Professional Summary:

• Over 7 years of comprehensive experience as a Business Analyst in requirement gathering, analysis, and business processes management with a strong knowledge of System Development Life Cycle (SDLC) using Waterfall, Rational Unified Process (RUP), and Agile methodologies.
• Expertise in all phases of the software development life cycle (SDLC), with emphasis on business requirements, design, construction, documentation, risk assessments, project plans, testing, and implementation.
• Highly experienced in designing, developing, and implementing innovative business processes and system solutions for healthcare, Pharmacy and insurance domain.
• Thorough knowledge of regulatory working environment (HIPAA principles, FDA regulations, 21CFR part 11) and International classification of disease (ICD 9 and ICD10 classifications).
• Strong qualifications in Business process Re-engineering, Business process automation, Object Oriented Analysis and Design and modeling using UML.
• Expert in conducting GAP analysis, Return on investment (ROI), Strengths, weakness, opportunities and threats (SWOT) and Impact analysis to understand the pros and cons of pursuing a business decision.
• Proficient in business scope definition, cost/benefit analysis, conceptual design analysis.
• Excellent Business writing skills in writing Business Requirements Document (BRD), Use Case Specifications, Functional Specifications Document (FSD), Systems Design Specification (SDS) and Systems Requirements Specification (SRS).
• Conducted System Integration Testing and facilitated User Acceptance Testing (UAT) to provide a smooth transition to the new system/application.
• Expert in identifying upcoming challenges in functional areas and proven ability to take a business concept and translate it in to an automated solution.
• Articulate communicator equipped with great work ethic, investigative & interpersonal skills with the ability to evaluate alternatives and influence and guide business decisions.
• Strong customer/user advocate, apt negotiator with excellent analytical, communication, decision-making and organization skills.

Education Qualifications:
Masters in Business Administration

Skill Set:
MS Windows (2000, XP, ME, NT, Vista), MS Office 2007/2003/2000 (Excel, Word, PowerPoint, Project, Visio, Access, Publisher, FrontPage, Outlook),UML, RUP, Agile methodology, Sales Force, Advanced Excel (Macros and PivotTables), HTML, SQL, Java, Rational requisitePro, ClearQuest ,Clearcase, Photoshop, LoadRunner, WinRunner

Projects Summary:

Confidential,Newark NJ 11/2009 –Present
Business Analyst
Confidential, is a leading health services corporation in the state and a major regional provider of health services. The scope of the project was to automate Horizon BCBSNJ MESP files. Automation will allow Horizon BCBSNJ to properly identify plan enrollees who have primary coverage with Medicare and receive claims only for a date of service for those members with active enrollment on those dates for secondary claims processing.
Hardware/Software:
MS-Project, MS-Office Suite, MS Visio, Mercury Test Director, Rational requisitePro , Rational ClearQuest, Rational ClearCase,CaliberRM,DB2, MS SharePoint.,MS SQL Server

Responsibilities:

• Facilitated requirements meeting, Conducted JAD sessions, focus groups and live conferences with business users and subject matter experts (SME) to elicit requirements.
• Identified documented business and technical requirements from both formal and informal sessions and validated the needs of the business stakeholders.
• Functioned as the primary liaison between the business line, operations, and the technical areas especially with the stakeholder’s team, which provided the web-based underwriting solution.
• Proficiently conducted user interviews and documented technical requirements document and RTM (Requirement traceability matrix) for the project.
• Documented the business rules for automation of the project.
• Conducted enterprise analysis and reviewed feasibility report consisting of economical, organizational and technical analysis. These reports were presented and discussed with the business users.
• Documented and maintained all the Project Change Request (PCR) and Work Product Review (WPR) documents and updated them accordingly.
• Proficiently worked in NASCO, QBlue, claims processing engines.
• Involved in all phases of SDLC. Extensively experience working with RUP and Agile.
• Worked extensively to create use case scenarios, UML use cases, Activity diagrams and documenting work flow and business process.
• Worked extensively on Data Warehouse and RDBMS concepts as SQL Server database & BI Developer.
• Created the analysis artifacts; business and technical flow diagrams, context diagrams, collaboration diagrams, use case specifications etc.
• Tested Medicare eligible files sent to EMDEON. EMDEON is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers, and patients in U.S healthcare system.
• Responsible for application functionality improvement and coordinate process through the Project Management Office (PMO).
• Assisted in creating Test Plans, Test Cases and Test Scripts; Involved in build process for QA, UAT and Product environments.
• Assisted in developing training materials for new technology and process improvements.
• Authored progress and completion reports, which were then submitted to project management on a weekly basis.
• Verified the Business Scenarios on new builds to allow extended testing by the QA team once the system was in testing environment.

Confidential, Kingston, NY 5/2008 – 10/2009
Business Analyst
Confidential, is one of the largest health care companies in New York established in 1937. Worked in GHI (HMO)-Health Maintenance organization, a subsidiary division of GHI. The project involved re-engineering of the Health Insurance Management application to incorporate the conversion from ICD9 to ICD10.
Hardware/Software:
Rational Requisite Pro, MS Visio, MS Project, Enterprise Architect, Rational Rose, EDI, UML, JAD, MS-Office Suite, WinRunner

Responsibilities:

• Conducted interviews and Joint Application Development (JAD) sessions to gather requirements from stakeholders and users to prepare and update Business Process Requirements (BPR) and Software System Requirements (SSR).
• Analyzed business requirements and segregated them into high level and low level.
• Performed impact analysis of conversion to ICD 10 on the current system.
• Analyzed the existing business process and created AS-IS workflow and possible TO-BE solution to illustrate the proposed system.
• Helped manage risk analysis and mitigation plans, status reports, and client presentations; prepared business process models, defined milestone deliverables, and established critical success factors.
• Assisted in extracting data from raw data files, Excel spreadsheets and external Relational database management system (RDBMS) tables (databases like SQL and MS Access).
• Assisted Project Manager in updating and maintaining Project Schedule, assigning project resources and monitoring deliverables using MS Project.
• Maintained a requirements traceability matrix (RTM) in order to keep the clients and all the teams up-to-date with the current progress of the project.
• Produced DTS packages for ICD-9 data migration from CSV files and excel files to SQL Server.
• Developed EDI specifications and applications structures for data feeds and mappings for integration between many systems to follow ICD 10 Code set.
• Drafted Use Cases, Activity and State Diagrams using MS Visioaccording to UML methodology .Created Use Case specifications, business flow diagrams and Sequence diagrams using MS-Visio so the developers and other stake holders could understand the business process with possible alternate scenarios.
• Generated weekly status reports by running SQL queries against the data repository. Performed defects tracking and updating using SQL queries.
• Worked closely with developers and testers throughout the entire development life cycle to elicit, manage and track requirements.
• Performed GUI testing on various screens and verified the properties and functionality of the objects on various windows.
• Managed and track defects, prioritized defects with each build and made sure that they were communicated to the affected teams.
• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT).

Confidential,Bridgewater, NJ 11/2006 – 4/2008
Business Analyst
Confidential, is a world leader in the discovery, development and marketing of innovative pharmaceutical products. The project involved creating a safety system to report the adverse events across the product lines. This solution will facilitate in capturing case related data reported by doctors /trial nurse/pharmacist through a reporting station to the central repository.
Hardware/Software:
MS Project, MS Office, Rational Team Test Suite, Windows NT, Java, HTML, MS Visio, UML

Responsibilities:

• Facilitated and managed meeting sessions with Business Users and process analyst to review business requirements. Set-up weekly status meeting and JAD Sessions with the Stakeholders, Business Users and Technical leaders from various departments (Clinical trial, Drug Discovery and Pharmaceutical Development).
• Implemented FDA Guidelines to avoid non-compliance, delays in production and increased costs.
• Mastered the Working knowledge of regulatory requirements (HIPAA, 21 CFR Part 11) and audits.
• Conducted GAP analysis and Return on Investment (ROI) analysis.
• AppliedRUP for software development and involved in the development of User Requirements Document (URD) and Functional Requirements Document (FRD) using Rational Requisite Pro.
• Translated functional and non-functional requirements to be used as input to the functional design specifications.
• Maintained the Requirement Traceability Matrix (RTM) and participated in development of the Test Validation Methods for writing Performance Qualification specifications (PQ).
• Extensively worked on creating User Requirement Specifications, Functional Requirement Specifications, and Business Process Documents and also assisted in developing System Requirements.
• Designed and developed Use Cases, Activity Diagrams, OOD (Object oriented Design) using UML and Visio.
• Updated and wrote several Standard operating procedures (SOPs for day-to-day functioning of the system as well as emergency operation (system recovery, back-up, etc).

Confidential,CA 6/2005 – 10/2006
Business Analyst
Confidential,is a leading global provider of insurance, annuities and employee benefit programs, serving 90 million customers in over 60 countries. The project was to develop a comprehensive online health insurance application processing system. The system runs on a Mainframe and has a Web-integrated front end that provides free insurance quotes to individuals and families.

Hardware/Software:
MS Office, MS Visio , MS SharePoint ,Windows 2000/NT, Java, HTML, JavaScript, HP Quality, UML , Crystal reports

Responsibilities:

• Interacted with business heads to finalize the business requirements for the application.
• Worked with internal and external users to define requirements and coordinated user management and developer expectations.
• Successfully conducted JAD sessions, which helped synchronize the different objectives of stakeholders and helped the developers comprehend user requirements.
• Created business flow diagrams, performed SWOT analysis, and assisted in designing the web structure.
• Developed graphical representation of reports such as bar charts, pie charts etc as per the end user requirements using Business Objects and Crystal Reports.
• Designed use case diagrams, activity diagrams, and sequence diagrams to analyze the system usingUML.
• Performed requirements traceability and managed changes to the requirements for the application using Rational RequisitePro.
• Performed requirements analysis and prepared the technical and business documents.
• Maintained proper communication with the developers ensuring that the modifications and requirements were addressed and also monitored those revisions.
• Provided guidance and assistance in UAT and also developed user manuals.

Confidential, Nashville, Tennessee 03/2004-5/2005
Business Analyst
Confidential,is an operator of hospitals and other medical facilities in five different states in U.S.
The aim of project was to develop an IVR( Interactive voice response ) applicationthat would help customers toaccess information about their health plan, policy details, update the personal info, details of co pay, deductible, billing information, pay over the phone, and their account details etc over the phone.
Hardware/Software:
Microsoft Excel, Microsoft Word, Rational Rose, Requisite Pro, UML Modeling Tool, RUP methodology

Responsibilities:

• Claim validation and Pending/Denied Claims Analysis for the Health plans of Medicare and Medicaid programs.
• ConductedJoint Application Development (JAD) sessions between the end users and the development team.
• Played an active and lead role inidentifying and analyzing requirements and writing business requirements.
• Conducted feasibility analysis and assisted Project Manager in setting realistic project expectations and in evaluating the impact of changes on the organization and plans accordingly.
• Collected and documented business processes as well asbusiness rules. Provided key input in working with users indefining project and system requirements.
• Implementedrequirement Traceability Matrix and Business Requirement Specification Documentverified the functionality coverage.
• Designed and developedUseCases, Activity Diagrams, Sequence Diagrams, and OOAD using UML
• Assisted in building a business analysis process model usingRational Rose and Visio.
• Documented theFunctional Specifications Documentwith the help ofUML.
• Worked with the software architects / developers to ensure that the applications conform to customer requirements.
• Developedtimelines for project delivery, and managed projects and resources for successful completion
• Coordinated with QA anduser acceptance testing.
• Worked closely with project managers to assist them with project plans, budget.
• Assisted the Data Analyst in analyzing existing reports and lead preparation of data warehouse requirement document.