SUMMARY:

• A versatile Business Analyst / PMO around 8 years of experience in IT Industry.
• Possess superior knowledge in Health Insurance, Brand Management and Project co - ordination Process.
• Extensive BusinessAnalysis experience in all phases of the project life cycle from including requirements gathering, risk analysis, project planning, scheduling & testing.
• Strong understanding of various methodologies Waterfall.
• Adept at Business Process Improvement (BPI) and implementing best practices to drive business objectives.
• Dexterity to learn and teach new concepts, adaptable to change and direct concurrent tasks.
• Skilled in preparing business requirements document (BRD), Use Case specifications, functional and technical specifications, and system requirements specifications (SRS).
• Efficient in gathering, detailing, documenting and validating the requirements in a format that is useful to theirbusinessarea experts and the technical developers using MS Access, Word and Excel.
• Conducted Joint application development (JAD) sessions with relevant Subject Matter Experts and documented reports, implementation requirements, project status reports, oral presentations, e-mails, etc.
• Quickly learned technicaltroubleshootingspecifications.
• Oversight of projects for each business unit includingUtilizationManagement, QualityManagement, Ambulatory CareManagement, and the Compliance Unit to ensure projects
• Ability to lead from the front and focused to reached the set goal.
• Conducting requirement elicitation sessions by implementing techniques such as Interviews, Brainstorming, Interface Analysis, Discovery Sessions, Feasibility Studies and Stakeholder Analysis.
• Excellent skills in performing GAP Analysis to check the compatibility of the existing AS-IS system with the new TO-BE business requirement, and document the changes
• Working with Project Managers, Program Directors, SMEs, Stakeholders, Business users, and clients to analyze and document business requirements and map them to high-level functional, non-functional specifications.
• Possess superior knowledge of MS Office Suite, MS Visio, SQL Server and Rally
• Experience in dealing with different data sources ranging from Flat files, SQL server, Oracle, My SQL, MS Access and Excel.
• Strong expertise in Data analysis, Data mapping, Data modeling and development of Databases for business applications in client/server applications and Data warehouse environments
• Experience in the documentation of system and business requirements and specifications, design and development of use and test-case scenarios and root-cause analysis, GAP analysis, developing test plans, conducting user acceptance testing, training, and implementing new processes and technology.
• Desire to continually improve, understanding industry trends and seeking out new tools techniques
• Superior research, business writing, oral, and interpersonal skills
• Involved in writing Test plans, Test strategies and Test cases with QA teams.
• Experience in using defect tracking tools to address bugs/issues and interacting with development team to fix them.
• Demonstrated ability in a fast-paced, results-oriented environment with a high degree of endurance and flexibility
• Worked on offshore - onshore model of project execution.
• Facilitated User Acceptance Testing (UAT) with the appropriate stakeholders, clients and business users.

SKILL:

Technical expertise: Previous work experience with R, Python, C and Stata.

Proficient in: MS Office applications especially Excel (VLOOKUP, Pivot Tables, Index/Match) and Word.

Intermediate relational database language knowledge such as: SQL (SELECT, UPDATE, JOIN, TRANSACTIONS).

Novice knowledge of web technologies: HTML+CSS, XML and JavaScript (mostly jQuery).

PROFESSIONAL EXPERIENCE:

Confidential, Long Beach, CA

Sr. Business Analyst

Responsibilities:

• Worked with senior program manager to develophealth insurance claims reimbursement system process flows.
• Elicited and gathered user and business requirements through open-ended discussions, brainstorming and storyboarding/prototyping.
• Claim validation and Pend/Denied Claims Analysis for the Health plans Medicaid programs.
• Conductedbusinessanalysis, acted as a liaison between project manager,businessusers, & IT team.
• Expertise understanding in proxy product owing and the benefits related to it.
• Extensively involved in Payer life cycle encompassingClaims, Payments, Provider, Portal, Billing, Benefits.
• Processed a high volume of customer inquiries of One CallCareManagementproducts and services, and resolves a targeted percentage of those inquiries.
• Interacting with the stakeholders to get a better understanding of clientbusinessprocesses and gatherbusinessrequirements.
• Prepared documents forbusinessrequirements document (BRD), systems requirements specification (SRS), high level design documents (HLDD), and traceability mapping / matrix with the assistance from thebusinessgroup, and the IT team members.
• Created Mapping Documents, Report Mock-ups and modified existing report mock-ups and finalized for development.
• Expertise in quality management in improving the quality of the business and also dealing with the business scenarios.
• Analyzed "AS IS" and "TO BE" scenarios, designed and documented new process flowsbusiness process and variousbusinessscenarios.
• Gathered requirements from collection,claims, Billing, and insurance appeal departments.
• Participated in JAD sessions withbusinessstakeholders to integrate the requirements of the project.
• Responsible for the Clinical Administration Supervision andmanagementof the High-riskCare ManagementTeam.
• Collected and evaluatedbusinessrequirements, functional specifications, project schedules, documentation and test plans for the Online Account Management system to ensure the registered customers had online web based access to their accounts and investment portfolios.
• PreparedBusinessContext Diagram, Use Case diagrams and corresponding Activity Diagrams.
• Designed and developed Use Cases using UML andBusinessProcess Modeling. Applied Unified Modeling Language (UML) methodologies to design Use Case Diagrams, Activity Diagrams and Sequence Diagrams in Rational Rose.
• Worked with the testing team to create the testing scenarios, Queries and helped them to understand the logic.
• Performed Data Analysis of existing data through SQL and MS Access.
• Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data.
• Planned and documented procedures for data processing and prepared data flow modeling for the application.
• Collected and evaluatedbusinessrequirements, functional specifications, project schedules, documentation and test plans.
• Participated in UAT and worked with HP Quality Center for bug and defect tracking.

Confidential, King Of Prussia, PA

Business Analyst

Responsibilities:

• Interacted with the client and the Technical Team for requirement gathering and translation of Business Requirements to Technical specifications.
• Prepared Business Requirement Documents (BRDs) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Prepared process flow/activity diagram for existing system using MS Visio and re-engineer the design based on business requirements.
• Tested different functionality of the application like Medicaid eligibility data, state available funds program, Medicaid claim processing etc.
• SupportsUtilizationManagement using HEDISwith data entry.
• Prepared Excel Reports using advanced excels features such as Macros, Pivot Tables & VLOOKUPS.
• LeadsCareManagers with recovery focus bridging strategies to support members with increased aftercareengagement and reduce readmissions.
• Performed SWOT and Gap analysis for the new functionality requirements.
• Performed data cleansing, assisted with data modeling and conducted data extraction activities.
• Well versed with HIPAA, claim adjustments, claim processing from point of entry to finalizing, claim review, identifying claims processing problems, their source and providing alternative solutions using best practice model and principles.
• Involved in preparing project plans and identifying major milestones for each stage as per the SDLC model Waterfall Methodology.
• Used MS Project for various planning and budgeting activities.
• Worked with HIPPA rules and regulations to draft business rules and claim processes.
• Identified and documented the dependencies between the business processes.
• Responsible for testing Medicaid Claims for peach state health plan using MMIS.
• Tested all internal and external file transfer outputs manually and automatically.
• Identified bugs during the test phase and reported them using HP Quality Center.
• Extensively involved in mapping data from various sources to the target database tables.
• Helped improve the loading process for various external data into Oracle database.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance testing (UAT).

Confidential, Snellville, GA

Business Analyst

Responsibilities:

• Involved with the project management, systems analysis and design of a web-based application to track and manage various case and customer data.
• Worked with the Stakeholders, Project Manager and seniorBusinessUsers in defining, documenting and diagramming thebusinessneeds andBusinessProcess flow.
• Involved in converting the business rules into Functional Requirements Document (FRD), Business Requirement Documents (BRD) and also created business process models from the requirement specifications.
• Design using UML include development of class diagrams, Sequence diagrams, and State diagrams and implemented these diagrams in Microsoft Visio.
• Performed GAP analysis and documentedbusinessand system level use cases to derive the requirements illustrating the functional behavior of the application.
• Collaborated and reviewed with different application owners and SME's to ensure the GAP Analysis was performed accurately.
• Created and updated tasks in the MS Project and Project Management Directory for the management reviews.
• Maintained Traceability Matrix to ensure all the features for the project has been captured and mapped back to the requirements in the BRD.
• Documented test plans, test cases and test summary.
• Used SQL to extract data from database for data analysis and testing.
• Used rational clear quest to log defects and assign to the right team to ensure the defects are addressed on a timely manner.
• Reviewed UAT test cases withbusinessowners to test the application functionality and also provided necessary training material

Confidential, Minnetonka, MN

Business Analyst

Responsibilities:

• Extracted the business requirements from the stakeholders keeping in mind their need for the application and documented them using Rational Requisite Pro.
• Documented business functionality requirements in Business Requirement Document (BRD).
• Organized and conducted Joint Requirements Planning sessions (JRP) as a facilitator to gather requirements from the Business User. Facilitated Joint Application Development (JAD), and Rapid Application Development (RAD) sessions when needed.
• Maintained and monitored project progress and status through MS Project.
• Implemented the entire waterfall methodology of application development with its various workflows, artifacts and activities.
• Analyzed Business Requirements and created Use Cases, Use Case Diagrams, Navigation Flow, Business Flow Diagrams and Work Flow Diagrams for applications and created Activity Diagrams using MS Visio.
• Developed non-functional requirements and documented them as Business Rules, Quality attributes and constraint documents.
• Involved in Facets Configuration to make sure all information will be sent without any error.
• Effective communication made possible between the developers and the end-clients to guarantee that development efforts were within the scope of the project and the development was as expected.
• Designed and implemented basicSQLqueries for QA testing and report.
• Facilitated smooth transition of the project from the project environment to the live environment.
• Worked with QA lead in validating Test Plan and Test Scenarios.
• Executed test scripts in different cycles to get the perfection and logged defects in defect tab of Quality center.
• Executed test cases manually. Compared and analyzed actual with expected results and reported all deviations to the appropriate individual(s) for resolution.
• Assisted Business User during deployment in formulating User Acceptance Testing (UAT) for customized application and getting confirmation for product Release.

Business Analyst

Confidential

Responsibilities:

• Acted as liaison between business and technical teams
• Developed project Vision statements
• Reviewed epics, user stories, use cases, and other analysis artifacts produced by the analysts, and provided feedback and guidance.
• Reviewed SQL data models, UML models, and other design artifacts produced by the team, and provided feedback and guidance.
• Worked closely with technical project managers and scrum masters to develop project plans, understand project and team interdependencies, manage risks, and conduct retrospectives.
• Coordinated with the QA team to resolve ambiguities in the requirements and ensure requirements were traced to test cases. Worked with the business to coordinate UAT.
• Coordinated with the program architect and design and development teams to ensure requirements were well understood and that technical risks were captured.
• One of two senior analysts in the Mobile Applications program, supporting the development and deployment of Schwab's mobile applications, including an iPhone application, iPad application, and Android application. Responsibilities included:
• Defined the Vision for each of the projects (iPhone, iPad, and Android). Identified stakeholders, defined stakeholder needs and current process pain points, developed features which addressed those needs, and worked with the stakeholders to prioritize the features.
• Developed the use case model, detailed use case specifications, and other functional and non-functional requirements. As the program shifted to agile, developed epics and user stories.
• Built an analysis-level UML model for implementation.
• Coordinated with the architects, development team members, and QA team members to ensure there was a common understanding of the requirements and that ambiguities were addressed.
• Developed and delivered a series of training courses for Schwab, covering topics such as the role of the BA, key BA skills, playing the role of a lead BA, identifying and modeling use cases, building detailed requirements specifications, and coordinating UAT