- 8+ years of experience as Business System Analyst and a Certified Scrum Master on large time - boxed projects with strong domain knowledge of Health care, Health Insurance and Banking industries expertise in Business Analysis, Data Analysis, Business Rules, GAP Analysis, Business process and technical process workflows.
- Knowledge base of clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements, and the managed care industry.
- Assisted Project Managers in developing SOW (Statement of Work), RFP, Project Charter , Project Plan , and WBS.
- In depth knowledge in Software Development Life Cycle (SDLC), Software Testing Life Cycle (STLC) and Project Life cycle (PLC) phases like Planning , Analysis/Design , Development and Testing for the system development process.
- Skilled at performing SWOT Analysis, Impact Analysis, Cost-Benefit Analysis, Feasibility Study, Root Cause Analysis, Predictive Analysis, Risk analysis, ‘AS IS’ and ‘TO BE’ analysis.
- Experience working on Agile , SCRUM , Waterfall, RUP and Waterfall-Scrum hybrid, SAFe .
- Experience in facilitating Joint Application Development ( JAD) sessions, Joint Requirement Planning (JRP) sessions, Storyboard Sessions, interviews and workshops and acted as a Liaison between business users and technical teams .
- Highly skilled in collecting Functional Requirements that provide appropriate scope of work, and Creating Business Requirement Document (BRD), Functional Requirement Document (FRD), Requirement Traceability Matrix (RTM) and Data Mapping Documents.
- Involved in maintaining product backlog, writing PBIs, sizing user stories, managed open issues, removed impediments, & worked with cross-functional teams to improve software quality & test coverage .
- Sound Knowledge of HIPAA standards and code sets (EDI 834, 835, 837, 270, 271, 276, 277, 278, ICD-9, ICD-10), HL7(Health Level-7) and PPACA (Patient Protection and Affordable Care Act).
- Good knowledge of Health Insurance Plans (Medicare Part A, B, C and D), managed care concepts (Medicaid and Medicare), CPT coding, claim forms and reimbursement forms, EDI, ANSI X12 and Electronic Health Record (EHR)/Electronic Medical Record (EMR).
- Experienced in writing User stories, Use Cases and handling the Change Requests (CR).
- Experienced in facilitating and performing Prioritization techniques like MoSCoW and KANO.
- Effectively participated in Estimation Techniques like Planning Poker, Bucket estimation, T-shirt Sizing, Relative Mass Evaluation, Delphi technique, Percentage distribution.
- Skilled in analyzing and creating Use Cases, Use Case diagrams, Activity diagrams, Sequence diagrams, Class diagrams, Data Flow diagrams, Business Flow diagrams and ER diagrams.
- Experienced and assisted in creating Wireframes, UI mock-ups and GUI designs.
- Solid Understanding of Data Warehouse architectures - Hub and spoke, federated, independent, centralized, along with ETL process, Star/Snowflake Schema, Facts, Dimensions, OLAP, MOLAP, HOLAP.
- Knowledgeable in ETL (Extract, Transform and Load) process to load the data into a data warehouse or a data mart using Informatica and designing Physical and Logical Data Models using Power Designer.
- Worked on Informatic Power Center tool - Source Analyzer, Data warehousing designer, Mapping & Mapplet Designer and Transformation.
- Involved in SQL and PL/SQL queries using joins, unions, outer joins, group by, aggregate functions and stored procedures, triggers, functions and indexes to extract data from different databases (Oracle, SQL Server) for reporting and Validation and also proficient in creation and development of ETL mapping documentation.
- Good Understanding on Web services like REST/SOAP using XML, WSDL and UDDI using Internet protocol suite like HTTP, TCP/IP under the Three-Tier, N-Tier, Service Oriented Architecture (SOA).
- Experienced in creating Operational Dashboards to monitor changing business processes, Strategic Dashboards to track the KPIs and Analytical Dashboards to analyze large volumes of data using Informatica and Tableau.
- Assisted in creating API Documentation containing all the information required to work with the API, with details about the functions, classes, return types and arguments using Open API and Swagger Tools
- Adept at collaborating with QA/Testing team in developing Test Plans, Test Objectives, Test Cases and Test Scripts. Also involved in maintaining Test Matrix and Traceability Matrix.
- Assisted QA teams to effectively perform GUI testing, functional testing, performance testing, integration testing and stress/ load testing by undertaking a comprehensive review of test cases to ensure their integrity, Facilitated user acceptance testing (UAT) with the business users.
- Ability to manage, monitor, and control software development projects to reach successful deployment and use, and the ability to understand and work with peers, management, and client base to achieve project goals and outcomes.
- Exceptional ability to quickly master new concepts , very collaborative , innovative , self-starter and self-motivated team player with highly motivative leadership qualities and team management skills .
Methodologies: SDLC, STLC, Waterfall, Agile, JAD, Scrum, Waterfall-Scrum Hybrid, SAFe.
Project Management Tools: MS SharePoint, MS Project, Confluence, Citrix Podio, Clarity PPM.
Requirements and Defect Management Tools: MS Office Suite, JIRA, Rally (CA Agile Central), HP ALM, Team Foundation Server (TFS), Bugzilla, Rational Clear Quest, Rational ClearCase.
Design and Modelling Tools: MS Visio, Smart Draw, Lucid Charts and Visual Paradigm.
Statistical Tools: SPSS, SAS (Base Programming for SAS 9.4m4, Essentials).
Version Control tools: GIT, CVS, Eclipse.
Change Management tools: Jira, Rational Clear Quest, Test Director.
Reporting and Data Analysis tools: Tableau, Power BI, MS SQL server, MySQL workbench, MS Access, HEDIS, IBM SPSS statistics, IBM SPSS Modeler, Informatica Power Center, Data Quality Center, MS SSRS, Cognos 8.3 BI.
Languages: UML 2.0, CSS, HTML, XML, SQL, Oracle, C, C++, Java, J2EE, PEGA
Testing tools: HP QC, Selenium, Cucumber, Test director, SOAP UI, POSTMAN, SmartBear.
Operating Systems: Windows XP, vista, 7, 8, 10, Unix
Database/ETL: Oracle DB, DB2, MS Access, SQL Server 2012, Java
Confidential, Dallas, TX
Senior Business Analyst
- Conducted GAP Analysis to derive requirements for approval workflow in the eDBR system.
- Used software methodologies including Agile (Scrum), Scrum - waterfall Hybrid.
- Initiated Scrum process, coached team with Agile implementation and adapting to Scrum.
- Interviewed Business users for eliciting requirements using JAD sessions, Survey/Questionnaire, Interviewing, Focus Groups and analyzed the feasibility of the requirements.
- Elicited requirements from the stakeholders and analyzed them for consistency, completeness and flexibility.
- Interacted with SME’s, asking detailed questions and carefully recording the requirements in a format that can be understood and reviewed by both technical and business teams.
- Proactively completed BRD, determined the scope of the project and divided the scope into Epics.
- Conducted User Story Writing Sessions to decompose BRD into User Stories to meet INVEST criteria and determine Acceptance Criteria for Potentially Shippable Product Increment.
- Collaborated with Scrum Master in facilitating Scrum events including Backlog refinement, Sprint Planning, Daily Stand ups, Sprint Review and Sprint Retrospective.
- Assisted the Product Owner to prioritize the Product Backlog items for developing Sprint tasks by taking suggestions from the cross-functional development team.
- Effectively collaborated in writing and prioritizing user stories in Product Backlog with Product Owner.
- Analyzed the Iteration Burn Down charts and reviewed defects.
- Collaborated with development team in preparing mockups and wireframes to provide better insights of the project.
- Worked closely with Scrum Master to anticipate and remove obstacles from project team’s path and pushed them to deliver quality results based on schedule.
- Used Rally Software for issue tracking, user story management and requirement traceability.
- Assisted with User Acceptance Testing, developing and maintaining quality procedures, and ensure that appropriate documentation is in place.
- Collaborated with testers in writing the test case scenarios and determining the level of testing, Assisted in Black box, White box and Smoke testing.
- Extensively involved in the User Acceptance Testing phase to ensure the requirements and functionality of the system was in accordance to the users and their feedback was incorporated.
- Communicated effectively across company contacts and clients, internal team about the project requirements, scheduled and trained users with new updates to the system by conducting sessions.
Environment: Scrum - Waterfall Hybrid, MS SQL server 2012. Visual studio 2013, Clarity PPM, Rally software, Cognos, PEGA 7.3, SmartBear, MS Office Suite (MS Word, MS Excel, MS PowerPoint).
Confidential, Melbourne, FL
Sr. Business Systems Analyst
- Facilitated JAD sessions to identify the business flows and determine any current or proposed systems are impacted.
- Ensured medical protocols has been followed based on the clinical pathways or guidelines to support decision making process of the end users in the implementation of the project.
- Used IBM SPSS Statistics to analyze Pre and Post-Test Data. Participants responses were evaluated using descriptive statistics to obtain means of percentage.
- Responsible for gathering, analyzing and writing business requirements from patient accounting Stakeholders and SMEs by conducting JAD sessions, Structured Interviews, Questions/ Surveys.
- Transformed Epics into userstories and assisted the product owner in writing Acceptance criteria.
- Assisted product owner in the prioritization of Product Backlog Items (PBIs) using MOSCOW and assisting the technical team in breaking down EPICS into user stories to meet the INVEST criteria.
- Assisted Scrum Team in creating user stories, acceptance criteria, high level artifacts, also provided reports, metrics, and recommendations, as needed, to all Business stakeholders.
- Designed and developed Use Cases, Activity Diagrams and Sequence Diagrams using MS VISIO.
- Used JIRA for user story management, Change requests (CR), issue tracking, and requirement traceability. Co-ordinated with the team to document plans and product knowledge in Confluence.
- Analyzed the teams Sprint Burn-Up and Burn-Down Chart, calculating their velocity to track progress and prepared the status reports.
- Used SQL queries like Select, From, Where, Insert, Update, delete to fetch and manage complex data to perform data analysis, data validation and data manipulation.
- Assisted in various ETL transformations on extracted data using Informatica like Unconnected and connected Lookups, Routers, Joiners, Filters, Aggregators, Union on flat files and also worked on ETL mapping documents.
- Worked extensively in Source to Target Mapping documents with data transformation logic.
- Used HP QC to write test cases, log defects and create an error repository to support QA/testing team in testing, tracking defects and systematically managed defects and bugs in web and mobile application.
- Created feature file following given, when, then format in Cucumber to enable automation.
- Collaborated with QA team for test plan, test cases for UAT after integration of HIS and CDSS.
- Coordinated with the Web Services team in documenting requests and responses for the REST Web Services in JSON. Manually tested and executed the Web services using Postman and helped the QA team in automation. Involved in API technical writing for SOAP API documentation and documented XML request and responses.
- Developed Tableau dashboards incorporating Waterfall charts, Bubble charts, Heat Maps, and Histograms for real-time metrics to optimize and enhance the KPI’s.
- Designed and implemented proof of concept solutions and created advanced BI visualizations using Tableau platform
Environment: SAFe, Microsoft Office Suite, Microsoft Visio, UML, Tableau v9.0, SQL Server, TFS, IBM SPSS statistics, IBM SPSS Modeler, Informatica PowerCenter 9.6.1, JIRA, Cucumber, Postman, HL7, M LLP, HP QC.
Confidential, Minneapolis, MN
Business Systems Analyst
- Created and Reviewed the BRD to ensure the business deliverables scope and objectives correlate with the business requirements. Documented FRD based on the BRD.
- Produced detailed and structured BRDs including mockups (layout)
- Identified process and documented process/data flow diagrams using Microsoft Visio
- Performed gap analysis for migration of HIPAA transactions from 4010 to 5010.
- Performed impact analysis for readiness of ICD-10 conversion.
- Identified Prioritized features, Requirements by features and developed Traceability Matrix.
- Involved in mapping and validation of EDI transaction used for claims filing like ANSI X12 837 (I, P, D) for claim submission, ASC X12 270/271 for the eligibility/benefit inquiry and response, ASC X12 276/277 for the claims status enquiry and response ASC X12 835 for the healthcare claim payments.
- Involved in mapping data from EDI files onto database using different routing transformations.
- Assisted in Data profiling and checking for data integrity by looking for various data anomalies and doing data normalization and data verification
- Involved in evaluation of CPT codes and CMS-1500 claim forms used for billing.
- Documented simple structured designs and prototypes to define user requirements.
- Involved in evaluation of CPT and ICD-10 codes to ensure diagnosis meets medical necessity for the specific CPT code.
- Tested Web services like SOAP and REST using SOAPUI to test the business process flow of the enhanced system.
- Used Rational Rose to visually determine the proper structure, key elements and optimal design for the database and aid efficient creation of tables, stored procedures.
- Created ad-hoc and custom prompted reports using Cognos BI 8.3 for business decision-making
- Helped the QA team in logging defects, monitor status and track them for closure using JIRA.
- Helped in System Testing to ensure that the system components and business processes are operational after being integrated with one another. Also, supervised the development of User Manuals for customers.
- Involved in User acceptance Testing (UAT) by writing high-level Test Cases, on hypothetical end-to-end scenarios leading to the expected results. Also validated if the final result matches the expected one.
- Used Rational ClearCase, a Configuration Management tool, to maintain different builds of the application with descriptions about all changes and versions
- Responsible for managing and validating bi-directional traceability between business and functional requirements for Change Requests (CRs).
- Participated in full development lifecycle within Cognos reporting framework from developing business requirements to QA and production deployment
Environment: RUP Methodology, Microsoft Word, Microsoft Excel, JIRA, Microsoft PowerPoint, Rational Requisite Pro, Rational Rose, Test Director, Cognos 8.3, Oracle 12c, SOA.
Confidential, Brea, CA
Business Systems Analyst
- Coordinated with Business Owner, Application Vendor, Business Project Teams, Payers and Clearinghouses to bring all processes to a level of execution to mitigate any impact to current revenue flow under the 5010-compliance requirements.
- Facilitated JAD sessions with SME’s and Development managers to understand the business process, gather Business Requirements and identify whether any current or proposed systems are impacted by the EDI X12 Transaction Code set and Identifier aspects of HIPAA and to determine the enhancements of the FACETS system.
- Involved in Gap analysis and Impact analysis for HIPAA 4010 and HIPAA 5010 transactions sets on different systems, and for the facets upgradation from .
- Managed and prioritized the product backlog, conducted Backlog Grooming sessions, Sprint Planning, Release Planning and Demos, participated in Retrospective meetings as well as daily Scrum Stand Ups.
- Worked closely with Scrum Master and other stakeholders in release planning and iteration planning, all scrum ceremonies, to Re-factor Epics into User stories, maintain prioritized Sprint backlogs and capture requirements in Rally.
- Prepared graphical depictions of Use Cases, State Diagrams, Activity Diagrams, Sequence Diagrams, Component Based Diagrams, and creation of technical design (UI screen).
- Assisted in Data profiling and checking for data integrity by looking for various data anomalies and doing data normalization and data verification using Informatica Data Quality Center.
- Involved in Data mapping to define how the Source data is modified before it reaches the Destination or the Target object, validated Claims daily load into FACETS for processing the transactions and in Facets Configuration to make sure all information is sent without any error.
- Executed SQL queries to retrieve data from data warehouse and validate the data Integrity.
- Tested Web services like SOAP and REST using SOAPUI to test the business process flow of the enhanced system.
- Assisted the QA team in writing test cases and test scripts for testing the migration of EDI 4010 to 5010 and the processing of member enrollment and benefits, batch jobs corresponding to the claims (837) and real time transactions like 270/271/276/277 . Also, used TFS for updating the status of all Test Cases & Test Scripts that are executed during testing process and Managed and assigned the defects to development team in Microsoft Team Foundation Server.
- Assisted in performing User Acceptance Testing for the ANSI X12 Version 5010/EDI transactions (HIPAA) for Claims Status and Eligibility (270, 271, 276, 277, 834, 837P, 837I, 837D, 835 remittances and NCPDP claims), for the Facets upgraded system with emphasis on ensuring that the HIPAA regulation are met across all the modules.
- Operated Automation Testing, White-Box and Black-Box Testing and created Automation scripts using Selenium.
Environment: Waterfall-Scrum hybrid, Windows XP professional, MS Office suite, MS Project, Oracle Platform, Oracle Application server, SQL, SQL server, MS Visio, Bugzilla, HP QC, TFS, Rally, Informatica Data Quality Center, SOAP UI.
Business Systems Analyst
- Interacted with Users and Stakeholders to identify business system needs, evaluated solutions for business problems
- Worked with SME’s of different groups to gain detailed knowledge of Investments and Capital Market and also to understand the cross impacts of the system
- Analyzed and documented information system requirements and the corresponding impact on business processes
- Studied the Business Requirement Document (BRD), supporting documents containing essential business elements, detailed definition and description of the relationship between the actors
- Designed and developed Use Case Diagrams, Activity Diagrams, Data Flow Diagrams to define the Business Process
- Analyzed the data entity relationships and worked on multiple short-term projects in between.
- Worked as a team with other business analysts to make object-oriented model of the application, created use cases
- Conducted JAD sessions to different stakeholders to communicate with each other, resolve problems at early stage
- Worked on the Functional Requirements Document (FRD)
- Hands on experience in working with active directory, to access to the users according to their roles and designations
- Analyzed Business Requirements documents to get a better understanding of the system on both Technical and Business perspectives
Environment: Waterfall, SDLC, MySQL, Java/J2EE, Active Directory, Rational Rose, AML, UAT, UML, MS Office, MS projects, MS Visio.
- Involved in technical requirement gathering, Analysis, designing, development.
- Designed a framework to upload data from XLS sheets or text files for various modules using different file delimiters, date formats and primary identifiers using Factory Design Pattern and developed the framework using struts (using Java, JSP)
- Designed and developed procedures, functions, cursors and triggers in Oracle for data verification and Extraction.
- Worked with JavaBean and other J2EE components using concepts like Externalization, property files to develop business and data process
- Log4j is used for logging different types of messages to write on to the proprietary log model.
- Performing the different modules like login, search and download with tracking.
- Involved in creating User Control to display Menus on web pages. Extensively used Datasets, Data table and Data view to retrieve, manipulate data and display it in an ASP.NET page.
- Designed and developed the various reports based on user requirement and export reports into excel and PDF files.