SUMMARY

• 9+ years of experience as a Business/Systems Analyst in Healthcare, Financial and Retail Sector.
• Complete Understanding of Software Development Life Cycle (SDLC), involved in various phases like Requirements Gathering, Analysis/Design, Development and Testing.
• Experience in working in Agile, Scrum and Waterfall methodologies in different projects
• Experience in implementing the Rational Unified Process (RUP) in all four phases of a project: Inception, Elaboration, Construction and Transition.
• Proficient in Rational tools including Rational Rose and Rational Requisite Pro.
• Experience in writing Medicare and Medical requirements as per the Centers for Medicare and Medicaid Services (CMS) guidelines.
• Identify gaps, which require operational change in order to optimize system solutions by GAP analysis.
• Acted as liaison between management and development team for requirements and QA.
• Excellent in Business Process Modeling and Workflow modeling
• Proficient in creating Use Case diagrams, Class diagrams, Sequence Diagrams, Collaboration diagrams, State Transition Diagrams and Activity Diagrams using UML methodology.
• Proficient in creating Project Charters, Storyboards, Scenario documents required for Business Discussions, User Stories, Acceptance Criteria(Given, When, Then)
• Experience in managing requirements from project inception through release.
• Creating use case models, process flows, system flows, data flows in MS Visio.
• Using MS Project for scheduling deadlines, resources, and facilities, Rational ClearQuest for Change Management (CM) and Defect Tracking, Rational ClearCase for configuration & software asset management.
• Good knowledge of basic SQL to access databases like Oracle
• Experience with BlueCross, Medicare, Medicaid, and commercial insurances in HIPAA ANSI X12 formats including 270/271, 276/277, 834, 835, 837, and NSF formats for interfaces and images to third party vendor applications using COBOL, Metafile, Visual Basic, Unix, DOS, Windows, and various other communication packages.
• Experience with Data Mappings including HIPPA ANSI X12 4010A 270/271, 276/277, 834, 835, 837 for institutional, professional, and commercial claims

TECHNICAL SKILLS

Databases: MS Access, Oracle, DB2

Languages: C, C++, SQL, HTML, XML, Java, Cobol, .NET

Reporting Tools: Crystal Reports 8.0

Operating Systems: MS - DOS, Windows95/98/NT/2000/XP, Apple McIntosh, Linux

Software: MS Office Suite(Word, Excel, Access, PowerPoint & Outlook), MS Visio, Rational Rose, Rational Requisite Pro, Adobe Acrobat, MS Office FrontPage, Lotus Notes, HP Quality Center

Performance Testing Tools: Virtual User Generator, Load Runner

Operating Systems: MS-DOS, Windows95/98/NT/2000/XP, Apple McIntosh, Linux

Automation Tools and Standards: Requisite Pro, Win runner, QTP, Test Director, Quality Center,EDI standards, HIPAA Compliance, Medical Claims clearinghouse,ASC X12 (cross industry standards), ANSI

PROFESSIONAL EXPERIENCE

Confidential, Chicago, IL

ITG Business Analyst

Responsibilities:

• Single point of contact for requirements written for the Membership System
• Conduct requirement gathering meetings with different stakeholders to derive detail requirements for the High Level Scope for the Project
• Work with the End Users of the System including the Customer Associates and Processors to understand their expectation of the changes needed
• Create Storyboards to give a high level picture of the changes required in the different systems to meet the Business Need
• Capture detail requirements in User Story Formats of “Given”, “When” and “Then”
• Capture all Functional, Non Functional, Assumptions, Interfacing/System Dependencies, Business Rules, Out Of Scope Items, and Glossary Items that provide clarity and detail to the Scope of the Project
• Create Screen Mockups to indicate changes to any UI Screens for the project and provide supporting Field Specifications for any addition/Modification of fields to the UI Screens.
• Create any supporting documents needed to provide clarity to the requirements like Scenario Documentation, Process Flows, Data Flows, Gap Analysis Documents, Business Metrics and Volumes Charts
• Create Requirement Traceability between all the deliverables
• Come up with possible solutions to help Business choose the most effective one as per the Business Need
• Work closely with the App Arch and development Teams to understand the technical feasibility of any requirements under discussion
• Identity any changes to the process followed by the end users of the Membership system so that they are captured as updates to the existing procedures that is followed by the End Users for Processing
• Review High Level Design, Low Level Designs prepared by the Solution Architects and Application Architects and provide feedback when necessary
• Review End to End Test Scenarios and Test Cases that involve testing holistically including end to end functionality
• Review UAT and QA Test cases and provide feedback to account for all requirements that has been documented for the project
• Review the test cases written by Load and Performance Teams to indicate the volume of Users and Transactions/Activity that can be performed using the System
• Create Presentations and present the Changes done to the functionality as part of the initiative to various audience including the Business Leadership, Project Sponsors and End Users/Business Users of the Systems impacted by the initiative
• Provided input in meetings related to Scope and Budget Discussions highlighting the Business Need of the Scope in discussion
• Work closely with the Project Manager and Delivery Manager of the Project to keep them updated on the status and progress of the Project.
• Conduct discussions and meetings when necessary to resolve any conflicts in understanding or implementing the requirements at any stage of the Project
• Conduct discussions and meetings when necessary to triage any defects raised for the project with the needed Stakeholders

Environment: MS Office Excel, Word, PowerPoint, MS Project, MS Visio, HP Quality Center, SnagIT, Basic SQL, Application Lifecycle Management

Confidential, Chicago, IL

ITG Business Analyst

Responsibilities:

• Single point of contact for any translation needed by the different workgroups
• Conduct meetings with different workgroups to help derive the Code Group Intent/Code Intent by understanding their need for the translation which is used by the Medical Coders to do the translation accurately
• Coordinate with the Medical Coders who provide Code Group translation services to all workgroups and medical policy.
• Reviewed and maintained the BRM (Business Rule Mining) Form that was used to document the ICD9 and ICD10 Code Translation requested by the different Work Groups and delivered by the Medical Coders.
• Coordinate with the development team to load and document any translation that was done and approved by the Medical Coders and the Workgroups
• Performing Change Management process for all the code translation documented into the CRAA tool
• Support Pilot Testing by providing code translation rationale
• Assist in the creation of Learning and Development modules

Environment: MS Office Excel, Word, PowerPoint, MS Project, MS Visio, HP Quality Center

Confidential, Bloomington, IL

Business Systems Analyst

Responsibilities:

• Responsible for Gathering Requirements to produce Business and Functional Requirements.
• Participated in Primary and Secondary Research to determine User Requirements and Goals and converting them into Business and Functional Requirements.
• Participated in meetings with the management team, and the SME.
• Conducted Requirement analysis and Design Walkthroughs with the designers, developers and management staff.
• Followed the UML based methods using MS Visio to create Business flow diagrams, Use Case diagrams, Activity diagrams, State diagrams, Sequence, and Collaboration Diagrams.
• Facilitated Joint Application Development (JAD) and Rapid Application Development (RAD) Sessions for communicating and managing expectations.
• Communicated Project Requirements, Business Issues, Solution and made recommendation.
• As a liaison between the developers and management, was instrumental in resolving conflicts between stakeholders and technical development teams.
• Produced System Diagrams, Business Requirements, Report Specifications, Workflows and other documentations as required for Project Analysis, Planning and Design.
• Established a business analysis methodology around the RUP (Rational Unified Process).
• Utilized RUP to configure and develop processes, standards, and procedures, to provide technical leadership and expertise in reorganization of a complex End-to-End Testing effort, and to perform system analysis and organizational review of existing QA processes.
• Prepared and Reviewed Business Requirement Documents and the Technical Specifications using Rational Requisite Pro.
• Developed Test Plans, Test Cases, and Expected Results, and coordinated the tests with the QA team to verify implementation of new features and enhancements.
• Worked with the technical and business staff to produce Test Scripts, Configuration and Change Management Plan documents.
• Assisted the development team during the second and third iteration using the RUP model.
• Worked closely with the Project Manager and different teams with effective presentations. Also delivered training and presentation to lenders, colleagues, and customers.

Environment: MS Office Excel, Word, PowerPoint, MS Project, MS Visio, UML, Rational Unified Process (RUP), Rational Suite Requisite Pro, Rational Rose, Windows XP, HTML, PHP, XML.

Confidential, Eagan, MN

Business Analyst

Responsibilities:

• Assisted in identifying project scope, to conform to the regulatory compliance related to X12 837 (I/P), 835, 834, 270, 271, etc.
• Responsible for soliciting and eliciting requirements for 4010-5010 conversions.
• Involved in building training material and planning material for 4010-5010. Define communication plans and build a project budget for the transition.
• Carried out Risk Assessment, GAP analysis and Impact Analysis for the 4010-5010 conversion project.
• Authored Computer Validation Report, which involved extensive research and interaction with SME’s and Business owners.
• Involved in one-to-one interview sessions and JAD sessions with stakeholders, SME’s and business owners to discuss the scope of the conversion.
• Produced for transaction sets 835 and 837 (I/P) a full gap analysis 4010 vs. 5010 against the documented application 5010 enhancements ensuring the upgraded application included the required changes and additions for 5010 compliancy.
• Involved in up-gradation of HIPAA X12 4010 transaction to HIPAA X12 5010 by conducting Impact Analysis and Risk Assessment and worked on the mitigation plan to avoid the risks.
• Identified the impact on the existing services of Business Units, local impact of the transition on the organization and forthcoming challenges and issues related to the transition.
• Worked as a liaison among stakeholders both business and IT side in order to elicit, analyze, communicate and validate requirements for changes to business processes.
• Involved in Validation of HIPAA for 837, 270/271, 276/277,835, 834 EDI transactions.
• Involved in creating Reports and Documents like Requirements Documents, and Management Plan, Issue/Alternatives documents, Project Summary and Plans with formats like PDF, HTML, Excel and Word.
• Prepared UML diagrams (Activity diagrams, Sequence Diagrams, Use case diagrams) for Extensions and Surrounds.
• Played a key role in project planning activities, User Acceptance testing, and implementation of the system enhancements and conversions.
• Involved with reviewing defects reported from UAT efforts and analyzed for root cause and took actions based on the findings.
• Identified the master file changes and builds needed to enable the 5010 format to be utilized.
• Conducted Business Process (As Is/To Be) sessions with various department directors and staff to ensure the Testing Plan and Test Approach would meet the identified Business Requirements, and the Training Program covered all identified new and changed processes.
• Gathered requirements for impacted system and business areas for ICD-10 and their needs to embrace the changes.

Environment: Rational RequisitePro, Rational ClearCase, RUP, UML, HTML, MS Project 2000, MS Visio, TestDirector7.6, MS Office (Excel, Word).

Confidential, Kansas City, KS

Senior Business Systems Analyst

Responsibilities:

• Conducted stakeholder meetings to understand how the bank differentiated customer relationships. Represented them in requirements traceability matrix.
• Analyzed and collected business requirements, identified system interfaces and created the Requirements Specification Document.
• Performed Requirement Analysis to Develop Use Cases, Activity Diagrams and Use Case Diagrams.
• Managed and tracked change control process of requirements and design changes. Documented the changes, issues and their impact on the system design and delivery.
• Provided documentation such as requirements management plans, functional requirements, test plans and test cases.
• Incorporated the best practice methodologies as advocated by the Rational Unified Process.
• Designed and analyzed Business Process Model, Use Case model and test procedures based on RUP methodology.

Environment: ASP, Visual Basic, VB Script, Ms-Visio, SQL, HTML, UML, Front Page, Photo Shop

Confidential, Nashville, TN

Business Analyst

Responsibilities:

• Gathered requirements from various business areas like Claims, Provider Relations, Enrollment, Finance and Benefits Administration for their updates to the Claim Processing Engine.
• Developed Use Cases using MS Visio, and a detailed project plan with emphasis on deliverables.
• Monitored Change Requests and documented requirements, integrating them with Use Cases.
• Developed and implemented Test Strategies using the Test Director.
• Assisted QA team in testing phase by creating Test Plans and Test Cases documents.
• Followed the RUP methodology for the entire Software Development Cycles.
• Assisted the development team during the second and third iteration using the RUP model.
• Checked the data flow through the front end to backend and used SQL queries to extract the data from the database.
• Involved in project planning, coordination and implemented QA methodology.
• Developed the Requirements Traceability Matrix, prioritized and determined impact of all applications.
• Identified the all applications and interviewed the application owners to recommend the process improvements.
• Provided overall project management to multiple projects successfully completing them on-schedule and on-budget.
• Defect Tracking and Bug Reporting was performed using Test Director

Environment: RUP, Enterprise Architect, Rational Suite Requisite Pro, HP Quality Center, MS Project, MS Visio, MS Access, MS SharePoint.

Confidential, Atlanta, GA

Business Systems Analyst

Responsibilities:

• Ensured that all lines of business specifications were consistent in form and function to the Diamond Base System.
• Created screen-mockups using iRise to review the requirements and provide feedback on the screen design. Also, used Microsoft Paint to create ad-hoc screen mock-up to review with the users.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.
• Worked closely with GIS data and technologies as part of CRM Dashboard UI Interface.
• Custom tools upgrade client had created marketing, merchandising product tools to support their custom web application which needed to be re-architected to work with eCommerce suite
• Collaborated with the development team to enforce the implementation of requirements throughout the entire coding cycle and managed change request using Rational Clear Quest.
• Acted as a liaison between the development team, QA team and the business team and resolved any conflicts due to change in requirements.
• Data transfers from text files and Access databases using BCP and DTS; Data mapping and transformations while loading data using VBScript
• Reviewed requirements and understood technical recommendations and constraints, and developed comprehensive and accurate functional specifications; Data Mapping, and process flows.
• Worked on following applications: Business Objects, Enterprise Architect, Toad, PlanView (project management), Microsoft Suite (Word, Excel, PowerPoint, Visio, Access, Project)
• Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives.
• Followed SDLC, which included requirements specifications, design, analysis and testing. Followed RUP methodology with Agile/Extreme Programming and using Rational Test Suite for various phases of RUP.
• Provided suggestions and ideas more from a strategic and long-term perspective.
• Created Requirements Specification Document that translated business requirements into Technical specification including business and validation logic for ease of understanding for the development team.
• Used MS-Visio for flow-charting, process model and architectural design of the application.
• Designed and developed project document templates based on SDLC methodology
• Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Reviewed the defects entered by the QA team and prioritized the defects and assigned them to the development team
• Prepared UAT Materials, including the UAT Process, UAT Test document that would include step-by step process for UAT as well as all the tests that would cover all requirements.
• Interacted with the users and logged any defects, enhancements from the UAT.

Environment: MS Office, SQL Server, Agile, SCRUM, MS Project, MS Access, Rational Clear Quest, Rational Clear Case, Rational Requisite Pro, Rational Rose, UML, RUP, MS Excel, MS Word, MS Power Point, MS Visio.