- Thorough knowledge of Software Development Life Cycle SDLC including Iterative Rational Unified Process and Agile Sprint and Software Product Life Cycle Management PLM
- Adept at analyzing the current and future business processes.
- Experienced in project management, working with various internal teams and clients in tracking project progress and maintaining Change Request and Requirements logs
Role: Business Analyst
- Define and document business, user, and functional requirements using appropriate documentation techniques to describe statements of the goals, objectives, or needs of a particular stakeholder or group of stakeholders.
- Document speech enabled directed dialogue call flows with a high degree of usability which include pre and post call routing.
- Perform end to end testing including system and integration testing for IVR payment options for Emblem Health members.
- Make recommendations to improve operating efficiency and functionality of voice user interface.
- Understand business requirements and prepare test cases for Adhoc Testing.
- Participate in the planning, development and maintenance system and regression level testing scenarios.
- Perform analysis of software/system problems reported to determine deviation from system specification and business requirements.
- Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
- Prepare, design, and assist in the execution of the UAT test plans and cases based on documented requirements for online provider directory and IVR self-service.
- Work with core team members usability consultants, web designers, developers to design and implement new features for online provider directory.
Role: Business Analyst Duration
Confidential currently employs a highly manual process requiring heavy amounts of time and effort to record the intake of information from entities doing business with the agency. The identified solution is to reengineer the process of information intake from entities external to HPD, and providing data sharing capability of entity information for other HPD and HDC processes which requires a web based solution.
- Participate in knowledge transfer sessions with the business to subject matter expertise on HPD internal processes.
- Involve and contribute in visioning discussions to reason and suggest best solutions for automation.
- Document as-is process to identify problem areas and corresponding solutions.
- Collaborate with product management and business areas to facilitate and define scope and business requirements.
- Elicit and document business requirements from stakeholders, user groups, and vendors.
- Organize, present, communicate, verify, and gain approval of requirements from business and technical stakeholders at all levels.
- Analyze and document business workflows, for each individual process for business teams to approve and sign off.
- Identify and map key business processes, using appropriate tools and techniques
- Assess impact of new business processes on current business process models and systems.
- Collaborate with developers and subject matter experts to establish the technical vision and analyze tradeoffs between usability and performance needs.
- Work with Product Owner on product backlog items and hash out user stories.
Role: Business Analyst
Confidential is in the process of revamping the user interface of the existing Online Provider Directory application for the Horizon NJ Health network in providing more of an interactive search and impacting the front end user. The organization is also implementing Premium Billing transactions through a Third Party Vendor for Horizon Members subscribing through Federal Exchange Plan Affordable Care Act .
- Conducted initial analysis on business requirement and need for revamping the user interface of existing Online Provider Directory.
- Developed Business use cases based off of analysis and presented to business for sign off
- Developed flow diagrams to reflect appropriate workflow sequence.
- Created and updated Requirement Traceability matrix to tie in the business use cases to user stories and test cases
- Developed Test cases for all UAT testing and performed UAT testing on behalf of business.
- Logged and Tracked testing defects on ClearQuest
- SPOCandLeadfortwoprojects OnlineProviderDirectoryandPremiumBilling
- Transaction for both communication as well as project updates.
- Identified gaps in understanding of business need and portrayal of business requirements and restructured the writing of business requirements to capture requirements as per business need.
- Communicated with Third Party vendors on assigning testing tasks and accountability of work.
- Estimated level of Effort on Change Requests made by Business from time to time.
Role: Business Analyst
- Confidential is an end to end Cloud HIM product to enable accelerated adoption for all the HIM needs of a typical Healthcare provider with negligible IT Investment and no IT Maintenance. The system streamlines the access and procedural processing of Healthcare Information from Patient Admission to archiving the Chart for the Medical Care provided with adherence to standards and compliances and offers seamless integration between hospitals and clinics and effectuates effective communication between physicians and patients.
- Roles Responsibilities:
- Developed business requirements and facilitated JAD sessions to build product to support new sales of ALFA Cloud EMR.
- Conducted feasibility analysis for procurement of new cloud service solution to be used as a platform in the development of the EMR product.
- Responsible for On-shore and Off-shore coordination during requirements gathering and development phases.
- Designed workflows per recommendations of physicians and performed requirement mapping during development.
- Prepared evaluation forms and survey orders for various physician groups using currently available EMR products in order to document pain points and identify solutions.
- Performed AS-IS and TO-BE analysis based on current products and expectations of users and stakeholders.
- Used Requirements Traceability Matrix RTM to trace the relationship between business and functional requirements to test cases.
- Created Use Case diagrams and Story Boards to best express to the technical team, user scenarios from a business perspective and created documents with use case scenarios for developers from a system perspective.
- Coordinated UAT User Acceptance Testing , created UAT Plan, Test Cases and UAT summary report as part of the standard Project deliverables documentation and involved in the project release implementation process.
- Role: Business Analyst
- Confidential as their billing system and has migrated to Trizetto FACETS through a Third Party Administrator TMG Health , which uses FACETS and administrates billing on VNSNY's behalf. I have worked as a Business Analyst on the migration project to enable VNSNY to focus on patient care and better administration of billing and am currently working on analysis of various system generated reports and building tech spec documents based on modifications.
- As a Business Analyst I gather requirements from end users of various systems and prepare the Business Requirements Document BRD .
- Responsible for providing overall system and operational support to the VNSNY CHOICE Operations and Implementation Department in order to assist with departmental and plan-wide operational projects and initiatives
- Schedule and coordinate meetings, Facilitate JAD sessions for developers to understand the requirements and for issues with migration to be discussed. Document all agreements and resolutions for future reference.
- Record data sources both at front and back end for numerous parameters/metrics of the system derive actively used fields
- Perform UAT on various system applications with updated reports.
- Compare analyze if the business requirements have been met according to the required suggestions/changes
- Actively communicate with cross-functional teams and other internal divisions to ensure that research and resolution opportunities are appropriately identified, pursued and reported to senior management
- Identify and document system problems. Escalate system defects with a sense of urgency to avoid member data disruption, assist in meeting provider guarantees, and to promote provider and member satisfaction.
- Analyzed PLEXIS and FACETS as separate systems and conducted gap analysis between the two systems in tandem with Confidential and prepared VNSNY-TMG Health BRD GAP Analysis Document.
- Created a Migration Action Item List for PLEXIS to keep track of developments in the project.
- Prepared the Managed Long Term Care MLTC Benefit Grid
- Ran Ad-hoc and Production reports on MOOP Reconciliation.
- Assisted in Provider communication on process changes in PLEXIS and TMG billing
- Worked on training providers on changes in billing and transitioning to a new system
- trends referred by health plan, providers, system, bringing issues to resolution.
- Observed and shared notes on Operations changes for Migration and Testing a system application with updated reports.
- Facilitated and assisted in Provider communication on process changes in PLEXIS and TMG Health billing.
- Updated and worked with training providers on moving to a new system in VNS through EOS portal and the changes on billing to Confidential.
- Prepared Training Documentation for Providers on billing changes with screen shots on system rules and details with the support of the IT group and Provider Communication.
Role: Change Consultant
- Worked as change consultant for The Next Step M3dia Sanders Sports Marketing on their current change initiative.
- Used the Kotter's 8 step model to induce change and initiate necessary steps to bring positive outcome
- Examined and Analyzed Market and Competitive realities and identified crisis, potential crisis, or major opportunities. Documented evidence as per analysis to support the need for change.
- Assembled a group of key change leaders with enough power using the help of resource mapping to lead the change effort. Encouraged the group to work together as a team.
- Created a vision to help direct the change effort and developed strategies to achieve that vision.
- Build alignment and engagement through storyboards and used innovative vehicles to communicate the new vision and strategies.
- The process that was to be value stream mapped was one which lay within the supply chain management group specifically in procurement , and involved the procurement card P-card . APS has many field employees who are scheduled to manage the electricity lines all over the valley to ensure that customers have power. Those field operators who work more than 100 miles away from their home base are registered with the company to receive per diem procurement cards. These cards enable the company to pay them 85 per day for their services and are to be
- used for meals and hotels but can be used for anything if the employees choose to spend on anything else . These cards have eliminated the use of traditional forms of payment for these field employees, including purchase orders and requisitions, while allow for a paper-less system.
- Mapped the business process by value stream and consolidated business processes for a paperless system.
- Documented issues and recommendations to mitigate the same along with steps for standardization.
- Project: Assessment of Industry Trends and Identification of Value Segments
- GE healthcare is a huge player in the Medical Devices market in the US and other countries. They needed Business Intelligence Research and reports on whether it would be a good idea to enter the value segment with a low priced ultrasound device.
- The organization needed to know in particular whether it would affect their brand image and create conflict when competing in the mid and high range markets for medical devices.
- Researched on competitors in the Ultrasound device segment in six different countries.
- Analyzed and documented trends on the ultrasound devices used best by providers based on demographics.
- Analyzed the Value segment and drew up reports on competition and advised on the decision to join value segment as compared to mid and high range.
Role: Project Manager
- Planned, organized and managed 8 MM projects in railway flyover constructions, resulting in completion on time within budget.
- Managed 2 projects simultaneously and focused on detailed planning of all stages of construction by resolving labor relations issues and coordinating material flow.
- Conducted make/buy analysis for purchasing machinery, collaborated with team members to conduct efficient budget review, contributing to reduced cost and market stability of organization.
- Inspected hoists, scaffolding, and equipment, ensuring all documents and test certificates were in place.
- Negotiated all purchases, managed vendor relationships, and scheduled inspections.
Role: Business Analyst
- Confidential is a Business Process Outsourcing organization which is focused on revenue cycle management and EMR implementations. As part of the EMR projects, we worked with MISYS now ALLSCRIPTS for their claims processing integration and implementation of TIGER PMS with PayerPath. On the Revenue Cycle Management end we worked with Raritan Bay, CIGNA and Greenwich for Accounts Receivable.
- Worked with the Lead BA on preparing Functional Requirement Documentation FRD for Clients in order to customize the MISYS PAYERPATH now ALLSCRIPTS per provider specialty practice.
- Hands on knowledge of Claims Processing and Resolution along with understanding of the implementation of HL7 Interface.
- Liaised with Client staff and the development team for better coordinating and creating a conducive atmosphere for the project.
- Handled Clients with regards to questions on EMR Capabilities and Customizations.
- Conducted JAD Sessions to resolve issues and increase productivity of the Design team and Clients
- Conducted sessions, Video conferencing and coordinated offshore operations with developers to meet deadlines.
- Acted as a liaison between systems software development staff, management and application end-users
- Developed clear and concise ad-hoc reports utilizing the current analytical and reporting environment.
- Conducted User Acceptance testing on behalf of the Client and reported to the Lead BA.
Hospital Billing Projects:
- Worked as an Accounts Receivables executive on Raritan Bay Medical Center and Greenwich hospital billing accounts to resolve P,I,D, Worker's Comp and Medicaid Claims.
- Part of the team working on Resolution of denials and delays in third party payment processing, ensuring the best A/R metrics possible.
- Resolved outstanding medical claims to the tune of 4 MM at the grass-root level by networking with medical insurance companies on behalf of hospitals, resulting in speedy resolution of medical claims.
- Trained and mentored associates on various processes related to USA healthcare system including legal aspects of health insurance claims and functioning of client relationship management system, helping trainees to get acquainted with the software used for claim and patient information.
- Used Meditech, Invision and ARMS Systems to access, check claim status and resolve claims.
- Planned a strategy, road map and allocation pattern for claims processing, effectively resolving accounts receivable claims.
- Maintained record of correspondence with insurance companies through mails and fax of important documents and verified information with clients if further action was needed on denials.
- Developed the 'Process Change Notification' for an internal reference and ensured agreement was reached by all team members, resulting in increased efficiency for speedy resolution of claims.
- For specific clients revised work patterns according to the needs and ensured resource were aligned as per business need.
- Pioneered an initiative for multiple claim resolution on a single call with the payers which resulted in increased achievement of targets and productivity.
- Worked on a TPA claims dump Pilot project for claims processing and gained new business.