SUMMARY

• 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

TECHNICAL SKILLS

• 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

PROFESSIONAL EXPERIENCE

Conduent, NJ

Sr. Business Analyst

Responsibilities:

• 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

Confidential

Sr. Business Analyst

Responsibilities:

• 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 SURGE application 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 SURGE application
• 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

Responsibilities:

• 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

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