Assistant Project Manager

As a part of my assignment in Horizon’s I work as Business Analyst/ Asst. Project Manager in Central Product Library (CPL), a scalable data model that is reaching across all products of Horizon. Central Product Library is a robust, scalable repository to serve as a single source of truth for benefit information across the company. I also worked in Horizon’s data services area for Horizon data Hub – horizon’s data warehouse which gets data from multiple sources as Business Analyst.

Responsibilities:

Responsible in assisting Planning, Scheduling, Estimating, and managing each phase of the project.

Facilitated workshops to analyse business requirements, identify impacts, risks, and assumptions for Project implementation strategy.

Performed requirements gathering from the business users of the system while adhering to SDLC (Software Development Life Cycle) industry best practices.

Organized and facilitated meetings, which included Planning, Daily Stand-ups, Review & Retrospective

Leverage business knowledge for process improvement & construct documentations to work with Development teams on SDLC activities.

Managed key claims related projects such automated claims and report development.

Provided analytical support to projects based on claim reimbursement.

Performed benefit data mapping for migration projects from legacy systems (BIFS & NEAGS) to CPL.

Worked with project management lifecycle models, SDLC, UAT, business analysis, resolved any kind of issues related to system feeds as well as system upgrades with the IT team

Defined and managed the Change Management process and ensured team complies with the defined process in Horizon’s application upgrade projects.

Manage Horizon change management strategies including process improvement, training and communicating change at organization level.

Involve with Horizon vendor (FJA) and business stakeholders to improve change request process improvement.

Severed as a liaison between Horizon blue list project teams, Product vendors for development and downstream systems for change impact analysis.

Assist business stakeholders in doing Gap analysis and develop action plans.

Created new process which can resolve business stakeholder’s pain points and identify impact for downstream system.

Created the new CPL_ChangeRequest Process Flow for central product library by Visio.

Involved in Horizon Blue List projects implementation for HCA (Healthcare reforms) which included Patient Protection and (ACA)Affordable Care Act, upon Horizon’s existing product, Horizon Private Exchange, BeneFact Integration Mapping (Mapped 4000+ Variables), Telemedicine and Payment Innovation with HIPPA compliance parameters.

Lead the $1.5 Million project as Business Analyst of Central Product library’s Plan Configurator 2.0 application upgrade which was JAVA spring-based tool.

Conducted requirement gathering sessions involving with Horizon’s various business stakeholders from Sales Admin, Quality Assurance, Account Implementation and Underwriter area to write BRD and TRD using enterprise approved templates

Responsible to prepare Requirement Traceability Matrix. Involved in establishing Traceability between the Requirements and the Tests cases in Traceability Matrix.

Developed a new process for Group approval using IBM blueworks..

Prepared XML mapping for downstream system to map various healthcare benefits across web services using Ms Excel.

Did the in-depth analysis of Schema changes and compared old and new Schema using Beyond Compare.

Gathered and provide reporting requirements to Cognos system for generation of CPL reports.

Conducted sessions to review Use Cases and validating it with Business stakeholders.

Involved in identifying defects criticality and fix.

Involved in Quality Management activities such as Root cause analysis, Defect prevention, Risk register and Lessons learnt.

Responsible to plan and manage all release activity at enterprise level.

Provide Release coordination and communication before, during and after deployment for all systems scheduled for release.

Coordinate Release content and effort based on customer’s request for type of release i.e. Enterprise, Tactical, Exception, Emergency and NASCO releases.

Lead release health and deployment review meetings for enterprise releases.

Communicate all key project plans, commitment and changes in ClearQuest tool including planning and approving releases.

Lead and maintain Horizon BCBS release and deployment processes using ClearQuest.

Automate, streamline, create, and maintain release procedures.

Create weekly release schedule and discuss the same with infrastructure Change management board.

Review deployment Plan for each application scheduled in release.

Review outage time for each system and communicate the same throughout organization.

Provide approval for deployment request for all environment.

Coordinate with primary stakeholders regarding strategic release management planning activities.

Participate in overall team-wide preparations for release production implementations; build /maintain timeline; facilitate multiple cross functional walk-thru(s); work w/ individual deployment areas to finalize plans; publish Implementation, Communication Plan documentation

Provided cross functional support and resolved any functional or technical issues/queries in an expedited manner with horizon vendor (FJA).

Run Report and make changes to Output documents such as Customer Sign Off, Summary of Benefit and Coding Document using FJA’s Reporting Workbench.

Lead the migration project of Horizon Benefits across group and sub-group level.

Analysed and reviewed every Healthcare Benefit Change Request submitted by Horizon for migration to find out any impacts to the downstream systems.

Analysed the requirements associated change requests and connected requirements with Use cases.

Involved in preparing Document of Understanding, Business Requirement Document Documenting and Technical Requirement Document for various projects of central product library using MS word with enterprise approved template.

Run various SQL queries and do data validation.

Expertise in working in enterprise wide SDLC cycles, production, and non-production fixes, UATs, iterations/sprints, application, and process implementations/upgrades in both Agile and Waterfall environment.

Discuss the Scope locks for release with project managers and Business Stakeholders.

Performed Gap Analysis between the CPL Data and Downstream systems.

Prepared wireframe Mock-ups for new process changes, front end changes and benefit structure changes using Visio.

Participated Testing and Evaluation of projects at established integration points to assess progress and identify key functionality issues.

Worked in Data services area- HDH (Horizon data Hub) I was involved in various requirement gathering, map and gap analysis for Payment Innovation Finance project.

Managed and tracked change control process of requirements and design changes. Documented the changes, issues and their impact on the system design and delivery.

Performed requirement analysis by gathering both functional and non-functional requirements based on interactions with the process owners & stake holders and document analysis.

Express Script, Franklin lakes, NJ Apr 13 – May 13

Business System Analyst

Responsibilities:

As part of my assignment with Express Script, I was working on Benefit Administrator Application. Benefit Administrator was an application used to set the healthcare benefits for the customers.

Assisted JAD sessions to identify the business flows, GAP analysis and one on one meetings.

Prepared graphical depictions of Use Cases, Use Case Diagrams, State Diagrams, Activity Diagrams, Sequence Diagrams, Component Based Diagrams, and Collateral Diagrams and creation of technical design (UI screen) using Microsoft Visio.

Designed User Interface mockups to illustrate business needs. This ensures that the business requirements are met and that the software developers have a clear understanding of anticipated business results as dictated by business partners.

Experience writing User Stories for different requirements, providing defect status and taking meeting minutes

Conducted weekly meetings for deciding the Policies and Procedures to be followed at new sites.

Involved in all phases of software development life cycle (SDLC)

Allstate Insurance Company, Northbrook, IL Sep 12- Mar 13

Business Analyst

Responsibilities:

Headquarter in Northbrook. IL, Allstate insurance company (“Allstate”) is United States largest publicly held personal lines insurer. As part of my assignment I was working with Agency Gateway and 1View application. Agency Gateway was an application used by Allstate state agents for providing insurance coverage to customers and 1View was an application used by Call centre agents of Allstate for providing insurance coverage.

Acted as a liaison between the technology team and the business team by facilitating requirement gathering meetings and documenting requested features and changes to ensure timely and effective development of technology solutions.

Conduct business process qualitative and quantitative analysis; be a part of the Business team

and give regular updates to Development lead and QA team lead periodically.

Create Business system documents, work on UAT, testing and mapping documents.

Analyze user Requirements, conduct business/testing process analysis and gap analysis between systems and Cover any deficiencies as per the functional changes desired.

Participating in the Architecture Solution Design discussions, providing insight and thought

Leadership toward achieving optimal design

Helped develop data requirements, technical requirements, high-level design documents, detailed-design documents, unit test plans, system test plans, integration test plans, and user acceptance test plans for projects

Applied Unified Modeling Language (UML) methodologies to design Communication Diagram, Use Case Diagrams, Activity Diagrams and Sequence Diagram.

Prepare charts and diagrams to assist in problem analysis.

Study work procedures, information flows, production methods, Set operational specifications

And formulate and analyze software requirements as assigned.

Determine feasibility, cost and time required and provide estimate to project manager for my tasks

Test, evaluate and validate new functions and applications, and identify issues in software or Processes.

Saffron Group Inc., FL Jul 11-Aug 12

Operational Management Analyst

Responsibilities:

Responsible for all online marking, vendors support and improve inventory control system.

Analyse and prepare specifications for the improved functionality.

Develop a standard process for evaluation of the impact of an operation's potential query and the consequent communication of result to the management of our company.

Involved in creating business processes and Operational aspects for the business.

Maintain the understanding and awareness of our customers on all our services offered and provide recommendations for improvements and develop strategies to remain competitive in market.

Ensure that operational performance and service level are being met in accordance to our cost and budgeting expectations.

Supervise the customer service activities; ensure that the customer service activities are consistent, accurate and professionally done in keeping with our company policies and Image.

Provide fast and efficient response to business needs with the highest achievable result at the lowest cost to the company.

Devish Investment, TX Aug 10 to Jun 11

Operations Analyst

Responsibilities:

Gather information by interviewing employees, reading reports and combing through computer databases and determine which data are relevant and what methods should be used to analyse them.

Use statistical analysis, simulation and optimization to develop practical solutions.

Advice decision makers on the appropriate courses of action, write memos and reports to document their recommendations.

Develops project estimates by identifying phases and elements, personnel requirements, and costs.

Verifies results by completing tests.

Prepares customers to use system by conducting training.

Provides reference for customers by writing documentation; providing support and help.

Maintains systems by researching and resolving problems; maintaining system integrity and security.

Maintains quality service by establishing and enforcing organization standards.

Contributes to team effort by accomplishing related results as needed.

Shalimar Hospitality group May 07- Dec 07

Business Analyst

Use MS Visio to create Business flow, Use Cases, Sequence and Activity diagrams.

Prepared and review reports and conferred with the management and users about the functions and identified problems and any suggestions for improvement.

Helping the management and other teams draw business goals and needs

Establishing new data gathering and analysis techniques within the organization

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

Contact this candidate