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Business Analysis * Business Process Analyst * Project Management
Business System/Process Analyst and Project Manager with 12 plus years of Information Technology Industry experience in Business Operations and application development environments with system development life cycle (SDLC) experience
SixSigma Greenbelt, Certified Associate in Project Management (CAPM-PMI), Certified BA and certified Professional Business Process Management
Trained JAD facilitator and Experienced business analyst in gathering business and technical requirements, requirements documentation, business process modeling
Managed user for User Acceptance Testing, executed test scripts
Excellent writing, communication and interpersonal skills. A self-starter with eye for details, and quick learner
Managed huge cross domain projects as Project Manager and Business Process Analyst
Utilized UML use cases in the development of functional and technical software specifications for the application and BPMN for Business Process Diagrams
Experience with information protection (PHI), HIPAA compliance
Focus on cross-divisional coordination and collaborative approach to customer-centric solutions
Industry experience: Healthcare, Finance, ePublishing, Industrial automation and others
Green Card Holder
Business Analysis & Business Process Management Methodology
SixSigma methodology, Project Management, Requirements gathering, Business Process Modeling (visio), Business Process Improvement and Implementation. Methodology development, Data gap analysis, UAT test script development and execution, familiar with methodologies SEI CMM, PMI PMBOK, P.BPM, IIBA, SDLC, Agile, Waterfall and manual test.
Technical Skill Set
MS Office Suite (Word, PowerPoint, Excel, and Visio),
Operating System: Windows NT, Windows 95 / 98 / 2000/XP , Mac OS
Database: DB2, SQL, ORACLE, MS Access, Mainframe DB2
Tools: IBM Rational Clear Case, ClearQuest, Requisite Pro, Unified Modeling Language (UML
BPM Tools: Interfacing
Lead Business/ Process Analyst, DentaQuest, MA 2010- Present
As Lead business/ process analyst for Enterprise Commercial Web Portal initiative. Responsible to guide and manage the BA team. Interact with Business Owner/SMEs to defined AS-IS, TO-Be process models for various processes impacting Member, Providers, Broker.
Gather the Business system requirements and act as SME for the system and Business
Interact with vendors/IT team to manage the business requirements
Responsible for end to end commercial Web portal implementation.
Business Process Project Manager/Sr Business Analyst, Fallon Community Health Plan, MA 2009- 2010
As Project Manger and business process analyst defined AS-IS, TO-Be process models for Broker Commission Payment a more than $20 million dollar worth of financial implications
Implemented new Broker Commission business process with supporting policy and procedures and established Process Quality Assurance standards, central location for the documentation
Other Business Process projects handled are Mass Health TPL, MSP (Medicare Secondary Payer) with respect to Coordination of Benefit (COB)/Recovery of claims, Sales and Enrollment divisions. Data gap analysis for existing and required data for MSP,
Creating business process flow to capture the required data in future, define business rules to determine Medicare (Part C and Part D) Member Coordination of Benefit letters as required by CMS, Medicare Secondary Payer for members with Workers Compensation, No-fault and Liability insurance, Business Process Modeling for Broker Commission Audit
Creating business process and requirement gathering for Medicare Part D Explanation of Benefit (EOB) letters processing. Data mapping from pharmacy vendor files. And final dispatch to the print vendor
Creating Business process flow and requirements gathering for COBRA Subsidization for Operational, Billing, Communication, Market research divisions.
Working actively with Senior Management to define/refine the processes and optimize existing processes e.g.: Project Initiation Process, Project Change Control process.
Created BPM and Vendor selection criteria for MTMP program. Worked with Business SME and Architect to select the vendor
Other projects handled for business requirements gathering include Medicare (CMS), Medicaid, Conversion to new core system, and Group Health insurance
Lead the team for huge cross domain team as project manager/business analyst/business process analyst
Got nominated for ‘The Power of You: Essential Piece Award’
Business Analyst, Aetna Inc., CT 2005- 2008
The projects handled include Medical Management, Patient management, Case management, Disease management, Utilization management, Real-time Precertification Online/EDI transactions, Impact of Medical Management on Claims. Integrating vendor inbound feeds to Aetna Strategic systems, Directing the Medicaid Membership to right systems (Texas/CT), Medicare business (Retiree Health Access- pre/post 65), Provider network fortification, Government Compliance and regulation on preferences, Data sourcing to Data warehouse for Member Assignment and Member Identification process through Micro strategy and Flow control, and others
Responsible for running the requirement JAD session which consisted Business, IT, QA, Business Subject matter Experts and the end user
Created high level and detailed level Requirement Specification document. Both Functional and Non-functional Specification documents
Created Use Cases diagrams and Use Case Narratives for each business process impacted
Created User Interface mockups for all the User Interface changes
Worked with Application Architect to create solution and Software design documents. Worked with Information Architects to create Logical Data Models and Physical Data Models
Work with cross domain team to determine the source of data and mode to bring it onto consuming applications (Enterprise Business Services)
Responsible support Development team in understanding business requirements in technical language
Work with QA (Quality Assurance)team to resolve any questions and review Test Strategy, Test Plan and also review Test scripts
Work with UAT (User Acceptance test) team to create Test scripts and execute UAT
Update Lookup table data using Mainframe DB2, MS Access. Also use SQL to extract data for research
Be the integral part of Implementation for smooth deployment
Created Function Point counts
Provide transition overview to the production support team on the implemented project
Work with production support to resolve complex Incident Management tickets
Work with Project Manager from Phase 2 (business need defining) till the phase 7 (Post Implementation warranty period) to complete all project related activities
Work as Medical Management SME to Claims, Provider and other domains
Responsible for Requirement Management, Traceability
Lead the team for huge cross domain projects
Implemented projects successfully without any issues
Identified defects well in advance to avoid huge project delay
Helped resolve several IM tickets
Identified SME (Subject Matter Expert) mistakes to avoid redo of the work
Worked successfully with onsite and offshore team
Business Analyst/Associate Project Manager, Think Development System Inc., GA 2004-2005
As Business Analyst I was involved in Human Resource Benefit management project. Was responsible for the requirement gathering and preparation of functional specifications using UML Use Cases. Responsible for the test plan reviewing prepared by the Development and QA team
Involved in the quality assurance as part of acceptance test team
As an Associate Project Manager I was responsible for assisting the Senior Project Manager is costing, scheduling and resource management for the internal HR benefit management project
Business Analyst/Manager Technical Writers team, Mphasis Technologies Ltd, India 2001-2004
As business analyst worked with different clients for different domains
Sprit of America, Inc. USA (Finance domain): The client is retail credit card provider to Fashion bug and others. I was responsible for collecting requirements and working with SAS expert team and Technical development to come up with solution (algorithm) to client’s customer care interface in handling late fee process. I took Base SAS training to work on this project
American Medical Alert Corporation. USA (HealthCare): The client provided medical alert system to the senior citizens to be accessed in emergency. I was responsible to work with Business Subject Matter Expert and Business Process reengineering team to document AS-IS business process work flow and come up with TO-BE business process. Worked with IT development team to complete the business of customer support on emergency. Was responsible for creating business process modeling using MS Visio
Plant Automation Services. Inc. Houston. TX. USA (Industrial automation domain): The client provides software to the industrial automation. I was responsible to work with Product manager and technical team to document requirements using Use cases for the Centralized documentation system. Was also responsible for working with Technical writer to get the online and paper User Manuals for the system
As Manager to the Technical Writers team: I was responsible for managing the team allocation and training needs. I got company enrolled with Society for Technical Communication as member. Established web page on company intranet for Technical writers to share there expertise with rest of the teams
Mphasis Hospital Management product: The product provided hospitals to manage the patient information on admission at the front desk and provide the data to billing department on discharge. I was responsible define the business process flow and gather business requirements. Work with development team to make system changes.
Project Manager/Business Analyst, Digital Publishing solutions Pvt Ltd, India 1999-2001
As a Project Manager was responsible for cross domain team of 25costing, scheduling, resource management and implementation of the project
As Business Analyst I was responsible for requirements gathering, creating the Prototypes for WEB/ LIT/ROCKET/SOFT/PALM BOOKS using HTML/XML/Java script
Successfully handled projects, such as Addison Wesley Longman, Gemstar, Lightning source, Simon & Schuster, and John Wiley & Sons Publishers, as well as other stand-alone publishers
Masters in Economics, Gokhale Institute of Politics and Economics, Pune, India, 1998
CAPM (PMI)-Certified Associate in Project Management
P.BPM- Professional Business Process Management certified
Inquestra-The Business Systems Analysis Certificate Program (BSAC) (IIBA BABOK® compliant)
Business Analyst Training-(Pierson Requirements Group Inc)-Business Analysis, Requirements Gathering, JAD and User Acceptance Testing
Six Sigma Green Belt certification in process
Business Process Management and Individual Empowerment
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