Senior QA Lead
NASCO
Total years of experience :15 years, 0 Months
Roles & Responsibilities:
Project: NASCO (MembersEdge - U10, MO and NPS)
•Involved in Automation Team to run all the Automation Related Test cases and run the scripts related to the Project during Shake Out and Regression Testing
•Responsible for identifying new Automation requirements for future releases and increase the number of Test cases that can be automatable
•Creating new test scripts based on test cases for the Automation team for future releases using Rational Functional Tester
•Team Lead in MembersEdge in Shakeout Testing, SIT (System Integrated Testing) and Regression Testing
•Created and maintained System Architecture Document (SAD) Requirement Traceability Matrix (RTM) and created document management tracker to upload deliverables on timely manner for CMS (Centers for Medicaid and Medicare Services)
•Thoroughly reviewing the Requirement documents with the Product BA, Technical Team and Providing feedback for Testability to make testing easier for the Team
•Developed many reusable functions using automation tools which also handles negative scenarios and reduced team effort to a very large extent
•Going through the Project Initiation from the Vendor (PIV) documents, Understanding the Existing and New Process to be implemented for the Release
•Thoroughly reviewing the Requirement documents with the Product BA, Technical Team and Providing feedback for Testability to make testing easier for the Team
•Helps the Team in Designing Test cases for the Projects and Executes the same
•Explain to the Plans (710, 780, 700, 690, 590 & 915) and NASCO SME’s about the requirements, Test cases and Enhancements assigned to the Team
•Developed many reusable functions using automation tools which also handles negative scenarios and reduced team effort to a very large extent
•Raising Defects into Clear Quest during execution, if identified and follows up with the Product and Technical team to resolve the raised defect.
•Works with the Team in executing Multiple Projects and delivering the Projects On time
•Identified Regression Test cases for the future releases and also help the team in executing the same
•Attending Daily status calls and sends Daily Status reports to the On-site Clients
•Maintains and Updates the Issue log, Defect log and Query logs for Quality Assurance. Also helps the team in triaging the Issue they face during execution
•Effective management of the resources and sending Project status to managers and On-site Coordinators
•Trained new resources on Billing (Premium and ASO) Membership (AE-834, AE-NPPE) and various other functionalities on MembersEdge
Environments: Model Office, U-10, U-30, PROD, MWC, NPS, PDM, RFT Tool, Clear Quest, Compliancy Tools
Roles & Responsibilities:
Projects:
ICD9 to ICD 10
•Involved in updating the current scripts based on Test Plans, Test Scenarios and Test Cases, for all Plan specific CSR’s
•Managed scope, planning, tracking, change control, and testing aspects of the project
•Translated customer requirements into system level requirements and high level design documents. Established specific solutions, and led the efforts in delivering the end product for the client
•Conducted joint test workshops to explain projects to the testing team for multiple projects.
•Gathered requirements to determine risk probability, gap analysis, documented flows, vendor evaluation and implementation plans
•Prioritized UAT scenarios and create training modules for end users
•Analyzing the task and distributed the work to the Team members and review of all day to day deliverables
ICD Pricing
•Prepared checklist and verify the functionality for multiple projects before it gets delivered into the various environment and production
•Engaged in full SDLC to maintain project schedule, and SDLC coordination of the business analyst team to coordinate the client's business needs.
•Engaged in full STLC, coordination of the QA team, and defect reporting, making test strategy, and master test
•Understanding the TDR (Test Data Requirements) and executing the Test Cases based on the given HLR’s
•Performed root cause analysis for the change request and present to the customer
•Actively involved in all the Frontend and Backend Job Extracts for Validations
Regression
•Create Quality Test Conditions/Scripts with reference to CSR & TDR documents to develop Test Scenarios/Test Cases based on the requirements
•Transferring the files to Mainframes using NDM(Network Data mover)
•Built a predictive model to identify customers who are likely to churn by using logistic regression for Exchange Business
Health Care Reforms
•Involved in Testing the coded string behavior in Model Office Environment
•Coordination with the Testing Teams for the Failed Defects
•Escalated the issues to the testers and verified the fixes received
Environments: Model Office, NPS, PDM, RFT Tool, Clear Quest, Compliancy Tools
Worked on the Hushpuppy tool to (QC) Quality Check the Product based on its Audio and Content which helps in rating the book for Approval or Rejection
•Working closely with the development and business teams to communicate Impacts and to understand Business requirements
•Ensured traceability of cases to requirements, working with the Project Business Analyst to ensure all requirements are tested
•Worked with the Technical Analyst to identify Unit Testing Coverage and ensures any gaps found are documented and addressed
•Worked with the Testing Coordinator to ensure testing of functional areas is complete, tracked and On-schedule
•Executed UAT Testing on the End Product that is going to be delivered to the Client
Participating in JAD sessions, finalizing BRD / BTRD and creating high-level designs for the technical and configuration team
•Manage the collaboration with users, analyze and redesign Billing and Enrollment processes.
•Designed and Developed an Informatica Mappings which generate an XPF Keyword File (Target Flat File) which will be loaded into the target tables using Facets XPF import batch job.
•Documented the impact of migrating from the HIPAA 4010A1 transaction set to the HIPAA 5010 transaction set.
•Worked on the three components of HL7 EHR system functional model and standard, functions within model, and content management components.
•Worked on EDI X12 transactions, HIPAA standard transaction codes including 837, 835, 834, 270, 271, 276, 277, 278 and performed analysis and testing of such transactions.
•Worked with XML Designer to create and edit XML Schema files.
•Have done analysis on HL7 that establishes criteria for representing and communicating data associated with health care.
•Understanding business requirements for AS-IS existing and TO-BE for Group Member Billing.
•Involved for defining the data conversion meetings and historical requirements and build systematic data conversion programs accordingly and provided Facets prospective in those processes.
•Have experience on HL7 Messaging Standard which is the workhorse of data exchange in healthcare.
•Conducted QA/Business Analysis on 4010, data mapping and testing 837 and 835 transactions
•Assisted in troubleshooting advanced legacy data to XML conversion.
•Involved and interacted across the Island approach followed by PBM Eligibility for the migrated members will reside on Medisys in the FACETs hierarchy.
•Intensively in involved in the Data Mapping meetings and process, used Crosswalk file prepared by Enrollment system (Medisys / Facets) and updated the Files (Design Documents) to send required field values to the downstream system for their payment to providers.
•Extensively involved in the analysis on conversion of Claims and Members files from legacy systems into Facets and to its downward systems.
•Performed Facets Data Analysis and data mapping between Facets Data elements and downstream system's requirements.
•Good knowledge on Data Models and their relationship between all functional areas.
•Worked on Membership information info. related to Payment methods and Associated Bill date for the selected payment method required financial system - People Soft Account Receivable system (PSAR).
•Worked on design documents related to Membership Eligibility Information file / interface, feed to PBM system for PDP migration in Medicare PartD project.
•Worked on Low Income Subsidy and Late Enrollment Penalty Reconciliation in Medicare Part D.
•Worked on Bill Print information system for Taglines with Bank info related to Billing area in Facets.
•Updated different Interface design documents and Mapping documents to satisfy business needs for advancing the PDP migration project.
•Provided Technical inputs from Facets perspective in the BTRD completion process for satisfying the downstream system's needs especially to PBM.
•Extensively involved in Membership Enrollment and Billing area by updating the Design and Mapping documents based on BTRD and through Change Requests / SSCRs as required to downstream systems.
•Extensively involved in Facets billing module mainly in Back - End system process for membership's enrollment info to downstream system and also involved in Front - End system process for the information feed to Facets from Source system WGS - Medisys - Facets file transfer process.
•Designed Billing History, Enrollment Reconciliation Process, Eligibility Feed.
•Involved in the Data Migration meeting and process to provide feedback from Facets side based on its technical functionality.
Environments: Trizetto Facets 4.41, Rational Clear Quest, Rational Clear case, Sybase, Business Objects, Confluence, HP Quality Centre, JIRA.
Interacted with department heads to finalize business requirements, functional requirements and technical requirements and created business process model.
•Performed requirement analysis by gathering both functional and non-functional requirements based on interactions with the process owners and stakeholders and represented them in requirements traceability matrix (RTM).
•Created gap/impact analysis document and operational analysis document for the analysis and management system of the application
•Developed, executed, maintained and documented test scripts, test cases, requirements - for web based applications
•Developed end-to-end Test Scenarios to ensure system functionality works as expected, Test scripts and Test Scenarios are covered.
•Upload the Test case work books and test case validations into the portal.
•Cases for different sub systems based on requirements and design documents for Managed Care, Member
•Management, Member Enrollment, Claims, Provider Management using spreadsheet and Quality Center
•Ensure the functionality of the system works as expected as per specifications.
•Conducted random Audits on the deliverables.
•Employed Rational ClearQuest for effective change management (requirements creep) and bug tracking during the testing lifecycle
•Reviewed and understood Business Requirements documents to implement them in the Test plans/cases.