Project Management/Business Process Analysis/Business Analysis

Summary

• Business System/Process Analyst and Project Manager with 14 plus years of Information Technology Industry experience in Business Operations and application development environments with system development life cycle (SDLC) experience
• Six Sigma 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
• 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 Product Development

Business Analysis & Business Process Management Methodology
Six Sigma 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) MagicDraw
• BPM Tools: Interfacing and knowledge of BPMN

Senior Business Analyst, Confidential. Wellesley, MA

• The projects handled include Sun Life Connect (external client website), QPS- internal Quoting, Policy System, Online Enrollment
• 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
• Work with User Experience Team for UI mockups for all the User Interface changes
• Worked with Data Architect to Logical Data Models and Physical Data Models
• 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
• Responsible for Business Rules, Requirement Management, Traceability

Senior Product Designer, Confidential, Boston, MA

• As Senior Product Designer on the (CareAdvance Enterprise) CAE designed several features for the product. It included both funded/non-funded projects. Worked with major customers of CAE.
• Provided Health Care Medical Management expertise to the team. Especially worked with Utilization Management work stream to help Development, and Quality Assurance team to produce business efficient product by providing Product design and business understanding.
• Worked with Product management team to understanding and provide advice on why certain feature in the product is/is not required. And it needs to be implemented.
• Created time estimates for all the projects for development and quality work.
• Made decisions to whether particular feature needs to be part of core product or custom development.
• Provided design advice to customer entered maintenance issues.

Business Process/ Project Manager/Sr. Business Analyst, Confidential, MA

• As Project Manager 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) MemberCoordination 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
• Managed project for vendor selection
• Established SDLC and Project Life Cycle framework

Achievements:

• 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, Confidential, CT

• 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

Achievements:

• 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, Confidential, GA

• 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, Confidential, India

• 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 their 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, Confidential, India

• 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, Confidential, Pune, India, 1998

Certification:

• 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