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Sr. Business Systems Analyst Resume

Mounds View, MN

SUMMARY:

  • Sr. Business Analyst with 9+ years of diversified experience in Project Coordination and successful implementations in Information Technology, involving in - depth understanding of Business Process Flows, Software Development Life Cycle, Process design, Business and functional requirements, Business case preparation, Development and Testing.
  • Successful in translating business requirements and user expectations into detailed specifications employing Unified Modeling Language (UML) using Rational Rose, MS Visio, and Visual Paradigm.
  • Strong Communication and Presentation Skills substantiated in past assignments with developers, Project Managers, Subject Matter Experts, Stakeholders, System Implementers and Application End Users.
  • Extensive experience in creating business documents including BRDs, FRDs, NFRDs and DRDs.
  • Developed Companion Guides for Insurance Companies to assist Health Benefit Exchange System and communicate system requirements.
  • Profound knowledge of Medicare, Medicaid and Health Insurance.
  • Knowledge of ICD-9 and ICD-10.
  • Extensive knowledge of HIPAA 4010 & 5010, Electronic Data Interchange (EDI) Transactions ex. 837, 835, 276, 277, etc.
  • Ability to gather Business and Technical Requirements from both formal and informal sessions utilizing a variety of elicitation techniques including One-on-One Interviews, Joint App Dev. Sessions, Document Analysis, and Interface Analysis.
  • Experienced in conducting Requirement Analysis, Use Case Design, Test Plan Design and developed database schemas based on the logical models.
  • Expertise in using Rational tools for creating Use Cases, Version Control, Defect Tracking, monitoring and extensively used the Agile, Scrum, Rational Unified Process (RUP) methodologies in all areas of the software development life cycle (SDLC).
  • Good experience in working with QA methodologies and processes.
  • Experience working as Joint Application Development (JAD) facilitator and meetings coordinator with excellent interpersonal and communication skills.
  • Skilled in working on SharePoint data loading/editing/publishing.
  • Performed GAP Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
  • Expertise in conducting User Acceptance Testing (UAT).

PROFESSIONAL EXPERIENCE:

Sr. Business Systems Analyst

Confidential, Mounds View, MN

Responsibilities:

  • Planned, developed and implemented new processes, techniques and standards that supported the strategic objectives of APM.
  • Led and provided guidance to the team in analysis principles and best practices while developing the solution.
  • Developed and maintained deliverables such as business cases, activity diagrams, sequence diagrams, class diagrams and process models.
  • Developed Use Case Specification to capture how a user will interact with the solution to achieve specific goals by capturing all the possible ways the user and system can interact; along with capturing all the things that can go wrong.
  • Extensively involved in researching and evaluating solution alternatives for business problems.
  • Documented and managed current standard operating procedures for set up of new applications as well as the ongoing lifecycle management and portfolio health.
  • Developed processes and templates to support policies and governance.
  • Involved in infrastructure mapping of various application systems; business applications as well as infrastructure application.
  • Worked independently with end-users and business partners to assess the business customer requirements, matched these requirements to objectives and guided them to the applicable processes and products including developing specifications and enhancements that will achieve the customers and business goals.
  • Managed the APM Dictionary information, understood gaps and drove integrity of data through working with Service Now. Educated owners and stakeholders on managing information about applications.
  • Analyzed and developed solutions to complex problems, process improvements that required the regular use of ingenuity and innovation. Ensured solutions were consistent with organization objectives.
  • Marketed and communicated program vision to project teams, key business stakeholders, and executive leadership. Ensured continued business sponsorship, engagement and commitment.
  • Ensured proper validation documentation was created for all projects (i.e., Client's System Validation Methodology).
  • Identified Sources of data and gathered related information from Application Owners.
  • Reviewed various data sources and infrastructure topologies and mapped the relationships in Integrated Service Management Library.
  • Reconciled discrepancies in the data sources and infrastructure topologies from different sources, like corporate CMDB, IBM Tivoli Application Dependency Discovery Manager (TADDM) data, Integrated Service Management Library(ISM) and other data sources, etc.
  • Involved in designing Templates and Inputting clean data for the IBM Data Librarians to enter into the CMDB database.

Environment: ServiceNow, MS Visio, Notepad ++, MS Outlook, MS Word, MS Excel, MS PowerPoint, MSSQL, XMLSpy, SOAP UI, SnagIt.

Sr. Business Analyst

Confidential, Minneapolis, MN

Responsibilities:

  • Worked on analyzing, documenting AS IS, and TO BE Business Process Flows by interviewing users to understand the functionality of the legacy system and the intended new system.
  • Elicited requirements from the business using best practices and conducted analysis and documentation of business rules, functional requirements and non-functional requirements.
  • Gathered requirements for building web applications using best practices in responsive design and layout, recognizing cross-platform requirements for receiving 270 and 276 Transaction requests from the Providers through a hosted site as part of the NCQA compliance project.
  • Worked as Lead BA in CAQH CORE compliance project as per regulatory mandate from Department of Health Care Services, CA.
  • Led Business Analysis Planning by building and maintaining the product and the sprint backlogs, including writing user stories from the gathered requirements, writing user acceptance criteria, assisting QA in building test suits by identifying and writing test scenarios and facilitating estimating and prioritizing sessions with the development and the business.
  • Conducted Agile scrum sessions including sprint planning, daily stand ups and retrospective meetings with core project team, including maintaining and managing backlogs and task boards.
  • Served as a strategic advisor to cross-functional business units in the development and end user testing.
  • Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
  • Worked with project team members, clients and vendors to coordinate activities, provisioning, environment setup, installation, and integration testing.
  • Gathered detailed requirements and wrote business rules to define SOAP web services.
  • Responsible for maintaining requirement traceability matrix to link requirements to acceptance criteria and test cases.
  • Worked with membership data and member enrollment for Alameda County members as an HR interface for the Health Plan. Communicated directly with the delegated entities and reported issues. Also worked with other health care pans to understand the concerns properly and to follow-up on member issues
  • Led the project team for collecting and monitoring Fraud Waste and Abuse data along with tracking the member profiles as part of the Law enforcement project by Department of Health.
  • Wrote database scripts & PL/SQL stored procedures, functions and triggers as part of documentation.
  • Analyzed and resolved 834-member eligibility file issues regarding the daily file processing by the plan.
  • Worked with provider in understanding the changes made in member codes and county codes assigned to the members; worked with the State (DHCS) in doing the mapping.
  • Performed business process analysis (Use Cases and/or process flows) and mapping (Gap Analysis) techniques in Curam.
  • Created data models by defining elements and establishing relationships to model the data in terms of the different types/categories of data and their relationships to each other.
  • Worked with the state (DHCS) in resolving the connectivity issues and missing member records in the daily and change files received by the Health Plan.
  • Analyzed and recommended improved department operating procedures for managing paper records.
  • Conducted Brainstorming sessions, focus group sessions and value based cost analysis; resulting in establishing a records management policy, formulating procedures and guidelines, as well as designing, implementing and
  • Coordinated with the project supervisor in additional assignments and small projects.
  • Planned and documented strategies for implementation and post implementation support and work

Environment: Agile, Waterfall, Diamond, Health Suite, MS SQL, Liaison ECS, MS Visio, MS Project, EDI Tools, Spec Builder, Test Management, Collab T. MS Office Suite.

Sr. Business Analyst

Confidential, Baltimore, MD

Responsibilities:

  • Facilitated requirement gathering sessions gathering high level 834 EDI transaction configuration and created configuration document.
  • Prepared and maintained Questions Log with Product Owner and other SMEs (Subject Matter Experts).
  • Prioritized and developed user scenarios for EDI transactions.
  • Worked in coordination with the project administrator and managers to complete the projects and served as a point of contact from project initiation to completion.
  • Facilitated daily stand ups and managed task board with user stories and board.
  • Prepared and tracked burn down charts and velocity charts for timely delivery of projects.
  • Utilized corporation developed Agile SDLC methodology used Scrum Work Pro and Microsoft Office software to perform required job functions.
  • Assisted in preparation of project scope document, which focused on what were the areas to be developed and analyzed the risks, assumption, dependencies and limitation of the project.
  • Worked with project team members, clients and vendors to coordinate activities, provisioning, environment setup, installation and integration testing.
  • Created work packages, task lists and schedule meetings with different group such as Business side, development side, QA and core project team to begin with HLR (High Level Requirement) gathering and HLD (High Level Design) session.
  • Managed Site Permissions, created and maintained views and communications for the Project using SharePoint.
  • Gathered and Analyzed records management requirements, guidelines, procedures and best practices for compliance and reference.
  • Facilitated review sessions with Record Managers and Business Users and improve records management policy, recordkeeping systems, practices, guidelines and procedures.
  • Involved with Records Management control process in creation, naming and coding of new files to facilitate accurate capturing and ready retrieval of records.
  • Assisted in determining retention periods for insurance related documents.
  • Conducted User Acceptance Testing for custom records management software to test record retention schedules.
  • Responsible for managing IBM Curam business analysis work with distinct deliverables to the direct client.
  • Analyzed data collected in stores (DTS Package, T-SQL, jobs, stored-procedures and queries) and provided reports to the commercial team (Excel, VB Script, Macro).
  • Worked with NCQA to build a portal to track and monitor criminal justice on submitted claims, collected requirements and created FRD and BRD.
  • Mapped Jobs in DataStage to populate tables in Data Warehouse and Data Marts.
  • Worked with Datastage Manager for importing metadata from repository, new job Categories and creating new data elements.
  • Maintained the Requirement Traceability Matrix table, Questions Log and to uniquely trace the identified business policies to the Guidelines and Requirements for issuers being engaged working with two types of Exchanges (Individual and SHOP Exchange).
  • Created and maintained PTR (Project Traceability Matrix) and Project Status reports for project manager so as to keep track of the current phase, delivery date, extended delivery date, issues related project and various follow up.
  • Created training documentation and user guide. Facilitated training sessions for organizational member and other end users.
  • Planned and documented strategies for implementation and post implementation support and work.

Environment: Agile, MS Visio, Word, Excel, PowerPoint, Oracle, SharePoint 2010, MS Project.

Business Analyst

Confidential, Chapel Hill, NC

Responsibilities:

  • Participated in the initial Impact Analysis (ICD-10) for all the critical functions, i.e., Membership & Enrollment, Claims Processing, Utilization Management, Medical Policy, Reporting, etc.
  • Involved with Vendor Management, including ensuring vendor compliance with key contract deliverables, reviewing vendor invoice and suggesting process improvements.
  • Worked with the internal team to build out a high-level roadmap and timeline to achieve compliance.
  • Collected requirements for and developed and deployed quality T-SQL codes, stored procedures, views, functions, triggers and jobs.
  • Worked with project team members, clients and vendors to coordinate activities, provisioning, environment setup, installation, and integration testing.
  • Performed Impact Analysis on 5010 upgrades and ICD-10 conversions.
  • Participated in ICD-9 to ICD-10 codes conversion requirement gathering sessions and created high level business requirements documents (BRD’s).
  • Prepared product backlog working with Product Owner and other SMEs (Subject Matter Experts).
  • Responsible for application support and development, design and analysis, and configuration with Mainframe and Distributed applications.
  • Involved in data conversion strategic planning and bulk loads.
  • Worked with technical team in developing a workflow for the existing 834 Member eligibility files received from the state.
  • Analyzed and provided assistance on technical terms in the 834 files and performed JAD sessions with the business in understanding the logic for pulling member records.
  • Worked with developers to create XML block additions and modifications based on business rules and workflow modifications to capture and manage client policy and underwriting data required to issue policy for a prospective insured.
  • Designed and defined User Interface Requirements (UIR) and visual patterns by creating wireframes, screen mockups and story boards.
  • Used SharePoint for document sharing and Discussion Boards.
  • Prepared 5010 GAP documents involved with 837 and 835 transactions in collaboration with other team members.
  • Defined ICD-9 to ICD-10 mapping process using GEM (General Equivalency Mapping) crosswalk file.
  • Maintained the Traceability Matrix table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.
  • Created training documentation and user guide. Facilitated training sessions for organizational member and other end users.

Environment: Agile, MS Visio, MS Word, MS Excel, MS PowerPoint, SQL, MS SharePoint 2010, MS Project.

Business Analyst

Confidential, Atlanta, GA

Responsibilities:

  • Defined and implemented the requirement gathering activities throughout the requirements process.
  • Assisted the Project Managers with the development of project management plans including scope identification, WBS, change control, risk analysis & project estimates.
  • Worked with Business Users to define Functional Requirements and Business Process Flows.
  • Interfaced with SMEs to prepare Functional (FR) and Non-Functional Requirement (NFR) Documents.
  • Designed and developed Enterprise Level Applications.
  • Assisted team using requirements management tools and issue tracking tools.
  • Conducted JAD/JRD sessions with business users and development teams to gather Business, Application & Quality requirements.
  • Developed Business Requirement Document (BRD) and Use Case Document (UCD).
  • Interacted with the users of the application to collect real time performance baseline data.
  • Involved in documentation during various phases of development life cycle including Project charter, BRD, SRS user training & Actor catalogue.
  • Designed and developed Use Cases, Activity Diagram and Sequence Diagrams using UML.
  • Participated in the training of current employees on basic navigation of Oracle applications. Created screen mockups for the new platform using MS Visio.
  • Created System Requirement Specification (SRS) and Requirement Traceability Matrix Documents.
  • Conducted GAP Analysis around the identification of Business Rules, Risks Involved, Business and System Process Flows, User Administration, Requirements, Product Customization and Assumptions.
  • Actively participated in Change Board Meeting (CAB) for any changes in the business requirements.
  • Assisted the testing team in developing the test plan, test conditions, and test cases based on business requirements and technical specifications in UAT.
  • Assisted in defining implementation and deployment tasks for the new platform as per the requirements.

Environment: Waterfall, UML, Use Case Analysis, MS Word, MS Power Point, MS Excel, Windows XP/2000/2003/Vista, Share point, MS Visio, Oracle, MS Project, Quality Centre.

Business Systems Analyst

Confidential, New York City, NY

Responsibilities:

  • Managed project and was involved in development of a Health care Access EHR project and implementation of an automated inter-operable web application that tracks patient medical history and health care plans via electronic health records.
  • Served as a liaison between the internal/external business community and the IT organization in order to provide technical solutions to meet user needs.
  • Analyzed existing Business Units, Business Process, System/Application and their interfaces with their capability through open-ended discussions, brainstorming sessions and prototyping.
  • Mainly assisted with documenting processes, used Agile methodology to write the Business Requirements documents and designed Functional Specifications.
  • Created operational workflows, data diagrams and other industry standard documents to represent client’s business processes.
  • Conducted AS-IS Analysis to capture and document current records management landscape. Reviewed current technologies and prior branch solicitations.
  • Prepared a set of possible records management requirements based on work previously completed by internal staff.
  • Worked with Business Users to help them define their system requirements and mapped their business processes.
  • Involved in analyzing cost-effective solutions to conduct successful implementation of electronic records management system.
  • Gathered requirements for records retention schedules based on statutory or regulatory requirements, audit requirements, and practical need or value.
  • Used SharePoint for document sharing and Discussion Boards.
  • Involved in proposing and attaining an approved records retention policy and schedule, including defining record series description, retention instructions, vitality, archival instructions and relevant statutes.
  • Developed disposition policy and procedures including preparing of policies, procedures manual.
  • Conducted JAD sessions between the business users, developers, testers & Subject Matter Experts to resolve bottlenecks.
  • Worked with the core team to create RFP and follow-ups.
  • Worked intensively with Medicare and Medicaid claims for 5010 X12 transactions on MMIS.
  • Assisted the team for preparing the existing SQL platform for upgrades that were installed as soon as they were released.
  • Assisted in creating and presenting informational reports for management based on SQL data.
  • Played an active role in the UAT and assisted in generation of test cases and test data.
  • Responsible for creating & maintaining Requirement Traceability Matrix in order to track the development and QA process.
  • Interacted closely with QA to finalize the Test strategies and maintained quality assurance using HP Quality Center.
  • Provided production support pre-production and post-production issue management and defect tracking.

Environment: Waterfall, UNIX, EPIC System, SQL Advantage, MS Visio, MS Word, KRONOS, Java Script, HIPPA 4010/5010, ICD 9/10, Clear Case, Agile, XML, XSD, XSLT.

Business Analyst

Confidential, New Brunswick, NJ

Responsibilities:

  • Analyzed the existing policies and procedures and provided the inputs to Executive Management Team to fit into the compass project goals.
  • Conducted JAD sessions with different Business Users to develop new policies and procedures for the Service Catalogue, Charge Capture and Service Worklist/Charge Router, Hospital Billing, Coding, Special Coding Requirements for BCBS and Claim Processing.
  • Performed GAP Analysis between Meditech and Soarian application for the Data Migration and Conversion.
  • Identified the impacts and trained the users on new policies /procedures changes.
  • Developed Use Cases, Test Cases for the Business Users and QA team.
  • Identified the Security Risks in the application that being built and addressed them in the requirement document to avoid the security breaches.
  • Improved the new revenue cycle management and Electronic Medical Record (EMR) for the RWJ Hospital.
  • Designed the flexible solution for patient treatment plan and patient care plan.
  • Designed the tight user authentication and application security.
  • Modified Existing policies and procedures for patient access such as Enterprise Scheduling.
  • Supported the Business Users after go live.

Environment: Agile, MS Visio, MS Word, MS Excel, MS PowerPoint, SQL, MS SharePoint 2010, MS Project.

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