SUMMARY:

Business Analyst with 7 plus years of IT implementation experience in IT, Hospital, Pharmaceutical and Health Insurance domains. Thorough knowledge of industry standard SDLC practices and UML tools. Worked closely with various stakeholders, SMEs and staff to understand and document Business, Functional and Software requirements. Researched, created and reviewed requirement documents along with business Use Cases.

COMPETENCIES:

• Possess exceptional organizational skills, with the ability to multi-task and deal with shifting priorities. Adept in learning new technologies and quickly adapting to new environment.
• Acquainted with MS Project to manage, schedule deadlines, resources, collaborate with different teams and analyze project information.
• Skilled at performing Gap analysis, Risk analysis, Cost Benefit Analysis, Traceability Matrix along with good knowledge of process workflow tools and techniques.
• Excellent analytical skills in gathering business requirements through analyzing the needs of Business and Stakeholders and converting them into functional/technical requirements.
• Excellent knowledge of industry standard methodologies such as Software Development Life Cycle SDLC , Iterative Software Development Life Cycle Process as per Rational Unified Process RUP .
• Extensive experience in analyzing and creating Use Cases, Use Case Diagrams, Data Flow Diagrams, Business Flow Diagrams, Navigational Flow diagrams and Wireframes.
• Conducted Requirement Gathering Sessions and Joint Application Development JAD sessions and interviewed subject matter experts with superior organizational and presentation skills.
• Knowledge in business process design, research implementation methodologies, data process mapping, applying Unified Modeling Language UML and the implementation of Performance metrics.
• Comprehensive Knowledge in reviewing Test Procedures, creating Test plans, Test scenario, defining Test cases, both System Integration and executed many test cases.
• Adequate knowledge of using database applications such as SQL Server and MS Access.

TECHNICAL SKILLS:

PROFESSIONAL EXPERIENCE:

Confidential

Sr. Business analyst/ Production Defect Manager.

Responsibilities:

• Conducted multiple JAD sessions between various organizations such as DHS, HHC, DCCA, and OIMT to elicit system requirements using stakeholder analysis, RACI chart and prototypes.
• Active member for the policy review to implement the blueprint requirements for Medicaid, CHIP and Tax Credits benefits per CMS guidelines.
• Responsible to maintain the defect log that traces back to the test cases and also to the requirements, involving Agile and Scrum methodology.
• Activating accounts for users registered through LifeRay by waiving the verification items in CRM and setting up licenses per certification and access levels.
• Interacted with the SME's to gather information about the health care enrollment, eligibility and health care claims processing and checked if they are processed correctly or not following the SDLC process.
• Worked extensively on Gap analysis, Root Cause Analysis and Mapping of issues to requirements to meet the gap and redesign of the user interface.
• Worked on many Change Requests, Parking Lot items, Action Items, Process Flow Diagrams, Pain Points, and Use Cases.
• Primary liaison between the development team and the business owner to understand and implement the amendment and modification required through change request or work request.
• Responsible for creating Dashboards, Reports, RTMs using MS Project for CMS and other organizations.
• Responsible for data analysis to support the marketing and outreach planning.
• Analysis of customer request/complains/suggestion to propose business opportunity and sustainability to the executives by creating SOWs across various functional areas.
• Created wireframes and GUI for the website design encompassing the industrial standard of UX deigns to manage the existing and new applicants. Responsible to triage defects/data issues/deficiencies from OneGate portal to SIEBEL, triage through SOA and transaction log.
• Lead on the SIEBEL CRM for management of Service request, verification, change processes and transaction code/status verification.
• Hands on experience for traceability matrix- to validate the SIEBEL CRM functionality per the functional and non-functional reuirements.
• Member of CCB to propose a CR Change request to enhance the SIEBEL CRM functionality or to produce a change in the given functionality and according validating the OPA rules engine.
• 100 accountable for the data mapping from OneGate portal to SIEBEL CRM, if for any glitches to support ETL.
• JAMA Administrator: Responsible for creating and maintaining the account credentials for all users with defined accessibility
• JAMA reports: Reports and dashboard preparation for meetings that included weekly and daily meetings with various organizations.
• Case Management Worked on Pre-Prod env for case management using CURAM. Owned by sub-vendor Exeter .
• Functioned as JAMA and SharePoint administrator for logging of Requirements, Test Cases, Defect, Risks and Issues.

Environment: SIEBEL CRM 8.2.2.2, Oralce SOA, ALM, JAMA, Oracle Liferay, RUP, UML, SQL, MS Office, MS-Visio. Rational Requisite Pro, Lucid chart.

Confidential

Sr. Business Systems Analyst

Responsibilities:

• Conducted interviews with key business users to elicit, collect and manage requirements and prepared BRD. Created RFPs and evaluated vendor proposals.
• Participated in ICD 9 codes mapping sessions as well as status meetings and provided comments and suggestions on challenges before it is implemented on SIEBEL platform.
• Processed EDI/X12 test files and verified system is able to validate certified and non-certified trading partners.
• Created an enterprise workflow application based on CRUD rules for Customer Data that would allow for future integration of data infrastructure across various business areas into a single User Interface SIEBEL for constant data monitoring and data validation.
• Utilized Rational Unified Process RUP to configure and develop process, standards, and procedures to create a Business requirement Document BRD .
• Developed business requirement and specification documents as well as high-level project plan and translated business requirements into data and process models following BABOK protocols.
• Developed process decomposition diagrams, data models, data flowcharts, entity relationship diagrams, screen mockups and state diagrams.
• Set up work flowcharts, and worked in close conjunction with Business Process Modeling tools for users for the procedures in claims with the help of SMEs.
• Developed scripts, scenarios and performed comprehensive testing User Acceptance UAT, Alpha and Beta testing of applications.
• Performed relational database design and modeling and conducted multiple SQL querying.
• Participated in meetings with Developers, Project Managers and Quality Analysts to discuss business requirements, test planning, resource utilization and defect tracking
• Used Rational Clear Quest for defect tracking and prioritizing defects and for enhancements after base lining the requirements.

Environment: SIEBEL, RUP, UML, SQL, MS Office, MS-Visio. Rational Requisite Pro

Confidential

Sr. Business Analyst

Roles and Responsibilities

• Participated for the creation of Business Process Workflow Diagrams with Stakeholders.
• Involved throughout the business solution Development Life Cycle SDLC .
• Conducted JAD sessions with business users and SMEs to identify and gather various functional and non-functional requirements.
• Worked on GAP analysis of ICD 9 and ICD 10
• Hands on experience on electronic medical record management system.
• Using of Request Tracking System, which is a part of the proprietary CMS application for fulfilling actions on different action codes relating to a corresponding number of actions.
• Utilized Rational Unified Process RUP to configure and develop process, standards, and procedures to create a Functional requirement Document FRD .
• Work with software for maintaining data about the enrolment, billing and health care claims management and to store, send, receive HIPAA transactions and facilitate the administration of HIPAA privacy rights and extensive work on X12 files and EDI transactions.
• Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio.
• Come up with change enabling ideas and lead initiatives executing the same. Should have a significant impact at the Service Line level in terms of revenue, processes or people
• Demonstrate expertise in multiple payers.
• Ensure that data reconciliation activities are performed regularly
• Ensure timely approval of data loads and timely escalation of data issues
• Identify all possible automation opportunities on the project and get the reports automated
• Reviewed System Test Plans, wrote test scripts and worked with business folks to validate and execute the test scripts.

Environment: HTML, XML, MS Visio, MS Excel, MS SQL, Rational Requisite Pro, UML, Rational Unified Process, SQL.

Confidential

Business Analyst

Responsibilities:

• Key player in Managing project and was involved in resource management.
• Analyzed existing Business units, Business process, System/ Application and there Interfaces with their capability through open-ended discussions, brainstorming sessions, and prototyping, prioritizing them and converting them as system requirements that must be included while developing the software.
• Assisted with documenting processes, used agile methodology to write the Business Requirements documents and designed Functional specifications.
• Served as a liaison between the internal/external business community and the IT organization in order to provide technical solutions to meet user needs.
• Participated in design review meetings and translated the requirements to the developers and guided the team when issues related to business requirements arose.
• Conducted JAD sessions between the business users, Developers, testers Subject Matter Experts to resolve bottlenecks.
• Used HL7 guidelines and dictionary for defining business rules associated with pre-defined workflows according to business requirements.
• Played important role into creation of CRUD Create, Read, Update and Delete Metric to make analysis and better understand data flows between different systems.
• Conducted Risk Analysis to identify the risks associated with developing the patches, and formulated a Mitigation Plan to eliminate or reduce risks of high severity and any major effects.
• Played an active role in the UAT.
• Responsible for creating maintaining Requirement Traceability Matrix in order to track the development and QA process.
• Interacted closely with QA to finalize the Test strategies and maintained quality assurance using HP Quality Center.
• Provided production support pre-production and post-Production issue management and defect tracking.

Environment: UNIX, SQL Advantage, MS Visio, MS Word, Agile, SSMS, HP Quality Center.

Confidential

Business Analyst

Responsibilities:

• Participated for the creation of Business Process Workflow Diagrams with Stakeholders.
• Involved throughout the business solution Development Life Cycle SDLC .
• Conducted meetings with business users and SMEs to identify and gather various functional and non-functional requirements.
• Utilized Rational Unified Process RUP to configure and develop process, standards, and procedures to create a Business requirement Document BRD .
• Constructed the Business Requirement Document and the Technical Requirement Document for 837 Professional, Institutional and Dental Claims, 835 Outbound transactions, 270/271 Eligibility Request and Response , 277CA Health Care Claim Acknowledgment .
• Conducted GAP analysis of the different reports that are being presented to clients to accommodate their requirements for the new enhancements.
• Created artifacts such as Use Cases, Activity Diagrams, and Sequence Diagrams using MS Visio.
• Come up with change enabling ideas and lead initiatives executing the same.
• Understand the various stages of a claim life cycle and utilize the knowledge in meeting client goals.
• Ensure timely approval of data loads and timely escalation of data issues.
• Identify all possible automation opportunities on the project and get the reports automated
• Conducted JAD sessions during the various stages of upgrading the matching system and discuss the current system preference.
• Developed Requirements Tractability Matrix RTM using MS excel to trace each software design requirement to test case.
• Reviewed System Test Plans, wrote test scripts and worked with business folks to validate and execute the test scripts.

Environment: UML, MS Visio, MS Excel, SharePoint, Test Director