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HARINI RAJAPURAM

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HARINI RAJAPURAM

  1. 1. HARINI RAJAPURAM Email: rini5584@gmail.com; Ph: 8143230972 SUMMARY: Business Analyst with over 8 years of IT experience in all phases of the systems development life cycle, analysis, design, development, testing and implementation of projects. Extensive experience in analyzing and requirements gathering and writing system functional specifications including use cases. Excellent in developing and evaluating business process Models. Proven success as a business analyst through the years, providing a well-balanced understanding of business relationships, business requirements, and technical solutions. Strong experience in RUP Business modeling process. Full Software Development Life Cycle (SDLC) experience including Analysis, Design and Review of Business and Software Requirement Specifications. Proficient in analyzing data using Pivot Table and Pivot Chart Report Wizard in MS Excel. Expertise in Rational Rose, Rational Portfolio and Unified Modeling Language (UML). EDUCATION: MS in Electrical Engineering, Gannon University, Erie, PA Bachelors in Electronic and Communication Engineering, JNTU UNIVERSITY, Hyderabad, INDIA TECHNICAL SKILLS: Modeling Tools: Rational Requisite Pro, Rational Clear Case, Rational Rose, Rational Portfolio Manager, MS Visio, ETL, Informatica Testing Tools: Rational Clear Quest, QTP, Mercury Quality center, SOAPUI, SQL Server Management Studio Operating Systems: Windows 9x/NT/2000/XP, Windows Vista, LINUX Languages: C, C++, Java, HTML, UML, SQL, PL/SQL, .NET, XML Databases: Oracle, SQL Server 2000, RDBMS, TOAD, MS Access 2000, DB2, FACETS Software: MS Office 2000 (Word, Excel, PowerPoint, Outlook), MS Visio, MS Project Suite, SharePoint EXPERIENCE: Aetna, Phoenix, AZ 06/2016 –Present Senior Informatics Analyst • Designs and codes efficiently using SQL programs. • Extracts data from multiple sources and creates integrated analytic datasets and creates reports and studies to address business and research questions. • Conducts periodic updates of analytical routines and department production systems. • Investigates and evaluates alternative solutions to meeting business needs. • Participates in presentations and consultations to constituents on information services, capabilities and performance results. • Documents methods, specifications and findings clearly; contribute to writing and presentation of results, findings and conclusions. • Creates and evaluates the data needs of assigned projects and assures the integrity of the data. • Participates in the development of project plans and timelines. • Motivated and is willing to understand and probe into technical details and data irregularities. • Contributes to a motivated work environment by working effectively to achieve common goals. • Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes.
  2. 2. • Created stored procedures in SQL server management studio. • Experience in Medicaid Claims, Member, Enrollment, Provider, Medical Management, Lab, Payment and PHI data Protection • Knowledge of health care claims, products, and systems. • Experience in working in a data warehouse environment as well as the ability to work with large data sets from multiple data sources. • Working experience of analytic programming and Reporting tools and methods (SAS, SQL, OLAP, Business Objects, Crystal and Tableau). • Experience in statistical analysis and database management and analytical and problem-solving skills. • Understanding of relational databases, data systems and data warehouses. • Deep knowledge of health care industry, policy, research design, univariate and multivariate statistical analyses, predictive modeling, case-mix and risk adjustment methods and tools. • Demonstrated written and verbal communication skills. Able to present information to various audiences. • Knowledge of other reporting platforms such as: Business Objects, Crystal Reports, Microsoft Access, web development technology, data analytics, data mining, Tableau, InfoBurst Enterprise, Visual Basic. • Actively involved in Project tasks and time lines, prioritizing tasks. • Actively involved in user training. Aetna, Phoenix, AZ 03/2014 –04/2016 Operational Data Services Business Analyst, Data/QA Analyst & Technical Writer • Work with internal project managers and external subject matter experts to extract and document business critical data definitions and processing rules. • Working on the data mapping of healthcare related data from an external data warehouse HEDIS, QNXT, PlanAudit to the Aetna Medicaid Analytical Data Warehouse in support of the Coventry Health Care Medicaid data integration into Aetna Medicaid. • Define data transformation rules required to convert all source system data into the existing standardized data definitions found in Aetna’s Medicaid Data Warehouse (RDMS). • Develop standardized business metrics for use in reconciling external data sources to internal data targets. • Creating Test Strategy, Test Plans and Test Cases. Executing Test Cases and finding defects. Tools Used are MS office, SharePoint, SQL Server Management Studio. SQL querying with SQL server management studio. • Analyzing stored procedures in SSIS to reverse engineer the source and target data mapping rules. • Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Created stored procedures in SQL server management studio. • Responsible for creating UML modeling plans, process flows, and business requirements documentation using MS Visio • Experience in Medicaid Claims, Member, Enrollment, Provider, Medical Management, Lab, Payment and PHI data Protection • Working experience on QNxT TriZetto application, Infoburst and Crystal Reports. • Actively involved in Project tasks and time lines, prioritizing tasks. • Actively involved in user training. American Express, Phoenix, AZ 10/2013 – 02/2014 Sr. Business Analyst/Data Analyst
  3. 3. • Involved in migrating the applications from Micro strategy to Web Focus Reporting platform. • Involved in migrating the DB2 database to Nettezza platform. • Part of team to elicit, validate, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users, Vendors in the projects, including company employees, business partners, testers and analysts. • Facilitated requirements meeting, JAR/JAD discussions with business users and subject matter experts (SME) to elicit requirements. • Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team. • Worked with different business users and analysts by conducting interviews to collect requirements and business process information. • Gathered Business requirements. Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Assisted project managers with the development of project schedules, JAR/JAD Sessions, Project Presentations and manage scope using MS Project and MS Excel. • Experience in working with application developers, Technical Architects, Enterprise Architects, DBAs, QA Testers and User Acceptance Testers. • Responsible for creating UML modeling plans, process flows, and business requirements documentation using MS Visio. • Systems Documentation included Agile Charter, Solution Architecture Document (SAD), Product Backlog Document, Sprint Backlog, Release Plan, Test condition, UAT and Show and Tell, Mapping Documents, and Meeting Minutes Document. • Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes. • Actively involved in Project tasks and time lines, prioritizing tasks. • Logged the Issues, Change Requests in SharePoint and assigned to stake holders to do research and generate the business requirements out of the existing issue which leads to the solution of the issue. CVS Caremark, Scottsdale, AZ 04/2013 – 08/2013 Business Analyst • Experience with the Med D Website Portal, Facets. • Part of team to elicit, validate, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users in the projects, including company employees, business partners, testers and analysts. • Facilitated requirements meeting, JAR/JAD discussions with business users and subject matter experts (SME) to elicit requirements. • Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team, which provided the web-based underwriting solution. • Worked with different business users and analysts by conducting interviews to collect requirements and business process information. • Gathered Business requirements. Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Assisted project managers with the development of project schedules, JAR/JAD Sessions, Project Presentations and manage scope using MS Project and MS Excel. • Experience in working with application developers, Technical Architects, Enterprise Architects, DBAs, QA Testers and User Acceptance Testers. • Responsible for creating UML modeling plans, Sequence Diagrams, Activity Diagrams, Use cases, process flows, Wire Frames and business requirements documentation using MS Visio.
  4. 4. • Analyzed and modeled the system using Data flow Diagrams, Functional Diagram and Process Diagram. • Analyzed data from FACETS for root cause of the defects. • Proposed an object change management system to support object-oriented system design. • Analyzed business requirements from user interviews and then convert requirements into Technical specifications using Rational Requisite Pro. • Systems Documentation included Business Process Document (BPD), Functional Requirements Document (FRD), Mapping Documents, and Meeting Minutes Document. • Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes. • Logged the Issues, Change Requests in SharePoint and assigned to stake holders to do research and generate the business requirements out of the existing issue which leads to the solution of the issue. • Documented Database/Stored procedures specifications and defined the database constraints. Consulted with management and designed and developed several SOA processes and data management tasks related to the project, whilst developing all phases of the application. • Documented Maintained all the Project Changes Request (PCR), Route Cause Analysis Florida Blue, Jacksonville, FL 10/2011 – 04/2013 Business/System Analyst III • Experience with the migration of ICD-9 to ICD-10. • Part of team to elicit, validate, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users in the projects, including company employees, business partners, testers and analysts. • Facilitated requirements meeting, JAR/JAD discussions with business users and subject matter experts (SME) to elicit requirements. • Experience with information security and risk management issues on the Medical Transactions. • Experience in Medical Management, Medical data, Medicare, Medicare Advantage, Long Term Care(LTC) and PHI data Protection. • Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team, which provided the web-based underwriting solution. • Worked with different business users and analysts by conducting interviews to collect requirements and business process information. • Applications were developed in Risk Based SDLC. • Agile, RUP and NexMo methodology. • Designed and implemented HIPAA 835 Payment Advice Transaction, 837 Health Care Claim Transaction, 276/277 Claim Status Transaction, 270/271 Eligibility and Benefits Transaction, 278 Medical Clearance. • Populated ICD-9, ICD-10, CPT, HCPC, REV, NDC Disease code sets as per the standards. • Experience with transaction sets 835, 837, 270, 271, 276, 277, 278 and HIPAA 5010. • Gathered Business requirements. • Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Involved in Project Management by preparing Working Break down Structure (WBS) in Gantt chart. Used Rational Portfolio for project plans, process templates and work products. • Assisted project managers with the development of project schedules, JAR/JAD Sessions, Project Presentations and manage scope using MS Project and MS Excel. • Experience in working with application developers, Technical Architects, Enterprise Architects, DBAs, QA Testers and User Acceptance Testers.
  5. 5. • Responsible for creating UML modeling plans, Sequence Diagrams, Activity Diagrams, Use cases, process flows, Wire Frames and business requirements documentation using MS Visio. • Analyzed and modeled the system using Data flow Diagrams, Functional Diagram and Process Diagram. • Proposed an object change management system to support object-oriented system design. • Analyzed business requirements from user interviews and then convert requirements into Technical specifications using Rational Requisite Pro. • Analyzed XML, Java Scripts, SQL Server Queries and Pipe delimited format transactions, EDI Transactions to identify input and output data in Web Services. • Systems Documentation included Business Process Document (BPD), Functional Requirements Document (FRD), Functional Design Document (FDD), Software Architect Document (SAD), Technical Design Document (TDD), Proof of Concept (POC), Mapping Documents, Meeting Minutes Document and test plans using MS Word, MS Excel. • Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes. • Created the HIPPA segments using Edifecs and conducted review sessions as required. • Opened the Issues in MSPEM and assigned to stake holders to do research and generate the business requirements out of the existing issue which leads to the solution of the issue. • Documented Database/Stored procedures specifications and defined the database constraints. Consulted with management and designed and developed several SOA processes and data management tasks related to the project, whilst developing all phases of the application. • Documented Maintained all the Project Changes Request (PCR), Route Cause Analysis Documents, Service Center Tickets and Work Product Review (WPR) documents and updated them accordingly. • Participated in all the phases of testing, documented the “User Acceptance Test” scripts and participated in Regression testing sessions, verified the Business Scenarios on new builds to allow extended testing by the QA team once the system was in testing environment. • Created test cases for preliminary testing of SOA suite using SOAPUI. • Analyzed member provider, Authorization and Claims details in production databases (RDMS) using SQL. • Traced the application log files on the production servers (LINUX) to diagnose root cause errors as part of production support. Horizon Blue Cross Blue Shield, Newark, NJ 05/2011 – 10/2011 Project Business Analyst • Part of team to elicit, validate, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users in the projects, including company employees, business partners, testers and analysts. • Facilitated requirements meeting, JAR/JAD discussions with business users and subject matter experts (SME) to elicit requirements. • Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team, which provided the web-based underwriting solution. • Worked with different business users and analysts by conducting interviews to gather requirements and business process information. • Applications were developed in Waterfall Methodology and Agile. • Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Involved in Project Management by preparing Working Break down Structure (WBS) in Gantt chart. Used Rational Clear Quest for project estimates. • Assisted project managers with the development of project schedules, JAR/JAD Sessions, Project Presentations and manage scope using MS Power Point and MS Excel.
  6. 6. • Experience in working with application developers, Technical Architects, Enterprise Architects, DBAs, QA Testers and User Acceptance Testers. • Responsible for creating UML modeling plans, Sequence Diagrams, Activity Diagrams, Use cases, process flows, Wire Frames and business requirements documentation using MS Visio. • Analyzed and modeled the system using Data flow Diagrams, Functional Diagram and Process Diagram. • Systems Documentation included Business Requirement Document (BRD), System Input Process Output Customer Document (SIPOC) for both current state and future state, Process Maps for current state and future state of the system, Meeting Minutes Document using MS Word, MS Excel and storing them in SharePoint content management tool.. • Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes. • Documented Database/Stored procedures specifications and defined the database constraints. Consulted with management and designed and developed several SOA processes and data management tasks related to the project, whilst developing all phases of the application. • Assisting the testers in the phases of testing, assisting in documenting the “User Acceptance Test” scripts and participated in Regression testing sessions, verified the Business Scenarios on new builds to allow extended testing by the QA team once the system was in testing environment. • Analyzed member and provider details in production databases using SQL. • Traced the application log files on the production servers (LINUX) to diagnose root cause errors as part of production support. Blue Cross Blue Shield, Jacksonville, FL 09/09 – 05/2011 Business/System Analyst III • Participated with migration HIPAA 4010 version to HIPAA 5010 for all the EDI Transactions (270/271, 276/277, 278, 837P/I, 835) • Implementation of Multiple Mailbox to the user. • Dynamic Forms for approving Authorizations and SSO using SAML 2.0 • Experience with information security and risk management issues on the Medical Transactions. • Experience with the migration of ICD-9 to ICD-10. • Experience in Medical Management, Medical data, Medicare, Medicare Advantage, Long Term Care(LTC) and PHI data Protection. • Part of team to elicit, validate, organize, and document required functionality and constraints by engaging in iterative requirements gathering sessions with the various business users in the projects, including company employees, business partners, testers and analysts. • Facilitated requirements meeting, JAR/JAD discussions with business users and subject matter experts (SME) to elicit requirements. • Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team, which provided the web-based underwriting solution. • Worked with different business users and analysts by conducting interviews to collect requirements and business process information. • Applications were developed in Risk Based SDLC. • Agile, RUP and NexMo methodology. • Designed and implemented HIPAA 835 Payment Advice Transaction, 837 Health Care Claim Transaction, 276/277 Claim Status Transaction, 270/271 Eligibility and Benefits Transaction, 278 Medical Clearance. • Populated ICD-9, ICD-10, CPT, HCPC, REV, NDC Disease code sets as per the standards. • Experience with transaction sets 835, 837, 270, 271, 276, 277, 278 and HIPAA 5010. • Gathered Business requirements.
  7. 7. • Interacted with the End users, Designers and Developers, Project Manager to get a better understanding of the Business Processes. • Involved in Project Management by preparing Working Break down Structure (WBS) in Gantt chart. Used Rational Portfolio for project plans, process templates and work products. • Assisted project managers with the development of project schedules, JAR/JAD Sessions, Project Presentations and manage scope using MS Project and MS Excel. • Experience in working with application developers, Technical Architects, Enterprise Architects, DBAs, QA Testers and User Acceptance Testers. • Responsible for creating UML modeling plans, Sequence Diagrams, Activity Diagrams, Use cases, process flows, Wire Frames and business requirements documentation using MS Visio. • Analyzed and modeled the system using Data flow Diagrams, Functional Diagram and Process Diagram. • Proposed an object change management system to support object-oriented system design. • Analyzed business requirements from user interviews and then convert requirements into Technical specifications using Rational Requisite Pro. • Analyzed XML, Java Scripts, SQL Server Queries and Pipe delimited format transactions, EDI Transactions to identify input and output data in Web Services. • Systems Documentation included Business Process Document (BPD), Functional Requirements Document (FRD), Functional Design Document (FDD), Software Architect Document (SAD), Technical Design Document (TDD), Proof of Concept (POC), Mapping Documents, Meeting Minutes Document and test plans using MS Word, MS Excel. • Bridged the gap between AS-IS and TO-BE business process flows, Integration of process flow diagrams to show one end-to-end business model and process mapping exercise including swim lanes. • Created the HIPPA segments using Edifecs and conducted review sessions as required. • Opened the Issues in MSPEM and assigned to stake holders to do research and generate the business requirements out of the existing issue which leads to the solution of the issue. • Documented Database/Stored procedures specifications and defined the database constraints. Consulted with management and designed and developed several SOA processes and data management tasks related to the project, whilst developing all phases of the application. • Documented Maintained all the Project Changes Request (PCR), Route Cause Analysis Documents, Service Center Tickets and Work Product Review (WPR) documents and updated them accordingly. • Participated in all the phases of testing, documented the “User Acceptance Test” scripts and participated in Regression testing sessions, verified the Business Scenarios on new builds to allow extended testing by the QA team once the system was in testing environment. • Created test cases for preliminary testing of SOA suite using SOAPUI. • Analyzed member provider, Authorization and Claims details in production databases (RDMS). • Traced the application log files on the production servers (LINUX) to diagnose root cause errors as part of production support. United Health Groups, CT 03/08 – 07/09 Business Analyst • OBM is built using Access Database as a rating engine for all of its plan designs. • The database is used to store rates, apply mark ups and provides extracts for TPA (Third Party Administrator), web portals and proposal letters. Responsible in the new design and development of Medical Service Plan. • Performed feasibility, adaptability study and risk analysis to identify the business critical areas from the user perspective. • Responsible for creating and reviewing business requirements, functional specifications, project schedules, technical documentation and test plans
  8. 8. • Involved in requirements discussions with business units, ensuring all business requirements were satisfactorily met the user needs. • Gathered user/business requirements by meeting with business users and generated business models and use case analysis. • Interfaced with internal clients and technical vendors on new feature requirements and conducted a thorough analysis of the system features to assist project team with implementation of new features. • Conducted individual and group (JAD) sessions with business and technical units. Gathered requirements by interacting with the stakeholders by interviewing them, by preparing questionnaires and getting feedback, which helped in developing application according to HIPPA Rules. • Responsible for defining the scope of the project, gathering business requirements, doing gap analysis and documenting them textually or within models. • Involved in creating functional specification documents for the design, development and implementation of the project. • Analyzed and documented Business requirements and detail design of the software for full understanding of the business. • Contracted with the Medicare Centers and Medicaid Services (CMS) to provide quick, easy, and affordable access to the health care service of their choice. • Performed Compliance-checks on all inbound/outbound HIPAA-regulated EDI transactions. • Reviewed, examined, calculated and authorized insurance claims investigated by insurance adjusters. • Ensure claims are valid and settlements are made according to company practices and procedures. • Examined reports and similar insurance claims or precedents to determine extent of insurance coverage. • Documented Project issues, Project Progress reports and project Status Reports. • Involved in creating the Use Cases Diagrams, flow charts and process models using Visio. • Documented business workflows textually as well as in Activity diagrams according to the stakeholder review. • Participated in JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly. • Involved in maintaining and managing different versions of Documents using MS Visio. • Prepared and analyzed “as is” and “to be” workflow scenarios and performed Gap analysis designed new process flows and documented the business process and various business scenarios and activities of the business from the conceptual to procedural level • Responsible for creating and reviewing business requirements, functional specifications, project schedules, technical documentation and test plans • Involved in requirements discussions with business units, ensuring all business requirements were satisfactorily met. • Gathered user/business requirements by meeting with business users and generated business models and use case analysis. • Interfaced with internal clients and technical vendors on new feature requirements and conducted a thorough analysis of the system features to assist project team with implementation of new features. • Assist with data conversion activities and all levels of testing (functional, system, regression, and integration) as necessary. • Assisted the Project Manager in many project management activities like – Project Planning, Budgeting, Scheduling and Costing. • Used Microsoft Project extensively as a part of these activities. • Developed Business Process Document, Meeting Agendas, Project presentations using Power point and created Project progress reports.
  9. 9. • Extensively worked on Version Control, library services, work flow, lifecycle management, security and audit trails. • Extensively worked on MS Project for project planning for defining project management functions such as scoping, planning, estimating, scheduling, organizing, directing, controlling and closing PERT(Program Evaluation and Review Technique) and Gantt charts. • Designed new process flows for the existing system as well as for the enhanced system. • Involved in Writing Views and SQL Queries for the Crystal Reports and developed standard, cross-tab, On Demand and Drill-down Reports using Crystal Reports. • Customization of reports using Crystal Reports. • Participated in code walkthrough & internal/peer reviews on application code and other deliverables, Participated in status meetings with SSA counterparts when required. • Conducted and lead status reports meetings with the business and the IT team on a weekly basis. Assisted project managers with the development of project schedules. • Developed requirements and preliminary design for client applications. • Worked with developers, DBAs, System Testers and User Acceptance Testers. • Performed analysis and design projects using a systems development methodology. • Worked with all levels of client staff in solution definition. • Worked with the Project Manager / Work Order Manager to ensure problem resolution and user satisfaction. • Conducted technical review sessions and facilitated cross-functional project meetings as required. • Worked with project management to analyze change requests to determine what is being requested and programming required and Experience with creating relational Database. • Documented test cases during requirements gathering, analysis and design phases and loaded them into Test Director • Responsible for addressing, diagnosing and resolving issues that arise on a day-to-day basis for the team. Also responsible for documenting the causes, analysis and final resolution to the issues/errors (RCA – Root Cause Analysis). • Actively involved in User Acceptance Testing and Training of the end users.
  10. 10. • Extensively worked on Version Control, library services, work flow, lifecycle management, security and audit trails. • Extensively worked on MS Project for project planning for defining project management functions such as scoping, planning, estimating, scheduling, organizing, directing, controlling and closing PERT(Program Evaluation and Review Technique) and Gantt charts. • Designed new process flows for the existing system as well as for the enhanced system. • Involved in Writing Views and SQL Queries for the Crystal Reports and developed standard, cross-tab, On Demand and Drill-down Reports using Crystal Reports. • Customization of reports using Crystal Reports. • Participated in code walkthrough & internal/peer reviews on application code and other deliverables, Participated in status meetings with SSA counterparts when required. • Conducted and lead status reports meetings with the business and the IT team on a weekly basis. Assisted project managers with the development of project schedules. • Developed requirements and preliminary design for client applications. • Worked with developers, DBAs, System Testers and User Acceptance Testers. • Performed analysis and design projects using a systems development methodology. • Worked with all levels of client staff in solution definition. • Worked with the Project Manager / Work Order Manager to ensure problem resolution and user satisfaction. • Conducted technical review sessions and facilitated cross-functional project meetings as required. • Worked with project management to analyze change requests to determine what is being requested and programming required and Experience with creating relational Database. • Documented test cases during requirements gathering, analysis and design phases and loaded them into Test Director • Responsible for addressing, diagnosing and resolving issues that arise on a day-to-day basis for the team. Also responsible for documenting the causes, analysis and final resolution to the issues/errors (RCA – Root Cause Analysis). • Actively involved in User Acceptance Testing and Training of the end users.

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