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Sr. Business Analyst Resume



  • 6+ years of work experience in Healthcare industry as Sr. IT Business Analyst in all disciplines of Software Development Lifecycle (SDLC): requirements gathering, analysis, testing and implementation
  • Solid experience in Business Analysis and Business Modeling Techniques using different SDLC models including Agile/Scrum, Waterfall, RAD, and Rational Unified Process (RUP)
  • Experience working on Health Insurance Portability and Accountability Act (HIPAA) standards, Electronic Data Interchange (EDI), HL7 and ICD - 9 to ICD-10 conversion projects
  • Practical knowledge on various health insurance programs: Medicaid, Medicare (Part A, B, C, D), PPO (Preferred provider organization), HMO (Health maintenance organization), and POS (Point of Service)
  • Knowledge of MMIS (Medicaid Management Information System), HIX (Health Insurance Exchange), EMR (Electronic Medical Record), EHR (Electronic Health Record) and healthcare reforms like the Patient Protection and Affordable Care Act (PPACA)
  • Proven expertise in working closely with project stakeholders, SMEs, staff to understand the requirements and specifications for new applications along with re-engineering the existing application
  • Experience in facilitating user group meetings and gathering system requirements for mainframe and non-mainframe application
  • Excellent experience with user interviews to gather business requirements and clearly documenting BRDs, translating requirements to functional specifications and documenting Use cases and FSDs
  • Proficient in using MS Visio for UML modelling (Use Cases, Activity Diagrams, Workflows, Swimlane Diagrams, Screen Mockups) and working with data management team for data mapping
  • Excellent experience in working with SQL - creating complex queries based on the given criteria scenarios to generate client’s reports, analyze data, and conduct data load testing
  • Well versed with creating Data Mapping document - capturing data requirements, identify source data feeds, target database tables / column names, and business rules governing the data load process
  • Experience with the Extract, Transfer and Load (ETL) process to integrate reference data feeds from various external data sources
  • Solid knowledge in Data Warehousing concepts: Data Modeling, Data Integration, ETL, Data Marts, and Business Intelligence (BI) tools (Business Objects, IBM Cognos, Tableau)
  • Proficient in assisting DBAs with Data Modeling - creating Entity-Relationship (ER) Diagrams and object diagrams to build data models for underlying database
  • Hands-on experience with project management - building project plan, scope definition, timelines tracking, resource allocation, status updates, team management, and contingencies planning
  • Excellent working knowledge on Project Life Cycle and clear understanding of Project Management concepts like Budgeting, Risk Assessment and Forecasting
  • Experience working with Project Managers and Project Sponsors to support project administration
  • Experience in performing GAP analysis, SWOT analysis, Cost Benefit analysis and ROI Analysis
  • Proven expertise in facilitating business meetings such as walkthrough sessions, joint application development (JAD) sessions, sprint planning meetings, daily status meetings, and sprint retrospective
  • Worked alongside Quality Analysts to document Test Plans, Test Scripts, Test Cases for Performance Testing, Functional Testing, Regression Testing, System Integration Testing and UAT
  • Hands-on experience in managing defect tracking lifecycle using JIRA - monitored the open defects status, logged and prioritized the defects, re-tested the fixed defects, and generated reports to summarize
  • Experience in documenting the Requirements Traceability Matrix (RTM) to ensure that the test deliverables are in line with business requirements
  • Attended a two-day National Conference on “Making Quality Health Care Available, Accessible and Affordable in India: Challenges Ahead” as a delegate


Operating Systems: Windows XP/7/8/Vista, Mac OS X, UNIX, LINUX

Languages: C, C++, HTML, XML, SQL, Java, Shell, AJAX, COBOL, VB Script, .NET

Databases: Oracle, SQL Server, MS Access, PL/SQL, Management Studio, Lotus Notes

Business Modeling: MS Visio, UML, Wireframes, Screen Mockups, Rational Rose

Business Intelligence: IBM Cognos, Business Objects, OBIEE, Hyperion, Tableau

QA Testing Tools: QTP, Load Runner, JIRA, Quality Center, ClearQuest

Tools: MS SharePoint, Informatica, Wiki, Confluence, Clarity, Advance MS Excel (Expert-Macros), Erwin, MS Office, IBM Mainframe, TOAD, SQL Developer, MS Project, DOORS


Confidential, NJ

Sr. Business Analyst


  • Conducted several meetings and interview sessions with business users and subject matter experts at DHCS - Department of Health Care Services - to gather, analyze, and document business requirements (BRD), transformed business requirements into MMIS functional specifications, documented functional specifications document (FSD) and high-level design document
  • Analyzed business processes and performed needs assessments to align MMIS with client’s business initiatives
  • Applied AGILE Scrum SDLC model for application development, analyzing requirements, progress tracking, and prioritizing user stories based on requirements in product backlog and facilitated meetings
  • Responsible for production of Specific Functional Design (SFD) document during Phase II - System Design Phase of the SDLC and working with technical staff to translate requirements into technical design
  • Processed requirements necessary to support both mainframe and non-mainframe MMIS applications
  • Provided deliverables within the time frames defined by appropriate personnel and reviewed often enough to ensure time frames and quality standards are met
  • Assigned primarily to specific MMIS application, but cross-trained over all MMIS functional areas
  • Developed various UML diagrams using MS Visio - Use Case Diagrams, Activity Diagrams, Swim Lane Diagrams, and Process Workflows
  • Designed user-friendly GUI screens and their functionalities as per requirements and SME’s guidelines
  • Created methods to store procedure codes, diagnosis codes, as well as their combined use for a Cancer Detection Program known as EWC
  • Extensively worked on SQL queries for data retrieval, data validation testing, investigate data issues and to generate reports; and to monitor performance of the query
  • Created new MMIS Table to adjudicate EWC claims. Also, performed Mass EPC (Erroneous Payment Correction) to capture and systematically adjudicate claims
  • Assisted Data Modeling team to identify various entities and entity types, develop a progressive Entity Relationship diagram by establishing relationships between various entities and respective constraints
  • Worked on IBM mainframe application to review logic within COBOL program to extract rules, polices, and write requirements that will be used to build or modify the architecture
  • Worked on non-mainframe mid-range applications such as SURGE and DETEC applications that use a Single-Sign-On (SSO) McWeb (Provider facing application) to continuously enhance system capabilities
  • Assisted Project Manager to develop the project plan (project scope, objectives, deliverables, timelines, pert chart), manage resources, and create the project deployment plan
  • Involved in conducting GAP analysis, Feasibility analysis, and Risk analysis for the application
  • Conducted several JAD sessions with business users, SMEs, IT developers, QA team, and other project stakeholders to discuss & analyze requirements; design application architecture; and resolve conflicts
  • Collaborated with QA team to communicate requirements and help creating test plan, test strategy, test cases and conduct various kinds of testing like Functional testing, Integration testing, System testing, GUI testing, Performance testing, Black-box testing, Smoke testing, Regression testing, and User Acceptance testing to ensure a defect free product
  • Extensively worked on IBM Rational ClearQuest to manage defect tracking lifecycle - analyze, log, and prioritize defects; monitor defect resolution, maintain defect log, periodic status update, and generate reports & graphs. Also used this tool to work with change requests.
  • Developed and maintained the Requirements Traceability Matrix to map and trace the requirements through all the stages of product development across various documents from BRD through Test Cases to ensure streamlined development and testing
  • Conduct training activities prior to project implementation and provided training to internal staff & business users. Also update provider bulletins and user training manuals in MS SharePoint
  • Extensively used MS SharePoint as a document repository for all kinds of project documentation starting from specific functional design document, technical design document, and test results to provider bulletins and user training manuals


Business Analyst / Data Analyst


  • Involved in validation of ICD-10 codes on a TAR against the ICD-10 Crosswalk mapping file in SURGE/Mainframe applications
  • Followed an agile approach to this expedited SDN (System Development Notice) to make the necessary system changes to the Confidential to validate the ICD-10 Codes requested on a TAR with the ICD-10 Crosswalk active/inactive ICD codes
  • Created Use Case diagrams and Process Flow Diagrams using MS Visio providing diagrammatic flow of different types of TAR processing on various web pages of the Confidential
  • Used IBM Rational DOORS as a requirements management tool to create DOORS IDs for requirements, business rules to track and trace requirements throughout the project life cycle.
  • Extensively worked on IBM Rational ClearQuest to manage defect tracking lifecycle - analyze, log, and prioritize defects; monitor defect resolution, maintain defect log, periodic status update, and generate reports & graphs. Also used this tool to work with change requests
  • Actively involved in all phases of testing and communicating test results to the client
  • After deployment, sent implementation notice to the client and project stakeholders providing details about the implementation date, project ID, project background, description of change and references
  • Extensively used MS SharePoint as a document repository for all kinds of project documentation starting from specific functional design document, technical design document, and test results to provider bulletins and user training manuals

Environment: Windows 10, Advance MS Excel, MS Access, MS Visio, MS SharePoint, IBM Mainframe Application, UML, MS Visio, MS Office, Tableau, J2EE, XML, SQL Developer, Java, .NET, Autosys, Oracle, Unix, JIRA, McWeb, IBM Rational ClearQuest, MMIS, Mainframe, IBM Rational DOORS, Waterfall/Agile

Confidential, NJ

Lead Healthcare Business Analyst


  • Implemented AGILE methodology for application development and played a lead role in all scrum meetings while analyzing requirements, prioritizing user stories and monitor the status of work
  • Interviewed several business stakeholders like SMEs and Operations Staff to understand and document business requirements in business requirements document (BRD) and functional specifications in functional specifications document (FSD)
  • Gathered and analyzed User Requirements from walkthroughs and interviews with business groups and in-house stakeholders, and many other departments like accounting, fund management, human resource
  • Understand EMR vendor and business requirements. Create comprehensive solution architecture plans that address the current and future requirements
  • Participate in meetings involving new EMR vendors, clinics, HIEs (Health Insurance Exchange) and design their solution
  • Identified and resolved numerous project related issues identified during all phases of projects by conducting JAR/JAD sessions and also leading all scrum meetings needed to prioritize, allocate and audit work in progress and report the same to business users
  • Providing the most up to date EHR solutions through major application upgrades, and by customizing templates, as well as shortlists containing diagnosis codes, labs, medications and injectables
  • Worked extensively in developing UML diagrams viz., Use Case Diagrams, Activity Diagrams, Swim Lane Diagrams, Sequence Diagrams, Class Diagrams, State Diagrams, Process Workflow Diagrams, Component Diagrams, Deployment Diagram, and Collaboration Diagram using MS-Visio
  • Worked extensively on SQL to query the database and performed data analysis to audit the data being retrieved and generate reports
  • Worked extensively on developing data mapping document which mapped data from various sources to targets within the application; assisted ETL team to integrate source and target data in the data warehouse
  • Prepared test data from user stories, wrote and execute test cases in JIRA
  • Involved in developing test plan, test case and test script and performed various kinds of testing like functional testing, integration testing, system testing, GUI testing, performance and load testing, black-box testing, smoke testing, regression testing, white-box testing and user-acceptance testing
  • Analyzed, mapped and maintained business requirements from all the documents throughout the life cycle of the project by developing and maintaining the Requirements Traceability Matrix
  • Worked closely with the Data Modeling Team to develop logical and physical models; helped in developing ER diagrams explaining the data flow functionally
  • Detailed knowledge of application features and functional specifications to help project management define the scope and impact of business needs throughout analysis, develop project plan, coordinate work allocation and create project deployment plan and monitored it
  • Liaised with business users, developers and testing team to clarify specifications as necessary to negate discrepancies in system development and manage deliverables within agreed timeframes and report progress to management.
  • Performed Gap Analysis to check the compatibility of the existing system infrastructure, features and functionality with the new business design using the "As Is" and "To Be" methodology
  • Handled end-to-end Change Management Process - Identify, Analyze, Evaluate, Plan, Implement, Review, and Close
  • Provided education and training for application end user community, keeping them informed of new release feature/functionality, changes/revisions that impact the operation

Environment: Windows 7, Advance MS Excel, Java, Quality Center, .NET, JIRA, Visual Basic, XML, MS SQL Server, Business Objects, Management Studio, SQL, MS Project, MS Visio, MS SharePoint, JIRA, Agile Scrum

Confidential, CA

Healthcare Business Analyst


  • Interviewed Subject Matter Experts and Stakeholders to get a better understanding of client business processes and gather business requirements. Defined business rules by interacting with stakeholders and users through Surveys & Brainstorming
  • Involved in conducting GAP analysis, Feasibility analysis, and Risk analysis for the application
  • Managed, analyzed, validated, and implemented the system following the Waterfall methodology throughout the system development process
  • Exercised various initiation techniques such as targeted questionnaires and interviews from business users and SMEs to gather business requirements and documented BRD, FSD, and Use Cases
  • Gathered requirements for Medicare Systems as part of Patient Protection Affordable Care Act (PPACA)
  • Identified & Analyzed trends in EDI failures - collaborating with new EDI partners to develop innovative solutions
  • Utilized MS Visio for use case diagrams and process flow diagrams using the CMS-MITA (Center for Medicaid and Medicare Services - Medicaid Information Technology Architecture) guideline, which enabled developers and other stakeholders to understand the business process.
  • Updated Crosswalk mapping file during conversion of ICD-9 to ICD-10 coding system and also created new entries/fields such as ICD-10 CM code fields, ICD-10 PCS code fields, short and long description of the ICD-10 diagnosis/procedure codes
  • Conducted UML modeling - use case diagrams, written use cases, activity diagrams, screen mock-ups, dataflow, and business process flows, thereby assisting development & QA teams in understanding the Crosswalk mapping file used for conversion of ICD-9-CM codes to ICD-10-CM codes
  • Interfaced with development team to design the application modules, identify system specifications, and process workflow throughout the application design phase
  • Assisted Project Manager in managing timelines for project deliverables, resource management, and conflicts resolution to ensure successful project completion
  • Managed project schedule and project timeline using Gantt Charts on MS Project showing all target dates for project deliverables
  • Worked as a primary liaison between business users and developers to facilitate communication, handle application requirements, issues resolution, and change management
  • Participated in JAD sessions with end users, designers, developers, QA, and project management to gather requirements and identify critical high-risk areas
  • Worked as an Interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes
  • Responsible for the full HIPAA compliance lifecycle from gap analysis, implementation and testing for Medicaid Claims
  • Actively involved in updating internal processes (submit claims, check eligibility), updating data collection and data reporting
  • Communicated results by sending implementation notice to the stakeholders while keeping the developers closely updated on all documented refinements
  • Constructed complex SQL queries to retrieve data, conduct data analysis, and perform data validation
  • Built data mapping to capture data integration process from data source to downstream databases
  • Assisted database modeling team in building data model - entity-relationships (ER) diagram and supporting data document defining the entities, relationships, triggers, and database constraints
  • Collaborated with QA team in developing test plan, test strategies, test scenarios, test cases, and test scripts ensuring that the final application addressed all the user requirements
  • Assist business stakeholders with user acceptance testing, defect reporting and resolution
  • Performed application testing along with QA team - conducted Functional Flow Testing, System Integration Testing, Performance Testing, Load Testing, Regression Testing, Sanity Testing, and UAT
  • Created Requirements Traceability Matrix as per business requirements and test cases to ensure that project initiatives meet the expected deliverables

Environment: Windows 7, HTML, MS Excel, MS Project, Unix, Java/J2EE, Visual Basic, HTML, Oracle, PL/SQL, TOAD, MS Access, Documentum, MMIS, Mainframe, HIPAA, Quality Center, MS Visio, Waterfall, IBM Cognos


Business Analyst / Data Analyst


  • Played a key role in the planning, testing, and implementing system enhancements and conversions
  • Provided key project inputs by working with users in defining the project and system requirements
  • Worked on Hospital data processing for improving database for storing user files
  • Various sources of hospital data mainly comprised of administrative data from clinics and hospital departments such as appointment scheduling, patient admissions, billing, quality control
  • Processed data received from vendors and loading them into the database. The process was carried out on a weekly basis and reports were delivered on a bi-weekly basis. The extracted data had to be checked for integrity
  • Analyzed business needs, created and developed new functionality to meet real time data integration that facilitated decision
  • Automated the existing system to achieve faster and accurate data loading
  • Knowledge in ETL (Extract, Transform and Load) of data into a data warehouse/date mart and Business Intelligence (BI) tools like Tableau
  • Developed SQL queries to collect and retrieve the required information such as hospital data (patient details, appointment scheduling, billing related information) and created customized reports for respective clients
  • Involved in detailing project mission and maintaining project timelines and schedules using MS Project.
  • Assisted in building a business process model using MS Visio
  • Developed Use Case diagrams with MS Visio and created Business Flow Diagrams, which enabled developers and other stakeholders to understand the business process
  • Assisted in business process modeling; conducted and participated in JAD sessions with system users
  • Developed strategic partnerships with the business unit to develop a solid knowledge of the business line, including the business plan, products and processes

Environment: MS Office, MS Visio, RUP, Windows/Unix, Requisite Pro, Rational Rose, Java/J2EE, Visual Basic, HTML, UML, MS Project, MS Access, MS Excel, SQL

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