PROFESSIONAL SUMMARY:

• Sr. Business Systems Analyst with over 8 years of diverse experience in analyzing and gathering requirements for business processes in functional and technical roles across Healthcare and Healthcare Insurance domain, HEDIS measures, IOT, Salesforce, AWS, Website design, Application Development, Healthcare system development and UX/UI Design.
• Extensive working knowledge about concepts of Healthcare domain such as HIPAA and FDAguidelines, Health Insurance coverage, EOB, HMO, PPO, POS, EDI, ICD - 9-CM and ICD-10-CM code conversions, FACETS configuration tools, Medicare, Medicaid, CHIP, EMR, Ambulatory services, Claim payment processing, EDI 4010, 834, 837, 835 and Healthcare eligibility 270/271, Patient monitoring devices, Healthcare Clearing House, CRM and KPI tracking.
• Strong experience in the development of Healthcare products such as Policy underwriting, policy issuance, Enrolment, cancellation, renewal, Claims management, policy Billing and Network X Pricing.
• Integrated Salesforce using REST APIs and developed Visualforce page using extension controller according to client’s requirement and customized Reports and Dashboard in real time and automated manual business processes via Salesforce
• Robust knowledge foundation of various processes of SDLC methodologies like Waterfall, Agile (Scrum),Agile Hybrid along with an expertise in STLC processes(Requirement analysis to Test Cycle Closure).
• Performed multiple feasibility studies, Risk analysis, Cost-benefit analysis, Root cause analysis, SWOT analysis, and impact analysis to find the needs of a project and execution of business decisions and possess an in depth understanding ofGAP analysisand defined theAS-IS and TO-BEbusiness processes to help the organization with designing the new system.
• Skilled in eliciting requirements from business owners and stakeholders through a variety of elicitation techniques such as Brainstorming, JAD sessions, Requirement workshops, Interviews, Survey/Questionnaire, Document analysis and Focus groups and articulating requirements and converting requirements into technical specifications.
• Collaborated with SMEs’ to understand Key Performance Indicators (KPI’s), and Service Level Agreements (SLA’s).
• Created multiple deliverables such as BRD, SRS, FSD, Project Charter,Project plans, Feasibility studies, Configuration documents, RTM, and RACI matrix thereby having a broad knowledge on deliverables at various stages of different processes.
• Intense knowledge of Agile (Scrum) framework including Scrum events &ceremonies like Backlog grooming, Sprint planning meeting, Daily Scrum,Review meeting, and Sprint retrospective meeting. Efficiently involved in requirement elaboration and worked as a Proxy Product Owner.Assisted in solving all the impediments dealing with internal and external stakeholders.
• Breaking down Epics into User storiesusing Slicing techniques and satisfying INVEST criteria and helped in prioritizing and estimating user stories usingPrioritization and Estimation techniques likeMoscow, Planning Poker, T-shirt Sizing etc.
• Competent in supporting the Product owner to define the Minimum Viable Product (MVP), Definition of Done (DOD), and writing Acceptance criteria for user stories and tasks. Worked in Test Driven Development (TDD), Acceptance-Test Driven Development (ATDD), Continuous Integration and Behavior-Driven Development (BDD) environments and developed Feature Files with high level description of Test Scenarios and Given-When-Then format (Gherkin format) using Cucumber.
• Designed High Fidelity and Low Fidelitymockups and wireframes for the requirements to get a visual andGraphical User InterfaceGUIunderstanding of the application using tools like Balsamiq and AdobeXD to assist the clients with better understanding of the outcomes of the project and making it feasible for the PO to define Minimum Viable Product (MVP).
• Highly proficient in creatingUnified Modeling Language (UML) diagramslike Use Cases, Use Case diagrams, ERD diagrams, UI designs, BPMN 2.0, Swim lanes, Sequence diagramsand activity diagrams using draw.io, MS Visio, and Lucid Chart.
• Experience in negotiating with developers, application architects, SMEs’, Business users, Testing teams and Senior executives and assisted Project manager and Product owner to plan, schedule, track and improve teams’ competence by creating Work Breakdown Structure (WBS) and Critical Path Analysis (CPA), end to end task and milestone list using MS Project and JIRA.
• Proven mastery in conceptual,and logical data modeling, data integration, migration and data conversion.Knowledge of source data identification, validation,data mapping, data profiling, data extraction, data transformation and data loading.
• Explicit insight and knowledge of Data warehousing, ETL process, Data visualization and reporting tools like Tableau and Power BI to drive operational intelligence. Strong acquaintance of implementing Databases, Operational data stores,Data table structures, Data marts, Data analysis, Data integration, Schemas, OLTP and OLAP operations like Drill down,Rollup, Slicing and Dicing.Practical knowledge ofData warehousing architecture andall theSchemasusing Kimball architecture.
• Thorough knowledge of SQL querieswhich includes Inner and Outer joins, SELECT statements, Order by, Group by and Aggregate Functions such as Count, Min, Max.
• Adept in XML, JSON, loosely coupled Web Services (REST, SOAP, WSDL) and system architecture like SOA and3-tier architecture.Documented multiple APIs using POSTMAN and SWAGGER.
• Meticulously created Test plan, Test cases, Test data, Test Scenarios,Test scripts, User Acceptance Testing (UAT), Manual and Automated Testing, GUI Testing, and familiar with Smoke and Sanity Testing and end-to-end Regression Testing.
• Experienced in Defect tracking,Defect analysis and ability to organize, document and track changes usingtools such as Atlassian HP ALMand JIRAwith zephyr plug inand createdCumulative Flow Diagram, Burndown, Burnup and Velocity Charts.

SKILLS AND TOOLS:

Healthcare and Healthcare Insurance Domain: Complete Member Enrollment cycle, complete Claims Life cycle, Medical Plans like HMO, PPO, POS, EPO,CHIP, Medicaid, Medicare services.(Healthcare Enrollment system, Claims adjudication system, EHR, EMR, Healthcare Data Migration, Health Data mapping, Health data Crosswalk files)

SDLC Methodologies: Agile-Scrum, Scrum-Waterfall, Waterfall, Spiral and Kanban

Business Skills: Business Requirements Elicitation, Change request Management, Incident Management, Impact Analysis, JAD Sessions, Project planning, Project Scheduling, Issue Management, Information Security Management, Conflict Management

Business Modeling tools: MS Visio (v.14, 15, 16), Balsamiq Mockups, Lucid Chart, draw.io

Project Management Tools: JIRA (v.6.3, 7.0), HP ALM (v.11.5), MS Project (2010, 2013), MS SharePoint (2010, 2013), Confluence (v.6.4, 6.3, 6.2)

Testing Tools: HP: QC (v.11, 12),Cucumber (v3.0), Load Runner (v. 11.5, 12.02), POSTMAN (v.3, 4, 5, 6), SWAGGER (v.2.0, 3.0)

BI and Reporting Tools: Tableau (v. 9.3, 10.0, 10.1), Kibana, MS Office Suite (Excel, Word, PowerPoint) (2010, 2013, 2016).

Architecture/Framework: Service Oriented Architecture (SOA), 3 Tier Architecture, N-Tier Architecture

Technologies: Mainframes

Databases and ETL Tools: MS SQL Server (2012, 2014), My SQL, Informatica Power Center (v. 9.5, 9.6.1) and Cloud

Data warehousing: Data Marts, Data Modeling, ETL

Languages: HTML5/CSS3, XML, C/C++, SQL, JavaScript, JSON

PROFESSIONAL EXPERIENCE:

Confidential, Fairfield, NJ

Sr. Business Systems Analyst

Responsibilities:

• Interviewed Medicaid Subject Matter Experts (SMEs), Conducted Brainstorming sessions to gather OLAP queries, performed extensive document review to develop an in depth understanding of business processes, IOT implementation, Customer behavior, and used Prezi Business Presentations to facilitate requirement validation using Joint Application Design (JAD) sessions.
• Gathered requirements for ICD 9 to ICD 10 codes conversion, helped developers migrate the clinical data from ICD 9 to ICD 10 to perform analytics through KAFKA real-time data processing platform through Hadoop Hive HDFS, ML fraud and Maps ETA.
• Performed Document Analysis, defined navigation path using Clickstream Activity and created Process Flow Diagram (PFD) to perform Cost Benefit Analysis, and GAP Analysis by understanding AS-IS process and then cooperated and collaborated with the team to design the TO-BE system. Drafted Process workflow, Use-case diagram and Activity diagram using Lucid Chart.
• Reviewed and analyzed the HIPAA compliances and guidelines pertaining to FDA class 1, class 2 and PHI/PGHD to develop and enable Device Authentication feature to make the rules and regulation of device integration clear and responsive.
• Assisted in practices such as Behavior Driven Development (BDD) by writing test cases in Gherkins using Cucumber.
• Participated in Scrum ceremonies, extensively used Jira for converting requirements to user stories, assisted the Product owner in writing Acceptance criteria in Gherkins using Cucumber and framing Definition of Done (DOD).
• Cooperated the developers to in corporate a backup data center to avoid the system to go downtime for any operation and use the client interface device to replicate the data for backup and then use the data as a backup data center during downtime.
• Helped and coordinated with the ETL team to construct OLAP queries through ETL packages in the data access layer to process multidimensional encrypted data from the data warehouse to decrypt, analyze, format report and incorporated a Web Socket API node for asynchronous transfer of data helping the data to flow from the server to the client and from client to the server.
• Implemented an authorization code for the intermediary device to give access for device integration through various applets and implemented the Web Application Firewall (WAF) for the same to deny access to the systems according to FDAclass 1 and class 2 guidelines and denying the access to the fraudulent end users and blocked accounts keeping the authorization system secure.
• Worked thoroughly on FACETS configuration tools to generate reports under HIPAA and NCQA act guidelines and regulations to keep track of eligibility request and prior authentication.
• Well adept with Medicaid Health Insurance policies and performed testing for Medicaid claims for Medicaid management information system (MMIS). Worked with providers and Medicaid entities to validate EDI transaction sets.
• Cooperated in defining Lambda functions for seamless computing and integration with each addition of new data to amazon S3 (Simple storage service) and the AWS Redshift data warehouse.
• Examined Source Data using SQL queries as a part of Data Profiling to configure and compute the profile data. Performed CRUD operations on SQL using SELECT and JOIN for drill downs, slicing and dicing to pull data from various sources.
• Extensively performed data mapping according to Data Mapping Specification document from sources like POS, ERP (CSV, Flat file, Excel) to the target database using Informatica PowerCenter (Source Analyzer, Target Designer, Mapping designer).
• Involved in developing an automated SMS, email and facsimile notification functionality in the service layer and store the same data copy in a NoSQL database and the EMR storage devices in the data layer for analytics through ELK platform.
• Integrated Salesforce using REST APIs and developed Visualforce pages using extension controller according to healthcare organizations, providers, physicians and patient’s requirement and customized reports and dashboard in real time.
• Helped the organization by collaborating with User Experience UX to analyze the interface by updating the PM and PO with monthly RPM device request reports by developing working wireframes prototypes using Balsamiq and Prezi.

Environment: Agile-Scrum environment, Jira (v.7.0), Confluence (v.6.4), Informatica PowerCenter (v.9.6.1), Balsamiq, MS Visio (v.16), Prezi, Salesforce, SFDC, SFMC, Kafka, Hadoop Hive HDFS, Machine Learning, SQL, Kibana, Cucumber (v.3.0).

Confidential, Deerfield, IL

Sr. Business Systems Analyst

Responsibilities:

• Gathered end user business requirements through interviews, surveys, and observing from current process of teaming through advisory group and product owners, validated UI needs and translated them into user stories.
• Participated in Business Modeling by documenting the needs of the Business and designed a new matrix covering all the conceptual parameters of the new system and then track the matrix back to the requirements of the business new processes.
• Extensively involved in gaining knowledge of relevant cross-industry data and messaging standard organizations and HIPAA and Electronic Data Interchange (EDI) industry specific organizations to maintain a point of view as to the current applicability and risk associated in implementing standards for patients having Medicare and Medicaid services.
• Created AS-IS process workflow and TO-BE process in MS Visio and conducted GAP analysis for projects.
• Analyzed and Prioritized user stories and acceptance criteria that must be included while developing the software.
• Created and updated data extensions, filtered data extensions and, wrote SQL queries inside of SFMC to import or export data between data extension and email campaigns. Generated reports based on the Salesforce application platform for evaluation.
• Developed a mobile application in Salesforce to track risk exposure and develop reports pertaining to blocked accounts.
• Created UML diagrams, Use-case diagrams and sequence diagrams to view the system in an understandable perspective for the stakeholders using MS Visio and created a working prototype in Balsamiq to gain an insight for the same.
• Helped in defining Lambda functions for seamless computing and integration with each addition of new data to amazon S3 (Simple storage service) and the AWS Redshift data warehouse.
• Assisted the Product owner in defining the Definition of Done (DOD) in the sprint review meeting for the respective demos.
• Designed and built custom emails and landing pages utilizing HTML, XML, JavaScript, AMP script and CSS. Used JavaScript to add dynamic functionality to landing pages. Integratedsentiment analysis with Salesforce marketing cloud using REST API.
• Developed design graphics, buttons and visually pleasing landing pages for the enterprise’s website ensuring all content is on-brand and consistent in terms of style, quality, and tone of voice to increase the effectiveness of marketing to increase sales, retention, and create a unified brand experience.
• Performed XML and JSON RESTful API documentation, and specification for request and response messages using POSTMAN.
• Created user stories and managed defect lifecycle in the HP ALM and JIRA tool and automated tests with Zephyr Plug in.

Environment: Agile-Scrum environment, Salesforce Sales Cloud, Salesforce Marketing cloud, SaaS, PaaS, JIRA (v.7.0), MS Visio (v.16), SQL, HTML, XML, Balsamiq, AMP Script, MS Office 2016, Tableau (v.10.1), Informatica PowerCenter (v.9.6.1).

Confidential, Houston, TX

Business Systems Analyst

Responsibilities:

• Gathered end user business requirements through interviews, surveys, and observing from current process of teaming through advisory group and product owners, validated UI needs and translated them into user stories.
• Participated in Business Modeling by documenting the needs of the Business and designed a new matrix covering all the conceptual parameters of the new system and then track the matrix back to the requirements of the business new processes.
• Extensively involved in gaining knowledge of relevant cross-industry data and messaging standard organizations and HIPAA and Electronic Data Interchange (EDI) industry specific organizations to maintain a point of view as to the current applicability and risk associated in implementing standards for patients having Medicare and Medicaid services.
• Created AS-IS process workflow and TO-BE process in MS Visio and conducted GAP analysis for projects.
• Experience working with both Government and commercial insurance companies such as Medicare, Medicaid, Blue shield, Blue Cross, United Healthcare, etc.
• Strong experience in the development of Healthcare products such as Policy underwriting, policy issuance, Enrolment, cancellation, renewal, Claims management, policy Billing and Network X Pricing.
• Expertise in BPM (Business Process Modeling) and documentation like BRD (Business Requirement document), Unit test plan(QC & UAT), test scripts, test cases and supporting UAT(User acceptance testing) to build an error free software application.
• Analyzed business requirements and provided end-to-end solution design for data foundation builds including Data Marts, Data Feeds, data warehouse subject area Etc.
• Created UML diagrams, Use-case diagrams and sequence diagrams to view the system in an understandable perspective for the stakeholders using MS Visio and created a working prototype in Balsamiq to gain an insight for the same.

Environment: Agile-Scrum environment, JAVA, JEE, ZK Framework, JIRA (v.6.3), MS Visio (v.15), SQL, REDMINE, Balsamiq, AMP Script, MS Office 2016, Tableau (v.9.3).

Confidential

BusinessAnalyst

Responsibilities:

• Understood the processes by interacting with stakeholders and facilitated JAD session.
• Defined user stories based on information gathered from stakeholders and estimated and prioritized them.
• Prepared the BRD (Business Requirement Document) and FRS (Functional Requirement Document) by creating the process flow diagrams by using Microsoft Visio.
• Used JIRA to implement defined plans to improve issue and bugfixes and documented risks using risk and issue logs.
• Acknowledged the Iterative & Incremental development process in order to understand Hybrid Agile Framework.
• Based on the Release Planning Document, assisted the Product Owner to set a limit on the release frequency and helped the testers to conduct System testing & UAT before creating a solution for Deployment.
• Actively took part in determining the cadence for the sprint based on the Capacity of the team& participated in Scrum Ceremonies.
• Created UML diagrams, Use-case diagrams and sequence diagrams to view the system in an understandable perspective for the stakeholders using MS Visio and created a working prototype in Balsamiq to gain an insight for the same.
• Performed SQL querieslike DML and join commands and supervised the source to target mappings (STM).
• Scrupulously involved in using Tableau for effective Ad hoc reporting to provide Business Intelligence (BI) to facilitate expenditure tracking using various matrices critical to decision making.

Environment: Waterfall-Scrum Hybrid, MS Office 2013, Tableau (v.9.3), JIRA (v.5.0), MS SQLServer 2012, UML, Balsamiq, Confluence (v.6.2), Cucumber (v.1), HP ALM (v.11.0).

Confidential

Jr. Business Analyst

Responsibilities:

• Worked in IPCS (Inventory Planning Control systems), Contract Management, Risk view meetings, Management Information System, Scope Planning and maximization of return of investments focusing on inventory turns.
• Worked in Waterfallto implement the technologies under specification and took rough feature requests from operational managers and real-time project stakeholders to turn them into detailed BRD.
• Implemented knowledge of QA principles, FMEA (Failure Mode Effect Analysis), Critical Path analysis, SWOT analysis.
• Documented requirements using BRD (Business Requirement Document), FRD (Functional Requirement Document), SRS (System Requirement Specification), ensured end-to-end requirement tracking using documents such as Requirements Traceability Matrix.
• Created Source to Target (STM) mappings in the Data Mapping Specification Document.
• Created UML (Unified Modeling Language) diagrams, Use-case diagrams and sequence diagrams using Microsoft Visio to view the system in an understandable perspective for the stakeholders.
• Created test cases for (UAT) User Acceptance Test and trained business users on usage of the application.

Environment: Waterfall, MS SharePoint, MS Word, MS Excel (VBA-Macro), IBM SPSS, MS Project, and Power BI.

Confidential

Junior QA Tester

Responsibilities:

• Worked in a Waterfall Methodology environment and extensively involved in Software Testing Life Cycle (STLC) phases - Requirement Analysis, Test Planning, Test Case Development, Environment setup, Test Execution and Test cycle closure.
• Defined Entry and Exit criteria for all the STLC phases and prepared the Requirement Traceability Matrix artifact.
• Studied the requirement from testing point of view to identify the testable requirements by interacting with various stakeholders.
• Identify defects in multiple environments and throughout all phases of the development life cycle and ensure that development groups address all open defects in a timely manner.
• Extensively involved in Functional Testing, Integration Testing, System Testing, GUI Testing, Performance Testing, Smoke Testing, Regression Testing.
• Proficient in developing, maintaining and executing test cases for different Black Box methodologies.