SUMMARY:

• Senior business system analyst with 8+ years of hands on experience in the domain of Insurance, Health care and Finance with strong understanding of business process modeling, business process flow, elicitation techniques and experience in management of business requirements using SDLC methodologies and RUP processes, UML modelling, Proto type design, RAD and JAD sessions.
• Experience in using Agile and water fall methodologies and working knowledge in all areas of project life cycle in a structured change management environment.
• Proficient in gathering and analysis of requirements and creation and development of financial specifications.
• Skilled at performing GAP analysis, Financial Analysis, User Acceptance Testing (UAT), SWOT analysis, Cost benefit analysis and ROI analysis.
• Good knowledge on various insurance products and plans like Endowment Insurance Products, Term Insurance Products and Unit Linked Insurance Plans, Health Insurance, Life Insurance Products, Pension plans, Retirement plans and Annuities etc.,
• Expertise in ICD - 9 to ICD 10 Conversion.
• Medical Claims experience in Process Documentation, Analysis and Implementation in … (X12 Standards) processes of Medical Claims Industry from the Provider/Payer side.
• Worked on healthcare standards such as HIPPA 4010, 5010, ICD-9 ICD 10.
• Strong experience and understanding of Medicaid and Medicare Services in health care industry, claims management process.
• Demonstrated ability to work both in independent and team-oriented environments with well-developed organizational skills, excellent interpersonal and communication skills, solving and delivering solutions under high stress environment.
• Dynamic experience as professional in domains of healthcare and insurance industry.
• Strong experience in documenting test cases, existing process, requirements and working with requirements traceability matrix, re-engineering business processes and designing.
• Facilitated workshops and developed metrics, measures, dash boards and reports to support management and client group needs.
• Sound health care finance domain knowledge of Relative value units, Operational statements, economic order quantity analysis, strategic financial plans and ratio analysis etc.,
• Good knowledge of HIPPA compliance life cycle, insurance regulations and HIPPA 5010 transaction standards.
• Proficient in using Use Cases, Activity Diagrams, Sequence Diagrams, Entity Relationship Diagrams, Collaboration Diagrams, Class Diagrams and document them using MS Visio and Rational Rose.
• Experience with various Facets modules such as Subscriber/Member, Claims, Plan/ Product.
• Extensive use of BABOK guidelines and practices in Life sciences.
• Effective in executing multiple tasks and assignments ahead of schedule.
• Participated on multiple analysis projects for various applications, developed internally and by other solution providers.

TECHNICAL SKILLS:

Microsoft Technologies: Microsoft Project, Word, Visio, Power point

Methodologies: Rational Unified Process (RUP), Waterfall, Agile

Languages/Standards: SQL, PLSQL, ICD9, ICD10, HIPPA 5010, XML

Requirements: test management Rational Rose, Requisite Pro & Rational test manager

Testing Automation Tools: Quick Test Professional, Rational Robot, ETL

Defect Tracking Tools: Rational Clear Quest, Mercury Quality Center, JIRA

Operating systems: MS Windows X, Mac OS X, Unix & Linux

Quality Management Concepts and Tools: of Quality Management Test Director and load Runner, Six Sigma Techniques

WORK EXPERIENCE:

Sr. Business System Analyst

Confidential - Los Angeles, CA

Responsibilities:

• Project governance, including day-to-day management and resolution of risks, issues and dependencies.
• The project followed Agile - Scrum methodology, was responsible for effective communication with in the scrum teams.
• Facilitated Scrum of Scrum for offshore teams in India. Assist the scrum master in Facilitating scrum ceremonies (grooming, sprint planning, retrospectives, daily stand-ups, etc.)
• Hand off the requirement and creating the solution as per stakeholder feedbacks.
• Estimations and resource identification for all Minor and Major releases.
• Analysis of the task like FRD and assigning to the offshore team member and assist the offshore team and review their prepared artefacts.
• Managed and optimized digital asserts using SITECORE.
• Demonstrated understanding of application design, development, testing, integration and support.
• Involved in Data Extraction, Transforming and Loading (ETL) using various tools such as SQL Server Integration Services (SSIS)
• Worked with complex SQL queries for data manipulations.
• Conducted Data analysis including creating tables, loading data in the tables, accessing databases, and wrote SQL queries to analyze the data.
• Handled tasks like reviewing, maintaining and highlighting the changes in project plan.
• Interacted with developers to report data related to bugs and re-tested the fixed issues.
• Planned, scheduled, and controlled projects based on plans and requirements outlined by the business.
• Developed the project schedules, timelines for project delivery and milestone tracking using MS Project.
• Created and submitted weekly status report to the project manager.
• Identified training needs for the Scrum team and coordinating with the training department to successfully conduct training programs.

Sr. Business System Analyst

Confidential - Portland, OR

Responsibilities:

• Drafted Business Requirement Document, Functional Specification Document and Use Cases Specification based on the information gathered through JAD sessions with end users, SME's and other stakeholders and participatory design sessions in involving major leads from the technical department using Rational Requisite Pro to provide appropriate scope of work for technical team to develop prototype and overall system.
• Used UML/Object-oriented design to gather and document business and system requirements; prepared entity relationship diagrams, class diagrams, and activity diagrams to supplement written documentation
• Initiated JAD sessions for design and documentation of the System Design Document (SDD) and made sure that all the requirements were implemented into functionality or a feature within the systemby means of Requirements Traceability Matrix (RTM)
• Utilized a variety of reporting tools such as SQL and ACCESS for querying underlying database tables and resolve data issues.
• Worked closely with both development and testing teams to improve quality of the application by actively participating in regression analysis and User Acceptance Testing (UAT)
• Tracked and reported project milestones and presented status reports to senior management using MS Project.
• Managed the Off-shore Web Development Team, On-site Database Development Team and Testing Teams to ensure the project is completed on time and budget.
• Created Wireframes using Adobe Photoshop and MS Visio, to effectively communicate the user-interface platforms to the system teams.

Business System Analyst

Confidential - Manhattan, NY

Responsibilities:

• Analyze business/functional requirements and work with project team to define functionality and solutions.
• Analyze and understand project scope and objectives based on discussions with stakeholders.
• Determine detailed requirements, define scope, and identify business model.
• Elicit business requirements from project sponsors and stakeholders through research, focus groups, internal and external data, interviews, process flow creation, surveys, or other methods.
• Prepare documentation at each of stage of the requirements phase, including deliverables like Vision and Scope Reports, Requirements Work Plans, Business Requirements Documents, Use Cases, Process Flows, Technical Specifications, Data Flow Diagrams or Functional Design Documents. Ensure documents can be understood by business users and development team alike.
• Authored data flow diagrams, sequence diagrams and business process models.
• Worked on different Health Plans data capture and analysis.
• Developed an overall logical information model for the architecture incorporating the reporting needs for business, clients and corporate users.
• Supported design efforts by lead Architects by defining Data Models and Use Case Analysis models.
• Involved in running the daily and weekly jobs to push the data into the application using Import Sets and Transform Maps.
• Analyze business trends, operational situations, flows and models, and gather input through observation or stakeholder interviews to formulate clear models of the current state, recommend possible improvements, and determine future state.
• Conducted Data analysis including creating tables, loading data in the tables, accessing databases, and wrote complex SQL queries to analyse the data
• Perform data analysis of reported production problems, determine impact and priority; and recommend corrective actions.
• Recommend changes to business analysis and project management policies, processes, templates and Create and justify the business case, identify stakeholders, and analyze and interpret customer or business need to determine high-level project and product requirements.
• Demonstrated understanding of application design, development, testing, integration and support.
• Support existing custom developed application.
• Create wire-frames to communicate requirements and visual solutions
• Test, track and report issues throughout the application development lifecycle.

Business System Analyst

Confidential - Richmond, VA

Responsibilities:

• Gathered user/business requirements by meeting with business users and generated business models and use case analysis.
• Prepared the Software Specification Document for the application based on business user information.
• Created use case document to elaborate user experience taking into account the business objective.
• Converted Business Requirements to the Functional Specification to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests.
• Assisted in on-going process improvement efforts to ensure Test Planning, Execution, and Reporting is effective, efficient, standardized, coordinated, and integrated.
• Assisted the Senior Business Analyst in writing Functional Requirement Specifications (FRS) and User Requirement Specification (URS)
• Conducted JAD Sessions periodically with various stakeholders at various phases of the Software Development Life Cycle (SDLC) to discuss open issues and resolve them.
• Feature identification, defining and documenting business requirements and priorities.
• Critically evaluated the information gathered from multiple sources during requirements and analysis and responsible for tracking, tracing and managing requirements using Requisite Pro.
• Developed Test Plans and Test Cases according to Business Requirements.
• Interacted with development team for communicating the requirements and use cases.
• Involved in generation and execution of SQL queries.