SUMMARY

• Over 8 years of professional experience as a Business Analyst in the Healthcare, Clinical and Medical Device industries.
• Extensive experience in analyzing and requirements gathering and writing system functional specifications including use cases.
• Strong skills in creating UML Diagrams and Data Models including Use Case Diagrams, Activity Diagrams, Deployment Diagrams, Data Flow Diagrams (DFD) and Entity - Relationship diagrams using Rational Rose and MS Visio.
• Strong skills in dealing with software development lifecycles (SDLC), both Waterfall, and Agile/Agile scrum, Rational Unified Process (RUP).
• Conducted training using multiple modalities for technical solutions; EXL CareRadius, Facets, Salesforce.com, WebNow, ClaimsXten, HIPAA Gateway,
• Expertise in defining and documenting Business process flows and "As-Is" & "To-Be" processes.
• Experience in data collection from multiple sources, interpretation, presentation, and management of reporting and decision making.
• Expertise in creating Business Requirements Documentation (BRD), Requirements Traceability Matrix (RTM), Business Rules Spreadsheet (BRS) and Functional Requirements Documentation (FRD)
• Expertise in project management activities like defining/managing project scope, planning various activities for execution, estimating business value/impact and providing a periodic status report to management.
• Experience in working with cross functional and cross-cultural team environments, different levels of management and liaison between system users, management and development teams.
• Experience in Healthcare Application Facets in different modules like Claims, Membership, Billing & payer and Provider.
• Well versed in writing SQL queries, together with inner and outer Join commands for data analysis and retrieval.
• Strong understanding on Electronic Data Interchange (EDI), both in 4010 and 5010 formats.
• Extensive experience in organizing and facilitating joint application development (JAD) sessions, interviews and workshops with user (s), subject matter experts (SME's), and business stakeholders.
• Expertise on website Wireframes and Business Process Modeling with excellent skills on Use Case, Activity, Sequence, Data-Flow diagrams using Unified Modeling Language (UML), in MS Visio and Rational Rose.
• Well versed in Relational Database Management System (RDBMS).
• Skilled user in Clear Quest for defect tracking, bug reporting tools like Test Director and Quality Center.
• Create requirements for custom business / billing applications, reporting, IVR, Web and contact center solutions.
• Excellent analytical skills with extensive experience on performing GAP analysis, User Acceptance Testing (UAT), Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, Impact Analysis, Risk Analysis and Mitigation plan, Cost benefit analysis and Return on Investment (ROI) analysis.
• Proficient in handling functional and non-functional requirements with exceptional understanding and skill set in writing Test Scenarios, Test Conditions, Test Cases, and Test Scripts.
• Experience and skills in creating design models and Extensive use of UML/RUP for modeling views using tools like Microsoft Visio.
• Extensive experience in creating Functional Specifications, UI specifications and UI prototypes.
• Conducted requirement analysis techniques such as Business Process Automation, Business Process Improvement, and Business Process re-engineering.
• In depth knowledge Rational Unified Process (RUP) methodology, Use Cases, Software Development Life Cycle (SDLC) processes, Object Oriented Analysis and Design (OOA/D).
• Facilitated Change Management across entire process from Project conceptualization to Testing through Project Delivery, Software Development and Implementation Management in diverse Business and Technical Environments.
• Strong experience in conducting User Acceptance Testing (UAT) and documentation of Test Cases. Expertise in designing and developing Test Plans and Test Scripts.

PROFESSIONAL EXPERIENCE

Business Analyst

Confidential, Hartford, CT

Responsibilities:

• Worked on developing the requirements (BRDs) based on discussion with Business teams during Joint Application Requirements (JAR) sessions, develop Business Process modelling (BPMs) & technical specification documents/ System Use case (SUCs)
• Analyzed the business and functional requirements, attend design review meetings and walkthroughs for new requirements with Systems Analysts, development team and mentor the QA team in understanding the requirements.
• Utilized Mercator as an EDI mapping tool to map the claims data that passes through the EDI gateway to the Facets claims processing application.
• Landcorp's CareRadius MMS Implementation - Responsible for business rule configuration of Complex Needs, Disease Management, Geriatric, and Pregnancy assessments, surveys, workbooks, and process flows.
• Conduct the Requirements gathering sessions and understand the Service Requests submitted in the JIRA dashboard.
• Discuss with the Business SMEs, Technical leads, Systems Analysts to capture and define Business Needs, In-Scope and Out-of-Scope items from the Requirements Perspective, explicitly call out the assumptions and accurately define the Functional Requirements and Detailed Functional Requirements in the Business Requirements Documents (BRD)
• Created System Use Case Documents (SUC) by updating the Functional Requirements, Business Rules, File Layouts, incorporating the Change Request and Version History in the SUC document.
• Interacting with the Technical Leads, Design Leads and QA and conduct review meetings for SUC documents.
• Performed extensive GAP Analysis to understand the As-Is and To-Be conditions and determine the feasibility of the new project with the existing system.
• Applied the SQL scripts to the test database and execution of the scripts on the database. Worked in close collaboration with the QA team in writing and reviewing the test cases and conduct test case walkthrough sessions.
• Upload the BRDs and SUC documents in the SharePoint and perform High-Level Designs HLD mapping for traceability using HP-ALM and track the approvals for BRDs and SUCs and get them published in the Source Deliverable Repository (SDR)
• Updated the b for the status of Service Request, tracked the defects, resolved and closed the defects in the JIRA workflow.
• Involved in processing claims in FACETS and validating the full cycle process to make sure the checks are generated and 835's are generated
• Tracking of the deliverables and report the daily status of the project to Manager, organize periodic status meetings with client teams to discuss on the progress of the project.
• Assisted in EDI 835/837/270/271 transactions of medical claims/underwriting for support and point of reference for the providers in business issues.
• Updated the Project Manager on the timelines, deliverables and status of critical issues.
• Used the MS-Visio to create the Use Case Diagram and Process Flow Diagram.
• Used Oracle SQL Developer to connect to the TriZetto Facets Backend Database and query the logics for tables and records.
• Coordinating and performing the entire test planning, test design, test execution, defect tracking and test data management activity through an Onsite-Offshore model.
• Acted as a liaison between the Business and technical teams including the technical leads, Development and QA teams.
• Assisted business on conversion, and implementation of current Medical Management System to Landcorp's EXL CareRadius Application.
• Worked on service requests for various interfaces and Line of Business (LOBs) including the Argus Eligibility interface, Blue Card Plan Profile data, Customer Experience cover letter and ID card generation, ReconNet - Reconciliation interface for b and WF/ASO Banking, MesVision Eligibility extract for premium coverage population through FACETS Billing modules etc.
• Support Business users in validation of critical UAT test cases and publish metrics and other status reports to the client and Project management during every testing cycle.

Business Analyst

Confidential - Bethesda, MD

Responsibilities:

• Interacted with various stakeholders to collect their user stories; document, manage and ensure real-time tracking of them as project proceed.
• Manage multiple relational databases using SQL and Enterprise SAS studio for processing, cleaning, and verifying the integrity of data.
• Performed extensive GAP Analysis to understand the As-Is and To-Be conditions and determine the feasibility of the new project with the existing system.
• Studied the current system functionalities & behavior and documented "As-Is" process; later upon business requirements and identifying the application shortcomings developed "To-Be" processes.
• Carried out User Acceptance Testing and extensively used SQL to perform Backend Testing to verify data integrity.
• Interacted with the QA team to perform Unit and Integration.
• Worked with TriZetto to resolve the issues identified at analysis state while building the Custom components for Claim life cycle.
• Analyzed EDI Transactions such as claim 837 P/I/D - medical claims, 835 - Health Care Claim Payment/Advice, 270 - Eligibility, Coverage or Benefit inquiry, 271 - Eligibility, Coverage or Benefit response, 276 - Claim status request, 277 - claim status response, 820 - Payment Order/Remittance Advice, and 834 - Benefit Enrollment and Maintenance.
• Updated, analyzed, and manipulated the SQL database.
• Collected, documented, organized, and tracked the business requirements using Rational RequisitePro.
• Made business requirements document, change requests, and use cases available to all teams using MS Visio.
• Developed business flow diagrams, activity diagrams, and interaction diagrams so that the development team and other stakeholders could understand the business process clearly.
• Maintained project milestones, schedules, and project progress using MS Project.
• Held presentations and participated in walkthroughs with the development team and the QA team to help them understand the requirements and formulate test plans and test scripts.
• Maintained Requirement Traceability Matrix (RTM) to check whether the requirements of the system were met accordingly and to produce RFPs.
• Performed claim validations and Pend/Denied claims analysis for the Health plans Medicaid programs.

Business Analyst

Confidential

Responsibilities:

• Conducted JAD Sessions to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests.
• Responsible for deriving, documenting and gaining approval for data accuracy and data mapping between different data sources
• Established a Business Analysis methodology around the Rational Unified Process.
• Interaction with underwriters to understand multiple data points. Prepared data flow diagrams using MS Visio for better clarity and to ensure documented process.
• Ensured that all Lines of Business specifications were consistent in form and function to the Diamond Base System.
• Installed, authored, and managed reports using SQL Server Reporting Services.
• Worked in compliance with FDA regulations and cGxP guidelines in documenting the Validation Master Plan and in all the aspects of Computer Systems Validation.
• Involved in XML Validation Testing and Web Services based testing using SOAP UI, API Tester
• Aided end-users in resolving any issues encountered while using various commercial software sys- tems including a Materials Requirements Planning (MRP) system.
• Created the SQL scripts for demonstrating the prototypes and for verifying the result sets.
• Ensured that project/requirement(s) are properly tracked and documented as per Project Manager's needs.
• Experience documenting requirements in the R&D workspace in client business domain. Designed and implemented a web service to support the outsourcing of clinical trial disclosure.
• Assisted in building a Business Analysis Process Model using Rational Rose and Visio.
• Gather final requirement and draft the BRD and Business Data Flow Diagrams.
• Conducted JAD sessions for communicating with Stakeholders and Project directors.
• Developed business requirement specification documents as well as high-level project plan.
• Used Requisite Pro for the Requirement Documents Preparation and Prepared Business Process Models that includes modeling of all the activities of the business from the conceptual to procedural level. Followed top down, levelled technique for building Business Process Models.

Business Analyst

Confidential

Responsibilities:

• Conducted JAD sessions and brainstorming with relevant business Units and developers for the requirement clarification.
• On-boarded by the IT infrastructure team to write JIRA feature stories to develop a portal to manage server patching automation.
• Responsible for requirements gathering, gap analysis, preparation of current-state and future-state process documents, functional design documents, test plans, test scripts and testing
• Used Agile/Scrum methodology for gathering requirements and organized user stories workshop.
• Documented User Stories and facilitated Story Point discussions.
• Conducted interviews with various business users to collect requirement and business process information using MS Visio, Requisite pro.
• Created screen mockups and end-to-end process workflows using Visio for new enhancements.
• Develop and maintain reporting using in MS Excel queries, SQL in Teradata, and MS Access.
• Produce performance reports and implement changes for improved reporting.
• Analyzed business requirements and developed Use Cases, Use Case Diagrams, Sequence Diagrams and Activity Diagrams.
• Maintained major release documents on SharePoint.
• Worked with front to back office, fund managers, financial advisors and technical team members.
• Developed and executed SQL queries for various ad-hoc reports requested from executive management.
• Worked with business line and external data providers to develop a suite of exposure management reports for the bank's Loan Portfolio and Credit Default Swap hedge book.
• Extensively involved with the trading activities of credit derivatives, credit default swaps, interest rate derivatives, Fx derivatives, equity derivatives and commodity derivatives; and futures including commodity futures contracts and financial future.
• Collaborated in building a business analysis process model using Rational Rose, Requisite Pro, and Visio.
• Provided key initiatives in working with users in defining project and system requirements.
• Defining Software Development Lifecycle (SDLC) and planning the entire process using MS Project.
• Identified, researched, realized, investigated, analyzed, defined and documented business processes and use case scenarios.
• Involved in managing data modeling project from logical design and implementation of Sybase database.
• Prepared detailed design documents to translate business process effectively for developers and product managers using MS Visio.
• Developed user documentation for all the application modules. Also responsible for writing test plan documents and unit testing for the application modules.
• Target Data Mapping documents and assisting ETL Development Team in development activities.
• Extensively used SQL for accessing and manipulating database systems.
• Helped QA team to create and perform UAT and responsible for user acceptance testing (UAT) of the final product.
• Prepared the traceability matrix in MS Word for Requirement gathering and MS Excel for testing and imported to Quality Center for the application.

Systems Analyst

Confidential

Responsibilities:

• Conducted Joint Application Development (JAD) sessions to elicit business and system requirements
• Assisted and executed full traceability among all artifacts throughout the software development life cycle (SDLC).
• Responsible for gathering and analyzing Business and system functional requirements
• Understanding and translating Business needs into Business Requirement Specification (BRS) and System Requirement Specification (SRS) documents.
• Collaborated with Finance, Compliance departments on a regular basis
• Prepared vision document for defining the scope of the project and the various functional and non- functional requirements involved in it.
• Collaborated with internal clients for current and future module configuration upgrades and/or implementation.
• Involved in various stages of code conversion in Workbench including Development, Testing, Stage and Production.
• Responsible for ETL design, Coding, Unit Test, Integration test, Workflow dependency from source to target.
• Analyzed Portfolio Risk and Market risk of trading. Prepared and documented Use-Cases using UML based on requirements gathered from stakeholders.
• Played a key role in User Acceptance Testing (UAT), and implementation of the systems.