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Sai K - Sr. Business Analyst/Product Owner(Healthcare)

[email protected]

Location: Hartford, Connecticut, USA

Relocation: Hybrid

Visa: H1B

Sai K Senior Business Analyst/Product Owner [email protected] 8609249369 Career Summary: 14+ Years of IT experience playing the role of Senior Business Analyst, Product Owner, QA Lead, QA Analyst; Certified in ISTQB, SAFe Agile, AHM250, OCJP, Certified ScrumMaster specialized in leading & managing the BA, QA teams works in Agile projects; QA Delivery Management with successful track record in Initiating, Planning, Executing, Monitoring & Controlling, Closing the projects in Waterfall/Iterative/Agile model. Participating in Project kick off meetings and understand the proposed changes. Analyzing the Business change and work with Product Owners, Business Team to finalize the requirements and writing stories in RTC. Provided Requirements walkthrough and clarifications to scrum team. Facilitate daily scrum calls, Sprint Planning, Sprint Retrospective, Sprint Demos and Triage calls. Schedule Working Sessions to understand and rectify critical issues for mapping and interact with cross domain business analyst to go over the issues. Participated in downstream and upstream teams Requirements sessions and proactively provided requirements clarifications to enable smooth functional flows across enterprise integrations. Worked as both onshore and offshore Business Analyst. Creation of features and stories for the respective sprint and facilitating sprint planning. As a Product owner, Conducting Sprint reviews and access the completion of the stories by end of sprint. Managing Product backlog, refining user stories and maximizing the value delivered by the team. Maintaining the scrum artifacts like Product Backlog, Sprint Backlog and Burndown chart. Experience in Agile Management and Software Development with SCRUM Methodology. Educate and reinforce Scrum Methodology & Agile Framework to new team members. Leaded team of 12+ resources in projects for Quality Control & Quality Assurance. Participate in Joint Application Design (JAD) session or kick off meeting/PI planning s with stakeholders to completely study/analyze the user requirements. Responsible in one hand for QA delivery and identify all the deliverables as part of project phases. Extensive experience in Test Management through documentation of Test Requirement/Testability Review, Test Strategy, Test Modelling, Training Effectiveness form and Delivery dashboard. Expertise in development of Test Scenario, Test Cases, Test Procedures & Traceability Matrix, Test Execution, Defect Logging/Tracking, Root Cause Analysis and Test Reporting. Leading, coordinating and managing offshore QA teams works in Agile Projects (Coimbatore; Chennai, Bangalore, Hyderabad & Bhuvneshwar). Facilitating Scrum Events (Sprint, Sprint Planning, Daily Scrum, Sprint Review & Sprint Retrospective) & Scrum Artifacts. Expertise in White Box Testing, Manual Testing, Automated Testing using tools Selenium IDE/WebDriver, TestNG, Jenkins, SOAP UI and Postman. Good experience on Selenium Automation using WebDriver. Good experience in creating automation scripts along with developing, executing and maintaining automation testing script with Selenium WebDriver. Good hands on experience in Web Services testing using SOAP UI, XML, & JSON. Providing required input data to request XML & get the required data from response XML & use the response data from other request XML using SOAP UI. Good hands on experience with Interoperability HL7, FHIR format. Accessing Clinical informatics and worked on requirements of transforming the data via Datastage. Good hands on experience with UNIX, COBOL, Datastage, JCL, DB2, EDI formats. Strong experience with SOA architecture, which include SOAP Web Service and Restful Web Service Testing. Developed Test cases manually and generated Automation Scripts using open source tools like Selenium Web Driver, TestNG, SOAP UI, Maven and Jenkins. Created and enhanced numerous test scripts to handle changes in the objects, in the tested application s GUI and in the testing environment using Selenium WebDriver. Hand on experience with security testing using Smart Bear Ready API tool. Expertise in documenting defects with high level of detail, accuracy, and informative recreation steps using Quality Center, ALM and RTC. Involved in executing SQL queries and PL/SQL procedures, functions and packages for backend testing. Used QC/ALM/RTC for bug tracking and reporting, also followed up with development team to verify bug fixes, and update bug status Accountable to lead the team for Test execution & handle the changes and get it approved from change control board based on impact of the project. Spearheading identification of Project Risk & Mitigate it to ensure project go-live smoothly on time with quality. Supporting SIT/UAT test, Smoke test, Prod checkout on Go-Live Date and prepare lesson-learned document, knowledge transition. Involved in QA Audit to ensure the quality standard follows across projects. Experience in Operational Activity, Resource Onboarding, Staffing requirements & Sub-Contractors Technical Skills: Web Technologies HTML 5.0, CSS2&3, JS 1.8 Languages Core & Advanced Java, COBOL Testing Tools Selenium, RFT, Splunk Smart Bear Tool SOAPUI (API),ReadyAPI(Security) Postman Tool API Testing User Story Tool RTC, JIRA Build Tool ANT/Maven Continuous Integration Tool Jenkins Configuration Tool GitHub Test Management Quality Center 9.0, ALM, RQM FTP Tool FileZilla, WinSCP Database MS SQL Server,DB2 DWH Tool Datastage Defect Tools QC,ALM,RTC Key Skills : Management QA Delivery . Test Management People Management, Transformation Levers Resource Optimization Project Methodology Agile Model, Waterfall Testing / Framework Functional & Non-Functional Web Service Testing Automation (Selenium) Testing , EDI Testing Cucumber, TestNG & Hybrid Domain Exposure Healthcare | Insurance (Eligibility, Member, Payor, Provider) Functional & Non-Functional Smoke Test, Security Testing System Integration, UAT & Regression Risk Based & Browser Compatibility Exploratory and ADHOC Test HL7/Interoperability QA Audit CMMI Level5 Test Management Agile Projects,Traditional Projects Estimation ,STLC phases, QA Metrics Certification & Accreditation: Software Tester Certified SAFe 4 Agilist Certified Scrum Master Certified AHM 250 Certified Software in Selenium Automation Testing Certified OCJP 6 Received the most prestigious Spot Light Award for Successful Knowledge transformation to cross application teams and delivering above and beyond Received Diamond recognition award for Performance and Collaboration Professional Experience : Project Name : EDH Decoupling & Strategic Propagation Client : Aetna/CVS Health Role : Sr. Business Analyst/Product Owner Period : Nov 2023 Present Description/Responsibilities : Strategic Propagation solution will improve accuracy of Provider Network data and lmore timely updates which will in turn improve auto adjudication, claim payment accuracy, reduce rework, reduce manual handling of error on IT and business side. Benefit Network Updates(Supplier location, Supplier, Practitioner Role, Practitioner and Supplier Network), UDT updates(Practitioner Role, Practitioner, Supplier, Supplier location) of Add and Replace, Demographic updates with PCP data. Full replace of benefit networks information for the provided data range, Add of networks could be multiple networks where the benefit network are tied to the entity for the data range specified and any other date ranges for the benefit network are left alone. EDH Decoupling: Rewriting of the entire Enterprise data hub integration of HRP(Health Rules payor) of Healthedge from Mark logic to ACE(IIB). This includes 47 transactions of Pass thru and Non Pass thru change logs from EPDB system to HRP. Processing of the all the 47 transactions including transformation of data from EPDB to HRP. High level transaction include Add Supplier/Modify Supplier, Add Tax Entity/Modify Tax Entity, Add Practitioner/Modify Practitioner, Add Supplier Network/Modify Supplier Network Environment : Web service, API, Soap UI, HRP, DB2, Selenium & Jenkins, RTC, RQM, MarkLogic, ACE Project Name : Interoperability Client : CIGNA Role : Sr. Business Analyst/ Product Owner Period : June 2021 Oct 2023 Description/Responsibilities : Interoperability Rule empowers patients, providers, and care givers by giving them access to electronic patient health information at no cost. Patient Access open APIs (Claims, Encounter, Clinical, Pharmacy - Covered Drugs, Formularies and Prescription Drug Claims) Provider directory & Pharmacy directory open API Validate FHIR Server (based on URL), FHIR HL7 Resources (request/ response) in XML or JSON formats API Implementation specification of resources based on ARCH, FHIR Profiles (USCDI), Argonaut Data query Implementation Guide Server, FHIR Server conformance, FHIR Consent resources & profiles, API Vocabulary & Content Standards (USCDI V1, HIPPA), Standards for electronic prescribing-Administrative Requirements Environment : Web service , API, Soap UI, Postman, SQL Selenium & Jenkins, RTC, RQM, FHIR, JSON, MarkLogic, IIB, APIC Project Name : Provider Onboarding/Credentialing Client : CIGNA Role : Sr. Business Analyst Period : Feb. 2020 Apr. 2021 Description/Responsibilities : To streamline the process by which a providers request to join Cigna network is received, reviewed and implemented. One smart platform integrated with third party data sources for eligibility and case creation through complete automation process. Create a reduction in onboarding and credentialing turnaround times and result in increased provider satisfaction. Credentialing is an important aspect of onboarding process. This process will be managed and automated by set of rules. Environment : Web service, API, Soap UI, Postman, SQL Selenium & Jenkins, RTC, RQM, JSON,Datastage, IIB, Salesforce. Mainframes, DB2. Project Name : Pronto Client : Aetna/CVS Health Role : Sr. Business Analyst Period : July 2018 Jan. 2020 Description/Responsibilities : Provider data innovation is the initiation project of aetna to reduce the incorrect data in the end system EPDB and to make the flawless provider data been access by end user. Provider data will be updated by the user from salesforce application and from external source that will flows to IIB, Data Router, Data stage and updates to end system. Environment : Web service, API, Soap UI, Postman, SQL Selenium & Jenkins, RTC, RQM, JSON,Datastage, IIB, APIC, Salesforce. Mainframes, DB2 Project Name : Pronto Client : Aetna/CVS Health Role : Sr. Business Analyst Period :July 2018 Jan. 2020 Description/Responsibilities : To Provide correct structuring of provider data in terms of networks and blocks with Network tooling applications. Blocks are logical entity which contains group of provider data in terms of sets. Environment : Web service , API, Soap UI, Postman, SQL Selenium & Jenkins, RTC, RQM, JSON, IIB, APIC, Mainframes. Project Name : AppStore Client : Aetna/CVS Health Role : Sr. Business Analyst Period : Jan.2018 June 2018 Description/Responsibilities : Aetna AppStore and Software Publishing Portal (SPP) are Inhouse Aetna applications which serves in delivering the user requested system software installation to the user machines Via an Auto application called AppToast. AppStore is the single platform for system software delivery for entire organization. Software Publishing portal is used to publish these system software to AppStore and version controlling of these software. Environment : MS Sql server 10.5, Service Now, APP Info DB RTC, RQM, Selenium & Jenkins Project Name : QNXT Migration Client : Aetna/CVS Health Role : Sr. Business Analyst Period : June 2016 Jan. 2018 Description/Responsibilities : QNXT migration is a version upgrade of QNXT system which impacts the Enrollment/Finance/Claims/Eligibility applications processing. All the internal systems which support the QNXT are upgraded to new servers and configurations. The applications are Care management systems, Health care Provider systems, Member Enrollments, Medicaid web portals, ID cards, CVS Eligibility,3M processing, Payment/Check Run processing, Claims, Adjudications and Claim recommendations systems for all the 17 different states. Enhancements are due to the Govt law change towards the business rules and tickets from the customer, either end user or health care providers. Environment : QNXT(Member/Provider/Claims processing), MS Sql server 10.5, 3M, Claims Adjudication, Enrollment Services(Enrollment Manager/ID Cards/CVS Eligibility), HP ALM, QTP Project Name : Medicaid Web Portal Client : Aetna/CVS Health Role : Sr. Business Analyst Period : June 2016 Jan. 2018 Description/Responsibilities : Medicaid web portal is a secure web portal that would be used by Providers, Members and Health Plan Staff (like Member Services, Provider Relations, Utilization management, Medical management) to access functions like real-time Member Eligibility check , Provider search, PCP search, Search claims, Search Remittances and so on that would assist their day-to-day operations and/or to be in compliance with regulatory requirement of the state. The key capability desired is the secure management/exchange of information between the Aetna Medicaid health plan and members and providers of that health plan, allowing for a greater degree of self-service. This porta will replace the aldera platform (which is called Above Health) which severs Members, Providers and Health plan staff in the current world. Project Name : EEMS IB to IIB conversion Client : United Healthcare Role : QA Lead Period : Sept. 2015 May. 2016 Description/Responsibilities : EEMS (Electronic Eligibility Management System) Application is a Java based system for Eligibility Billing & Accounts Receivable. The purpose of the E3 system is to process the files sent by customers and update the backend Legacy Systems. E3 is an important module in eBill. UHG has around 1800 corporate customers. IB is used to integrate various applications. It is implemented using See Beyond e*Gate Integrator. In the E3 project IB is used to send the data coming from customer and convert those files to corresponding XML format and send it to Gateway, read the response from the gateway and communicate it back to the corresponding Legacy System/Customer. The IB is now migrated to IIB to increase the processing capacity of the eligibility files. Environment : ALM, Ultra Edit, DB Visualizer, Putty, winscp, Quality Center, SOAP UI Project Name : EEMS DTR changes, EEMS OOP Max Client : United Healthcare Role : QA Lead Period : Feb.2015 July 2015 Description/Responsibilities : EEMS (Electronic Eligibility Management System) Application is a Java based system for Eligibility Billing & Accounts Receivable. The purpose of the E3 system is to process the files sent by customers and update the backend Legacy Systems. E3 is an important module in eBill. UHG has around 1800 corporate customers. IB is used to integrate various applications. It is implemented using See Beyond e*Gate Integrator. In the E3 project IB is used to send the data coming from customer and convert those files to corresponding XML format and send it to Gateway, read the response from the gateway and communicate it back to the corresponding Legacy System/Customer. New versions of gateway standard eligibility files need to process from the EEMS gateway. A new layout with extra eligibility fields were built to accept the customer data in EEMS portal, IB, Gateway and Backend DB2 tables. Environment : EEMS Portal, QTP, HP ALM, Data stage, UNIX, Monk script, IB, Rules Engine, Core Java, MQ, Ultra Edit, DB Visualizer, Putty, winscp Project Name : CES to CDB Migration CDB GUI and foundation Client : United Healthcare Role : Quality Analyst Period : Jan 2014- Jan 2015 Description/Responsibilities : As part of CES to CDB migration, the CDB GUI Update project is to enhance CDB GUI functionality to allow membership adds/updates. The CES function T updates will happen through CDB GUI after the migration. The CDB Foundation view cutover project is to migrate all the CES foundation views for portal updates (Myuhc, ISET etc) to CDB. Enviroinement : COBOL,CICS, JCL, File Aid, DB2, Endeavor, Xpeditor, Quality Center, Java, Adobe Flex, MQ series, SOAP UI Project Name : EEMS Client : United Healthcare Role : Programmer Analyst Period : March. 2010 Dec 2013 Description/Responsibilities : EEMS (Electronic Eligibility Management System) Application is a Java based system for Eligibility Billing & Accounts Receivable. EEMS 5010 is a Java based Dashboard tool environment integrated with various applications using EAI (Integration Broker). UI interface between EEMS and CES Unix server logs to verify the individual component present in EEMS application design Architecture. Environment : Java, Struts, EJB, Sql, HTML, Eclipse, DB2 Keywords: quality analyst business analyst user interface message queue javascript database information technology golang hewlett packard microsoft procedural language Idaho