SUMMARY

• Over 7 years of experience as a Business Analyst in business requirements gathering & analysis and solution design of healthcare and insurance systems.
• Proficient in Business Process Improvements, Requirements Elicitation, Requirements Management.
• Expert in Business Process Modeling using UML diagrams and Process Flow Diagrams (PFD). Have successfully converted desired features into UML models like use cases, data flow diagrams, and activity diagrams for the Development/Systems Engineering teams.
• Experienced with HIPAA compliance in healthcare systems. Created business processes for EDI conversion to XML standards and created data mapping documents for implementation.
• Expert in documentation: created several Business Requirements Documents (BRD) and Functional Specification Documents (FSD).
• Worked collaboratively with stakeholders, product owners, scrum masters and senior management for requirements and change management. Conducted GAP Analysis and provided reviews to project management and development teams.
• Strong understanding of EDI Claims, Member Enrollment, Eligibility, and HIPAA 5010 standards.
• Experienced working in Agile Delivery Model, identifying Epics, creating User Stories, and using Agile tools like Atlassian Jira, Agile Bench, and Confluence for project and program management and managing Product/Release Backlog.
• Collaborated with Scrum teams in backlog grooming sessions, provided estimates, story sizing, analysis, reviews and documented acceptance criteria to meet the definition of done.
• Proficient in writing SQL queries, conducting data validation & data mapping to help design data models.
• Proficient in conducting Test Case Execution, log defects, review with team on defect reports.
• Proficient in creating Test Plans, Test Scenarios and Test Cases for Manual and Automated testing.
• Proficient in Software Testing, User Acceptance Testing (UAT) and providing user training documents to Production Support teams.
• Excellent at collaborating with clients, self - organized, and able to facilitate meaningful discussions and have a strong desire to influence and meet commitments to lead and excel in project deliverables.

TECHNICAL SKILLS

Requirements Elicitation Tools: Office 365, MS Visio, Balsamiq, HP ALM, SharePoint, CaliberRM

Project Management: MS Project, Rally, Atlassian Jira, AGILE - Scrum, Waterfall, Iterative Models, Incremental Delivery, Storyboard

Technologies & Analytics Tools: Advanced Excel, SQL, SharePoint, Tableau, EDI

Databases: MS Access, Oracle11i, MS SQL Server2016-R2

Platforms: WindowsSserver 2016-R2, Mainframe/zOS, Linux, Ubuntu

Enterprise/EMR Suite: Managed Care/FMC, Acute Care, Ambulatory Care, Acumen EMR, Epic - Cadence, MyChart, Accumed Behavioral Health

PROFESSIONAL EXPERIENCE

Confidential

Senior Business Analyst

Responsibilities:

• Made major contribution in the implementation of EDW Incremental (pull and load) that constitutes different modules like claims, providers, pricing, members, and products for different source systems.
• Interacted with business users for better understanding of individual subject areas and modified specifications to reflect accurate user needs. Conducted JAD sessions with end user community ensuring that the software addressed all business needs.
• Led discussions/meetings with key members of the team: business analysts, project manager, stakeholders, and corresponding business management teams to ensure alignment of key priorities and requirements. Used Customer Relationship Management (CRM) before and after key meetings to improve relations and communication.
• Used knowledge of Health Care Information Systems EMR model to develop proposed workflow in MS Visio.
• Responsible for the development and implementation of a complex cloud-based SaaS solution to support Confidential customers.
• Updated & maintained data model/architecture standards, including master data management (MDM). Used MDM tool to support Master Data Management by removing duplicates, standardizing data (Mass Maintaining), and incorporating rules to eliminate incorrect data and filter data as per requirements.
• Used Excel & SQL extensively to produce analysis of the company’s member database. Used SQL ‘insert’, ‘update’, and ‘delete’ commands to query and modify company’s member database.
• Involved in the analysis of HIPAA compliance and EDI transaction sets and actively participated in the designing of the EDI transactions using the new HIPAA 5010 utilizing the ICD-10 codes.
• Worked on the HIPAA 5010 Transaction and NPI Implementation Phase.
• Directly dealt with the SMEs for the Medicare Claims for Crosswalk, Provider Audit Reports for Claims, NPI Maintenance and documented details in BRD and FRD and impact screens.
• Understood the technical specifications and developed a functional design document for Extract Transformation and Loading process of EDW.
• Created a decision tree using CART Technique for data migration and data mining of large-scale data that predicted target variable with existing input variables of the integrated system.
• Worked closely with BI and team leads in process of standardizing job parameters, job flows, audit process and rollback strategies that hold major attention for the successful implementation of EDW Incremental.
• Successfully merged legacy data in EDW.

Environment: MS Office, MS Project, SQL Server, EDW, ETL, Balsamiq, MS Visio, JIRA.

Confidential

Business Analyst

Responsibilities:

• Functioned as the liaison between the business line, operations, and the technical areas throughout the project life cycle.
• Conducted extensive brainstorming sessions with the product owner to elicit requirements. Communicated with external entities such as the New York Office of Mental Health and Confidential —the Subject Matter Experts (SMEs)—to understand the workflow processes and gather requirements.
• Organized and moderated Joint Application Development (JAD) sessions with the product owner and key end users (psychiatrists & other behavioral health providers) within the corporation.
• Developed use cases to self-understand and communicate the workflow processes to be deployed electronically in the new system such as: (1) Intake: self-assessment (PHQ-9 & PHQ-A), suicide safety screening (C-SSRS), risk assessment, substance abuse screening (CRAFT & AUDIT) (2) Diagnostic: Psychiatric Evaluation with DSM-V diagnoses (3) Identify & Track: identification of high risk patients, internal tracking of appointment compliance and weekly symptoms and suicidality (C-SSRS).
• Prepared a Business Requirement Document (BRD) and Functional Requirement Document (FRD) to capture the essential and extended functionalities for the proposed Suicide Safety module.
• Created screen-mockups using Balsamiq to review the requirements of the Suicide Safety Module with the product owner. Screen-mockups included automation of paper forms such as the PHQ-9, AHQ-A, AUDIT, C-SSRS, and Stanley Brown Safety Plan.
• Noted all feedback from the product owner and communicated change of requirements and additional requirements with the business analysis team and IT team.
• Performed walkthroughs and knowledge transfer of business requirements and functional requirements with the development and test teams.
• Created and maintained Requirements Traceability Matrix (RTM) to manage requirements.
• Performed impact analysis with the business analyst team when request for change (RFC) arrived. Escalated the results of the analysis to the Change Control Board (CCB), which consisted of the product owner and program manager, so that they could approve the changes and reprioritize the requirements.
• Accountable for documenting meeting minutes of the weekly team meetings and distributing them to the program manager and other team members for clarification and signoffs.
• Assisted the quality analyst in creating a test plan and test cases to ensure the quality of the system.
• Performed high-level testing of the new Suicide Safety module and documented defects for the quality analyst to review.
• Tracked open issues with JIRA and documented progress reports on weekly basis.
• Coordinated and monitored User Acceptance Testing (UAT) with several end users (psychiatrists, therapists, and social workers) and interfaced with the development and test team with regards to defect status and fixes on a regular basis.
• Facilitated post-production validation and actively participated in production call support whenever necessary.
• Assisted in preparation of user-friendly documents like user manuals and system guides; provided training to user community as and when necessary before project closure.

Environment: AccuMed Behavioral Health ER, HL7, ICD-10, JIRA, Balsamiq, MS Visio, MS Office.

Confidential

Junior Business Analyst

Responsibilities:

• Coordinated with business analyst and IT teams to understand KP Health Connect workflows, archive Health Connect data and worked with Epic implementation team to document system workflows.
• Communicated and maintained relationship with cross-functional teams, Level 1 and Level 2 support teams from product support while ensuring requirements are delivered and shared to all teams.
• Reviewed system and software requirements for Epic integration and implementation of Epic Grand Central for ADT, Epic MyChart and Epic Clarity, Epic Reporting Workbench for operational reporting using My Reports modules.
• Documented change requirements to medication orders, include dosage and route information in the admission HL7 ADT01, update ORU segment in HL7 mapping and reviewed with team.
• Used Epic My Chart to process patient treatment data, admission data and validate HL7 for review of health records, Labs, Radiology, Plan of Care and workflow rules.
• Documented patient ADT integration with CareLink and changes to IN1 and IN2 segments in HL7 for insurance and validated CDR for clinical data repository and EDI transactional data for Claims.
• Documented Use Cases for patient visits: create admission records, cancel or manage visits, create admission details for visit date, create manage My Medical Records and Plan of Care.
• Documented Use Cases for system workflows from ambulatory and in-patient modules, admissions, pre-admissions, pre-admit tests, record patient treatments and manage assessments in MyChart.
• Created documentation for Patient Reminders and Attending Staff messages, Patient Visits, My Medical Record, Billing, Preferences, Resources and Health Library and request or report on Immunizations and Lab tests.
• Contributed to the functional specification document; determined data sources and manage business rules for data transformation of data between staging and enterprise data warehouse.
• Documented wireframes, user-interface page design and mock-up screens supporting the product using Balsamiq.
• Designed mock screens for Patient reports, Physician reports, Nurse Assessment reports, Lab reports.
• Conducted UAT and lead end-to-end testing for Epic planned releases, delivered traceability matrix.
• Conducted unit testing in development environment for work queues, appointments, patient diagnosis and ICD10 validation, print and validate patient reports, admission reports and visit reports in Epic.
• Reported to Scrum team, Product Owner and Integrations Analyst on UAT test results and test reports.
• Used HP ALM to log defects, coordinated with test and development teams on defect report and analysis, participated in defect triage meetings, managed offshore test activities.
• Coordinated with nursing staff and integration analysts for epic go-live events with KP implementation group.
• Conducted user training for the workflow scenario changes at implementation.

Environment: Patient Care Portal, ADT, HL7, SQL Server2016, HP QC ALM, Epic MyChart, Epic Clarity, Epic Grand Central, EpicCare Inpatient, EpicCare Ambulatory.