Information Technology Quality Assurance

Harish Chava Email:******.****@*****.***

Sr. Team Lead II Ph.No: 781-***-****

PROFESSIONAL SUMMARY

Detail-oriented professional with over 16 years of progressive Information Technology (IT) experience in Banking, Finance & Health Care Domains with a focus in System Analysis/ Quality Assurance on web based and client server applications. Leadership experience of over 8 years providing guidance to medium sized multi-functional teams and product management. Proficient in business scope definition, cost/benefit analysis, developing functional and technical specifications, creating business and application use case documentation, leading business and technical analysis sessions, supporting development and testing teams throughout the Software Development Life Cycle (SDLC) and nurturing exceptionally good client relationships.

SPECIFIC EXPERTISE

Goal Oriented Project Management, Business Process Analysis and Modeling, Testing: Planning, Coordination, Execution, Process Re-engineering & Analysis.

Leadership experience in reviewing departmental process documentation for improvements and modernization.

Management experience in leading medium to large teams in a high visibility environment supporting internal stakeholders and external Vendors.

Experience in creating organizational goals and performing year end employee evaluations as per the company norms.

Demonstrated high level of subject matter expertise in functional area supported to bridge gap between business requirement and IT solution. Provide technical direction and ensure compliance with best practice solutions.

Full life cycle System Development experience including Requirements, Analysis/Design, Development/testing, and Implementation.

Conducted Cost Benefit Analysis, ROI, Gap Analysis, Risk Analysis, Feasibility Analysis, Requirement Analysis, and then organizes review meetings with various Stakeholders and the end users aimed towards finalizing the Software Requirement Specifications.

Working experience in Agile Process working on story cards, sprint planning sessions and updating Jira.

Experience managing offshore OBP resources.

Experience in development of Use Case Diagram, Activity Diagram, and Sequence Diagram by using UML methodology using tools such as Rational Rose and MS Visio.

Extensive experience in producing artifacts like the Business Scope & Vision Document, Business Glossary, Business Modeling Guidelines and Business Use Case Models.

Working experience with Databricks, MS Access, Excel for data analysis/ modelling to create custom reports.

Experience working with backend claims financial data providing data analysis to balance General Ledger and external client financial accounts.

Used Elicitation techniques like interviewing, questionnaires, brainstorming, JAD, observation, and document analysis for requirement gathering.

End to end knowledge of NASCO Claims processing.

Created Test Strategies and Test Plans to effectively test the system and to measure the performance.

Provider Data management and credentialing experience.

Customer centric performance evaluation and measurements using KPI’s and OKR frameworks.

Experienced in checking and validating requirements in conjunction with the stakeholders needs.

Keen problem-solving skills allowing rapid assimilation and resolution of complex problems.

Excellent written and oral communication skills with the ability to communicate appropriately in business and technical situations at all levels.

Experienced in interacting with the Users, Developers and Testers, thus, able to work as a bridge between business users and IT teams.

Experience in leading a large team, providing strategic support and guidance.

Experience in Product management from ideation to deployment and management.

EDUCATION:

Master’s in Business Administration October 06 – Jun 09

Eastern Michigan University, Ypsilanti, Michigan, USA GPA 3.7/ 4.0

Bachelor’s in Computer Science & Information Technology Dec 2000-- April 2004

Jawaharlal Nehru Technological university, India GPA 3.6 / 4.0

TECHNICAL EXPERTISE:

Web Design and Maintenance.( Dream Weaver, HTML), Quality Assurance, UML

Working Knowledge of the Software Development Life Cycle(SDLC)

Operating Systems, Windows 98, XP, NT & UNIX, Networking and Fireworks.

C, C++,Oracle, PL/SQL, DB2,HTML Dream Weaver.

Microsoft Word, Microsoft Excel, Microsoft Access, MS Project, Microsoft Visio, Jira, Photoshop, SharePoint and Business Objects.

Excellent knowledge of PC hardware (Troubleshooting skills) and software application procedures

Financial reporting and data analysis skills using TSO, Databricks and WS_FTP professional.

RELATED COURSES:

Computer Sciences: C, Java, FORTRAN, VB Script, Database management (SQL), Networking, Web design and implementation

Information Technology: Network Structures, Communication Theory. Data Analysis, Information processing and application, Software Development and Design

Business Administration: Marketing Tools & Strategies, Crisis Management, Supply Chain Management (SCM), Accounting Principles and Management Skills, Strategic Management, Production Operations Management, Financial Principles, Project Management.

PROFESSIONAL EXPERIENCE:

Blue Cross Blue Shield of Michigan, BCBSM, MI. (June 2009 – Present)

Sr. Team Lead II/ Middle Manager.

Worked as a senior Team Lead of the File Maintenance Provider Team for the last 15 years working on various NASCO related modules and leading different medium to large scale enterprise-wide Projects listed below. Also leading the NASCO stabilization process working closely with PEDM, Provider Systems and NASCO in identifying GAPS in provider data, logging tickets, and implementing solutions to improve NASCO provider data integrity & Claims processing. As a customer-facing high volume intake area we average about 250 tickets per month from various stakeholders, providing claims and data resolution support adhering to strict SLA’s and process documentation.

Experience in coordinating with multiple stakeholders to identify system defects. Integral part of SHS MA data migration and claims processing on to NASCO platform. Responsible for process documentation and improvements catering to the needs of the external clients and vendors. Claims testing experience supporting various projects. Claim analysis and error resolution for both MOS and NASCO classic.

Working experience in NASCO Finance data using informatics to run weekly reports for executive leadership. Data analytics support to external accounts using Databricks and SQL matching General Ledger with NASCO claims databases, Purge pend reports.

Team Lead Responsibilities:

Resource planning and task assignment

Provider. Facility, Pricing data and claim issues SME support.

Collaboration with cross functional teams to solve complex customer issues.

Quality review, performance improvement management.

Resource Training and creating process documentation.

Inventory management.

Defect triaging, escalation and providing guidance for resolution.

Resource Payroll Management.

Responsible for project BRD review, SME support and ROM estimates.

Annual department goals creation and employee performance evaluations using KPI’s and OKR’s.

Responsible for departmental documentation review and process improvement.

Participating in client meetings to ensure System Level agreements and regulatory standards are met.

Strategic implementation of new technologies as per the trends and organizational direction.

Finance data integrity report pull for high priority accounts and external clients.

Providing reporting support to the executive leadership.

Responsibilities:

SHS Data migration on to NASCO Platform have been an integral part of this critical project identifying key NASCO system capabilities for successful transition and ongoing maintenance.

Blueprint NASCO implementation; RBCE & Sub RBCE data migration on to NASCO PMR system for claims processing.

Hospital, Provider Data Network Management and credentialing.

NASCO modules and systems HIQK, HEHK, TPOL, HRLK, BFAST, PMR, NAPS, EDI, Portico, CAQH, BCBSM Local System.

Provider data integrity and Network maintenance including Value based entities, DME’s & specialty hospitals.

Working with Customer service representatives for intake and resolution of issues/defect’s enabling accurate and timely claims processing.

Working experience in creating NASCO CSR’s and filing NCSC tickets for high priority issues.

General Ledger and Financial accounts claim data balancing and support.

Strong working knowledge of Provider Data, Pricing, Claims testing and healthcare business domain.

Strong working knowledge of Excel, MS access, SQL for data analysis.

NASCO claims testing and analysis support for Customer service representatives in handling various Provider, Facility and pricing claim edits.

Downloading data from TSO and WS_FTP PRO General Ledger balancing, financial data reporting.

Worked as SME with the business owners and developers in charting the requirements and business needs for new group implementations.

Strong Dental Network management and credentialing experience through Dentemax and DNOA.

Worked as an SME in Facility Enrollment and Reimbursement improvement process, helping automate some of the key Facility modules to improve pricing accuracy and claims processing

Worked as the lead analyst on NASCO PGIP data migration from Portico systems and also has working knowledge of the application of PGIP percentages on NASCO claims.

Claims testing experience identifying claim edits and spec review.

Acting as a liaison between the business users and development teams, eliciting business requirements, creating Use Case scenarios for data modeling and migration.

Perform data analysis and create custom reports utilizing MS tools such as Visio, Excel ad Access.

Validating the SIT and QA Pre Production environments for the PCA Project as part of the QA data verification & validation effort.

Writing test scripts and preparing test data for data migration and data conversion validation with a focus on these primary NASCO functional components.

Citizens Financial Group Inc, MA. (Dec 2008 – May 2009)

Business/Data Analyst

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Description: Citizens Financial Group Inc owned by RBS is a commercial bank holding company is a leader in providing financial and banking services in the New England Region. Citizens, is the eight largest commercial banking company in the United States. Worked as a Data/Business Analyst on the Basel II project which requires the company to create international standards in data capturing, validation and analysis. A thorough analysis of the historical data sets of various Commercial R/E and Loans was required to determine the type of data to be captured in order to build varied reports for the business users.

Responsibilities:

Gathered, Analyzed and Negotiated User Requirements through questionnaires, interviews, JAD sessions and Business Process Modeling using UML, producing Business Requirements Document (BRD).

Implemented RUP approach through the development process.

Provided detailed documentation including specifications, diagrams, and charts of the projects

Assisted in creating and modeling system architecture; creating mock ups using MS Visio.

Involved in Data Modeling and Data Analysis using SQL running daily scheduled routine reports manipulating large volumes of data; presenting reports to the Finance Business Owners

Interacting with the off shore Quant Team, responsible for the development of user reports and technical statistical analysis.

Responsible for the design, development, and implementation of the test plans.

Involved in Reporting all defects found during reviews and testing to management.

Facilitated User Acceptance Testing (UAT) with help of testing team; created UAT plan and UAT workflows; coordinated testing sign-off for go/no go decision.

Defined the “As-Is” and “To-Be” processes through interviews, questionnaires and existing documentations; created Activity/Process Flow Diagrams.

Documented Use Cases and held review sessions with Business Users.

Conducted walkthroughs in an effort to identify and realize the processes and flows involved in the new system.

Performed SWOT analysis.

Performed manual tests on the application and hardware systems.

Implemented Six Sigma initiatives for the project team and created documentation to support improvements in processes and reducing the risk of deviations.

Created documentation for the release that included Implementation Plan, Support Plan, and Support Training.

Personal Traits & Management Skills.

Ability to comprehend and analyze complex business problems.

Excellent verbal and written communication skills

Competitive and studious nature, with focus on constant improvement

Positive leadership style with constructive feedback.

Finalist for TOPS Business Partner organizational IT award.

Ability to manage large teams with transparency.

Excellent man management and program coordination skills.

Proven ability to work in different team environments, both as a member as well as a leader.

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