Project Manager Quality Assurance

Sonal Raj

***** ******* ****** • Apt *** • Canoga Park • CA • 91304

818-***-**** • ********@*****.***

Senior Business Analyst / Project Manager

SUMMARY

An accomplished and target-oriented business analyst with extensive 11 years of IT industry experience. International experience and exposure to diverse technologies, cultures, and business operations. Experience in managing projects and expertise in analyzing the business system and their assimilation with technologies of the company. Achieved awards and certificates from reputed companies from UK, USA. Best record in successful implementations of services for the company.

Excellent analytical, design, documentation, testing and managing skills. Acquired knowledge of IIBA- BABOK Skill level for business analysis, system analysis. Thorough domain knowledge of Credit card authorization, Online Retail Store and US Healthcare Insurance (AHIP Certified US Healthcare Insurance professional). Experience includes managing onsite/near-shore/offshore model execution as part of Global Delivery Model with CMMI level-5 companies.

BUSINESS EXPERTISE

Business/System Analysis Project Management as per PMP practices Team Building

User Trainings Interviewing skills for HR Recruitments Gap Analysis

Requirement Management Risk Management Designing Problem-solving skills

Technical Expertise Cost Reduction Strong Documentation skills

Quality Assurance Software Verification and Validation Client Cultivation

Process Streamlining Knowledge Management Event Organization Innovative Analytical Skills Effective Writing Skills Communication Skills

ACHIEVEMENTS

Best Performance Award by American Express (UK – BRIGHTON). (2002)

Infosys Best Project Award - Infosys Technologies, INDIA. (2003)

Outstanding Performance for Chickering project - Certificate by Aetna INC, USA. (2004-2006)

Outstanding Performance for Aetna Navigator project - Certificate by Aetna INC, USA.(2004-2006)

Extra-ordinary contribution and outstanding performance – Wellpoint (USA). (2008)

“Initiatives” Performance Award by UST Global Inc. (2008)

AHIP Certification for US Healthcare professional (MHP Program) by HIAA USA. (2008-2010)

TECHINICAL EXPERTISE

Microsoft Office Professional – Microsoft Word, Excel, Powerpoint, Frontpage.

Mainframe and client applications for underwriting, actuarial and document management.

Operating System: MVS/OS390, Windows NT, Win 2000, WIN XP, IE 5.0, IE 5.5, IE6.0, NS 4.0, NS 7.0.

Web Portals for Healthcare Insurance, Retail Online Store, Credit Card Authorization.

Experience on Stratus System and Voice recognition system.

Details:

LANGUAGES PL/I, COBOL, CICS, IMS DB/DC, JCL, VB 6.0, HTML, and Java Script, Java (JDK1.2), advanced Java,C Language.

DATABASE DB2, IMS DB/DC, SQL Server, MS Access, D2K, PL-SQL, SQL* PLUS Editor, MATLAB.

WEB SERVERS SQL Server

TOOLS Rational Requisite PRO, Rational Clear Quest, Ezytrieve, Changeman, Endevor, Infoman, File-Aid, Xpeditor, Ezyedit utility, Luhn Method, STARTOOL for mainframes, Crystal Reports, Sharepoint, Planview.

OTHER VSAM, IDCAMS, SORT Utilities, MATLAB for Voice recognition system, UML, Stratus System, Use of Windows NT/2000/XP, Netscape.

WORK EXPERIENCES SUMMARY

AHIP Certified IT Professional with eleven years of experience with Insurance majors like Blue Cross of California (Wellpoint), Aetna Insurance, Guardian Life Insurance, North Western Mutual and Credit card major as American Express. IT experience in the field of business analysis, project management, Business process design, Process streamlining, application systems analysis, Quality Assurance and software verification and validation. Hands on experience of full life cycle of Software Development Cycle (SDLC). Worked on projects following standards as HIPPA, SOX Compliance, Six Sigma, CMMI Level 5 and IEEE Standards.

Highlights of responsibilities performed are as follows:

* Interacting with all necessary stakeholders to help define functional requirements relative to various healthcare insurance business initiatives.

* Expert in solving complex business issues with information systems and capable of providing problem-solving solutions in identifying, evaluating and developing systems. Identification of the solutions as procedures which are cost effective and meet user requirements.

* Working with best practices and company guidelines of International Institute of Business Analysis (IIBA), Project management Office.

* Conducting effective requirement group reviews, walkthroughs for project documentation with stakeholders.

* Complete and thorough testing for the entire SDLC, including version and change control and new software rollouts, helping project team to get to zero defect deliveries.

* Provide excellent documentation for project charter, project plan, scope definition in Business and Technical

Requirement Documentation, Use cases for functional and non-functional requirements using UML, Functional

Specification documentation, Functional Design, Requirement Traceability matrix, Defect management related

documentation, Test Scripts, Test results, release documentation, implementation plans, reports.

* Customer satisfaction has been a focus while maintaining accuracy in documented business requirements.

* Healthcare Insurance experience include knowledge for Individual and Group Insurance for Wellpoint covering

different plans of BC Life and Health such as Medicare – MEDRISK/Dental, PFFS, HMO, MA, MSA, MAPD, PDP, Life Plans information for Membership and Billing in WGS 2.0 System, STAR System at Wellpoint Inc. HIPPA Standards for Healthcare business processing with Privacy rules, transaction and code set rules (such as 270, 271, 276, 834, 835, 837, 278, 997), ICD-9, Creditable coverage information.

* Healthcare domain knowledge for Aetna Inc covering different plans such as Indemnity, HMO, PPO, Aetna choice QPOS, DMO, Managed Care plans information. Recent experience with Medicare Supplement, Blue Cross Products, Life insurance, Medicare plans. Guardian Life Insurance experience includes plans such as Basic, Life Ad & D, Supplemental Plans.

* Excellent skills in Business Analysis, OO Analysis, Data Analysis, Requirement Analysis, Business Modeling,

Business Process definition, Risk analysis, Use case Analysis, Data Flow Diagrams (workflows). Modeling business

Requirements, business processes and proposed business systems conceptual solutions using the Unified Modeling

Language (UML).

* Managing requirements from project inception through release. Skilled in eliciting user demands and translating them to data, functional, quality and usability requirements.

* In depth knowledge of Iterative Software Development Life Cycle process Proficient in Rational tools including

Rational Clear Quest and Requisite Pro. Defect management using the tool Rational Clear quest. (RUP)

* Quality related experience include following : System Testing, Integration Testing, End-to-End testing, Performance and User Acceptance testing, Test Plan and Test Scripts, Manual and Automated Testing, Test result Analysis and Reporting, Successful Implementations and warranty support including break fixes, change requests.

* Mentoring, Leadership, Innovative skills, Time management, Release Management co-ordination, People management.

WORK EXPERIENCES DETAILS

Client: Wellpoint INC. Associate Consultant Jan 2006 – Till Present Role in Company: Sr. Business Analyst/ Programmer Analyst/ Project Manager

Domain: US Healthcare Insurance

Project Details: All the projects mentioned are for a fortune 100 Healthcare Insurance Company.

Online Retail in a Box Nov 2010 – Till Present

The Project involves building first online retail shop reference model for company. Use cases for each functionality of Online Retail in a Box feature with all related process flows was a crucial part of this project. The uses cases for Shopping cart and related features, Checkout procedure, Address and account information, registration for inline customer, order management, order fulfillment, Product and category management related all features needed to be documented online in a systematic approach.

ESI Migration for STAR System Jul 2010 – Nov 2010

Health care reform has affected us all in the healthcare industry and will continue to transform our strategy, processes and products, which will result in significant technology changes. All the business at client was supported by NextRx, Pro-Serve and ProPBM systems, which was being migrated to ESI. The old integration points that NextRX had across WellPoint need to be replicated with ESI to support the integration and future operating model of supporting client’s medical products coupled with ESI pharmacy products. STAR, Medicare Supplement Groups, Data Warehouse, LITES, Quality Assurance and Finance systems have been affected by this requirement.

The project involved support for analysis, testing, implementation and post-implementation activities (Warranty Support). The project was challenging as continuous change in requirements and deliveries in very short period of time. Business Areas: Small Group, Individual, Senior, SSB plans, Unicare Plans.

Responsibilities: Major task of getting through the project in critical condition with very less time and all new resources to be trained was bit of a challenge. I trained all Manila (Philippines) and India offshore team to get clear picture of this big project with business and system knowledge transfer. I was only onsite contact involved in requirement gathering, analysis, design documents, testing (System testing, Integration testing, User acceptance testing), Reporting, Managing team work, Implementation, Warranty support and change requests with new additional requirements for ESI, SaveScript, MedVantx Systems.

Medicare Supplementary 2010(Stop Gap table) for STAR System Jan 2010 – Jun 2010

New Medicare supplementary products needed to be on the Star Membership system for 2010. The project involved support for analysis, testing, implementation and post-implementation in very short duration of time. Daily deliverables were made to get through the aggressive schedule. The project included various Medicare Supp plans for different states nationwide as CA, NV, GA and WA.

Health Programs Incentive Standardization Jul 2009 – Dec 2009

(Eligibility and Membership on WGS 2.0 and STAR system)

HMC is one of the nation’s largest, most experienced leaders in integrated care and total-population health solutions. Founded in 1983, HMC is a pioneer in providing quality health solutions for employers and health plans. HMC is part of the WellPoint family of companies. WellPoint and its affiliated health plans are committed to improving the lives of the people we serve and the health of our communities.

The objective of Health Programs Incentive Standardization project at Wellpoint was to satisfy HMC standardization and Incentive re-architecture requirements. The objective for HMC Standardization was to offer flexibility for customers to offer the same HMC programs for Gen C (consumer-driven health plans) and non-Gen C (HMO, PPO, etc.). The objective of Incentive Re-architecture was to expand incentive capabilities by building a consolidated, centralized technical platform with consistent rules and incentive adjudication across medical products.

The above two projects would utilize the same infrastructure to support eligibility and benefit transactions for incentive programs and HMC coaching programs. It affected all functional areas responsible for activities related to HMC program eligibility and billing, as well as incentive processing and all market segments and Gen C systems at Wellpoint.

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