Alok Kadam

Phone: (551)-580-6496 Email: alok.kadam@yahoo.com

PROFESSIONAL SUMMARY

Over SEVEN years of experience in Business / Systems / Data Analysis - Requirements

Planning, Management, Elicitation, Analysis & Communication - Solution Assessment &
Validation - SDLC - UML/RUP/Agile - Trizzetto Facets Healthcare - Medicare / Medicaid
- Data Warehousing/BI/Reporting.

BUSINESS ANALYST EXPERTISE:

 Proficient in interviewing stakeholders, documenting, troubleshooting and performing
requirement analysis using Use Cases
 Well versed in Rational Unified Process (RUP), Agile Development, Waterfall and
Software Development Lifecycle (SDLC) methodologies for application development
 Excellent experience in gathering requirements by conducting (Joint Application
Development) JAD sessions, interviews and questionnaires
 Extensive experience in collaborating and coordinating with various teams involving
Business Users, Systems Analysts, Developers, SMEs, Integrators, Data Modelers,
DBAs, etc to manage complex projects
 Strong business analysis skills and an understanding of the software development
life cycle (SDLC) and having thorough understanding of various phases like
Requirements, Analysis/Design, Development and Testing
 Experience in Center for Medicare and Medicaid (CMS) & State Government,
Medicaid / Medicare
 Proficient at creating and transforming business requirements into Software
Requirement Specification (SRS) using Rational Requisite Pro and Designing
Business Models using UML diagrams such as Use Case Model, Activity Diagrams
and Sequence Diagram in Rational Rose and MS Visio
 Knowledgeable in ANSI X12 standards both membership and claims transactions,
HIPAA (270/271,276/277,278,820,834,835,837P, 837I, and 837D), 27X, HL7, and
SOX regulations.

DATA ANALYST EXPERTISE:

 Expertise in OLTP/OLAP System Study, and understanding of various Data
warehousing concepts: approaches, Star/snow flake schemas, fact & dimension
tables, Normalization, Physical & Logical data modeling
 Expert in Feasibility Studies and Risk Assessment, making Project Plans, conducting
GAP Analysis, User Acceptance Testing (UAT) and SWOT analysis
 Worked on functional health plan areas including enrollment, member service, claims
processing, product pricing, and Medicare/Medicaid using Facets
 Experience in Data Warehouse development working with Data Migration, Data
Manipulation and Data Conversion
 Comprehensive knowledge of Web Portal Systems and hands-on experience in
portal design and layout

OTHER EXPERTISE:
 Strong analytical skills, resourceful problem solver with ability to work under pressure

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 Creative and aggressive self-starter and a versatile team player with excellent
analytical, problem-solving, communication and interpersonal skills
 Extensive experience in testing strategies and methodologies; functionality,
reliability, load/stress, usability, security and database testing
 Experience in working cross-functional groups, different levels of management and
liaison between system users, company management and development team

TECHNICAL EXPERIENCE

Business Modeling Tools
Requirement Tracking
Automation tools
Change Management Tools
Operating Systems
Web Technologies
Databases
Rational Rose3/4, Rational Enterprise Suite, MS Visio, Doors
Rational Requisite Pro 6, Mercury’s Test Director
Win Runner, Load Runner
Test Director, Rational Clear Quest 6.x, Clear Case 6.0/7.1
MS Windows, UNIX Linux
HTML, XML, ASP, XHTML, CSS
Oracle 9i, MS Access, Sybase ASE 12.5.x, SQL Server
2000/2005, Facets 4.31/4.5x

PROFESSIONAL EXPERIENCE

HealthNow New York Inc, Buffalo, NY October 2007- Present

Business Analyst

Environment: MS Access, Rational Suite, Facets 4.31 / 4.5x, MS Project, MS SQL

Server 2005, Microsoft Visio, Windows XP, UML 2.0, Rational Requisite 4.0, Rational
Rose 4.0, Sybase ASE 12.5.x

Responsibilities
 Involved in analysis of the technical specifications of the current system and the
infrastructure needs
 Prioritized the requests to fit the system and monitor feasibility
 Worked as a cross functional team member between the end users and the different
teams (Production Development Team, Testing Team, System Architecture Team)
involved in the application development for the better understanding of the business
and IT processes
 Converted Business Requirements into System Requirement Specifications
 Studied and analyzed applications and brainstormed to gather effective requirements
for a quality product
 Project implemented using the Rational Unified Process (RUP) Methodology to
produce artifacts in the different phases of the Software Development Life Cycle
(SDLC)
 Worked with Facets 4.31 / 4.5x, Facets interfaces, extension, Reporting & other
peripheral applications developments
 Scope definition, analysis, design, coding, unit testing, system testing, integration
testing, promotion and production support of Membership-Eligibility, Claims
Processing, Enrollment, Reconciliation, Group and Subscriber, Rate Category/Age
and Rate Component, Utilization Management (Inpatient, Services and Notes)

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 Translated client’s health insurance claim entries into HCFA dictated standard
formats
 Assisted the Project Manager in setting realistic project expectations and in
evaluating the impact of changes on the project plans accordingly and conducted
project related presentations
 Worked with FACETS data structures, data stores, and data relationships
 Created and maintained Data Dictionary and pursued to reach consensus.
 Played a key role in data domains like Claims, Provider, Member/Subscriber Plan,
and Accounting
 Enter claims data into system while interpreting coding and understanding medical
terminology in relation to diagnoses and procedures

MD Dept of Health and Mental Hygiene, Baltimore, MD August 2005- September 2007

Business Analyst

Environment: Rational Suite 4.0, MS Project, MS SQL Server 2005 / MS Access,

Quality Center/Test Director, UML 2.0, QTP, Microsoft Word, Excel, Power Point

Responsibilities
 Closely interacted with designers, integrators, modelers, SMEs and software
developers to understand application functionality, navigational flow and updated
them about the usability features that would benefit the end user
 Conducted walkthroughs with the end users and stakeholders to gather the
modification requests from the user to upgrade or change the business specifications
for the product
 Gathered User and Business Requirements through interviews and surveys
 Facilitated JAD sessions as a facilitator to gather business requirements and to
discuss different critical success factors of the project like Operational Feasibility
Analysis, Technical Feasibility Analysis and Cost Benefit Analysis
 Apply Unified Modeling Language (UML) methodology to create Use Case
Diagrams, Activity Diagram and Sequence Diagram using Rational Rose
 Prepared BRDs (Business Requirement Documents) supporting documents
containing the essential business elements, detailed definitions, and descriptions of
the relationships between the actors to analyze and document business data
requirements
 Played a key role in Medicaid, Medicare Part A, B, C, D / CMS
 Presented business benefits such as security, manageability, standardization, etc to
various business users
 Updated and modify progress and resources allocation in MS project for the team
and Set-up weekly meetings with the project team members to track the project
status.
 Developed SQL queries to analyze data and reviewed the Load test results

Healthbenchmarks Inc., Woodland Hills, CA May 2004- July 2005

Business Analyst

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Environment: Java, JSP, Requisite Pro 4.0, Rational Clear Quest 6.0, Test Manager,
MS Office

Responsibilities
 Coordinated collection of business needs. Converted high level requirements to
functional requirements and documented them in functional, navigational and page
Use Cases. Prepared Functional Requirements documents using the existing
templates. Documented business rules and functional requirements iteratively.
Imported these use cases into Requisite pro; tagged and traced them
 Developed use cases using RUP methodology for the technical team, which
consisted mainly of business rules, which were inherently related to the functions
described in the use case.
 Documented technical details including data source, file formats and data mapping
 Involved in writing use cases for medical, pharmacy and vision claims as part of
Health Statements
 Experience with gathering claims data and display of the same; also processing of
medical, pharmacy and vision claims as part of the Health Statements project
 Used Requisite Pro for requirements management to capture, prioritize and manage
requirements, which helped in controlling numerous artifacts produced by the teams
working on the same project by keeping track of simultaneous update, change
notification and multiple versions
 Researched claim overpayments and requested funds
 Actively involved in creating test strategy, conducted manual testing and logged
defects using Electronic Project Notebook and Clear Quest. Assisted testing team in
understanding the business rules and system development. Created users and user
groups to assist tester
 Executed SQL queries using SQL navigator to gather data elements from Enterprise
Data Warehouse
 Developed a comprehensive Test Strategy to determine how the testing would be
approached in terms of tools, people, procedures and support. This included test
management process, integration testing, description of test effort, test reporting plan
and the test case schedule

Datamatics, Bombay India April 2002- May 2004

Business/Data Analyst

Environment: Rational RequisitePro 3.0, Rational Rose, UML 2.0, SQL, MS Project,
MS Visio, Java, Crystal Reports XI, MS Office, Windows XP

Responsibilities
 Performed Gap Analysis to identify the deficiencies of the current system and
to identify the requirements for the proposed system
 Prioritized the requirements gathered from Clinical specialists, nursing
executives, domain experts through interviews, JAD sessions
 Created Process Work Flows, Functional Specifications, and responsible for

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preparing Software Requirement Specifications (SRS), Functional Specification
Document (FSD) for Nursing Outcomes Reporting application
 Developed Test cases and Use Cases and conducted User Acceptance
Testing (UAT), Functional System Testing, Integration testing and resolving the
various issues
 Created product documentation, printed user manual and training materials
 Developed queries using SQL to automate the weekly and monthly “Meds
Update Reports” and FCO reports
 Exported reports into formats like PDF, HTML, Excel, Word and RTF for the
users

EDUCATION
University of Mumbai, Bachelor of Engineering, Electronics and Telecomm, June 2001

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