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Health Care Business Analyst Resume

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Nashville, TN

SUMMARY:

  • Top performing Senior Business Analyst with 8+ years’ experience successfully directing projects by leveraging technical expertise with strong financial and business acumen to achieve considerable savings and optimized performance.
  • User Information Access Data centres
  • In - depth working understanding of project management, information technology and business practices utilizing PMP, SDLC, Method One, Six Sigma, RUP, and Lean Kaizen methodologies. Experience directing every project phase, identifying growth opportunities, developing innovative solutions and implementing best practices to improve processes.
  • Established multiple PMO working environments.
  • Solid understanding of business practices, business systems and information technology analysis resulting in in-depth comprehensive system understanding and documentation of existing systems. Full experience across internal and integrated external vendor systems including customized environments.
  • Ability and experience in providing visionary leadership, organizing and directing multiple high-performance teams. Skilled mentor and coach in establishing collaborative environments for optimum performance.
  • Expertise managing complex work streams for large multi-million-dollar projects/programs through all phases of strategic planning, design, testing and roll out for numerous industries including financial, datacenter, security, transportation and manufacturing.
  • Ability to easily absorb new technology and explain products and ideas to highly technical and analytical team members while simultaneously clarifying information for non-technical business and ranking stakeholders.
  • Keen ability to assess client needs and produce high quality deliverables on time and within budget covering application and hardware implementation, mergers, site relocation and restacking, disaster recovery, and audit/compliance.

AREAS OF EXPERTISE:

Business Analysis Business Requirements Project Implementation PMBOK/CMMI Frameworks

Project Planning Data Flow Diagrams Quality Control/Testing SDLC Methodologies

Visio & Word Change Management Release Management Iterative Development Methodology

MS Project Incident Management Problem Management Business Process Modeling (BPM)

MS SharePoint Storyboard Illustrations Process Flow Charts Policy/Standards/SOPs

Technical Writing PBX/IVR/LAN/WAN IT Infrastructure Library (ITIL)

SECTOR COMPETENCIES:

Banking/Finance Health

Transportation State Government

Human Resources & Payroll Cross Domain User Controls

Anti - Money Laundering Cross Environment User Controls

Accounting Credit Cards, Debit Cards & Prepaid Cards

PROJECTS & EXPERIENCE:

Confidential, Nashville, TN

HEALTH CARE BUSINESS ANALYST

Responsibilities:

  • Interacted as BSA to analyze and configure Health Care Reform system applications in current NAVI business and systems.
  • Conducted JAD sessions with business stakeholders to reach a decision on changing strategies regarding the way business will be conducted on the new platform.
  • Responsible for evolvingAGILErequirements practices and ensuring there is effective collaboration between product managers,businessanalysts, developers and QA.
  • Knowledge ofdata migration tools and interfaces- Integrity, (SharePoint), BizTalk.
  • Involved in Designing phase. Prepared Use Cases, Activity Diagrams / State Chart Diagrams using Ms visio according toUMLmethodology thus defining the Data Process Models and uploading documents in ReqPro.
  • Worked under the supervision of the Team Lead & Project Manager to gather requirements & functional specifications from Solution Architects, Business Users, Business Owners and Subject Matter Expertise (SMEs).
  • Performed GAP Analysis of business rules, business and system process flows, user administration and requirements to document the current as-is processes and the future to-be processes.
  • Responsible for training new employees at customer locations in all aspects of theeligibilityprocess. Includes screening patients, determining Medicaideligibilityand completing applications using the state Access system.
  • Responded to billing inquiries from patients and payers.
  • Experience working and testing mapping for X-12 transactions using Integration tools like TIBCO, EDIFECS and Sterling GIS suites.
  • Participating in assigned work group meetings and supports the development and maintenance of ICD 10 CM required documentation.
  • Documented Business Rules and Business Requirements for Claims Migration Project to align Third Party Vendors compliancy with current NAVI system by acting as a principle BSA for pre-adjudication process and claims processing for NAVI system and functional specifications.
  • Performed and executed Integrity Testing, Requirement Testing, Balance Testing, Situational Testing, Code Set Testing, Line of Business Testing, Vendor / Trading Partner Testing according to HIPAA compliance with EDI Transaction as a means of communication.
  • Facilitated UAT (User Acceptance Testing) with the stakeholders and the business users, and the errors discovered were fixed and then verified via Regression Testing.

Environment: Agile, SQL Server 2008, Toad SQL, SharePoint 2013, O365, Microsoft Outlook, Microsoft Visio, HP Quality Center, MS Word Excel, Rational Rose, Requisite Pro, MS Visio, Balsamiq, Java Script, MS Project, Jira.

Confidential, Dallas, TX

Sr. BUSINESS ANALYST

Responsibilities:

  • Collaborated with several virtual cross-functional teams with technical methodologies (CMMI and the PMBOK); this established a baseline of capability that helped projects complete on time.
  • Responsible for preparing estimation for swift projects, primary responsible for client interaction for onshore and off shore coordination.
  • An effective communicator, excellent team player, quick learner and creative problem solver with finely tuned analytical skills and significant hands-on experience in banking andInsuranceindustries.
  • Experienced in the Finance and Insurance domains with exposure to Investment Banking, and Global Capital Markets (Equity, Securities, Mutual Funds, Fixed Income). knowledge of Portfolio Management, Financing Structures, Cash Flow Forecasting, Financial Analysis, Capital Budgeting, Asset Allocation, Fixed Income Products, Derivative Products such as Options and Futures.
  • Performed duties of Business Analyst/Scrum Master on information gathering, estimating and implementation of the User stories, use cases and prototypes using msvisio.
  • Analyzed and presented key performance indicators (KPI) to Senior Management
  • Responsible for assisting clients in definingITIL strategy and roadmap, guiding organization in the adoption ofITILprocesses and functions.
  • Collaborate with sellers to perfectmortgage insurance claims.
  • Provided appropriate templates and examples to process owners to ensure each developed process area is comprehensive and aligns withITILbest practices
  • Communicating status of work to appropriate parties to keep them informed and involved and coordinating and managing off-shore team.
  • Created and maintained user stories in JIRA for better understanding of the requirements for the development team. Also used JIRA for bug testing.
  • Knowledge of cash flow analysis, cost analysis and Account Receivable/Payable
  • Created UAT Test Cases using HPQC. Presented Test Cases to end users and got approval
  • Proficient using MS Excel including Pivot tables.
  • Coordinating with top management in understanding different process plans, business process, and functionality in depth.

Environment: MS SharePoint, MS Word, MS PowerPoint, Rally, MS Visio, XML, JQuery ETL, SQL server (SSIS, SSRS)TFS, Balsamiq, MS Excel, Agile-Scrum, Micro strategy, MS Outlook, Igrafx

Confidential, SAN DIEGO, CA

BUSINESS ANALYST

Responsibilities:

  • Obtained business requirements in form of user stories from users and stakeholders using JAD sessions, brain storming sessions, focus groups and personal interviews to get a better understanding of the client's business process.
  • Document and Release ESRIBusiness Analystfor Server.
  • Supervise inventory counts (periodic cycle and year end), research discrepancies, and ensure timely adjustments.
  • Configured SAP HR / HCM core systems and sub modules
  • Provided the technical studies for data conversion to SAP system
  • Produced reporting infrastructure for KPI program for the Sales Organization that resulted in an 85% increase in sales revenue in measured metrics.
  • Knowledge sharing and expertise for GIS, ESRI, Access, and Oracle.
  • Performed Gap analysis, Impact analysis and SWOT analysis.
  • Created tables, indexes, views, snap shots, database links to see the information extracted from SQL files.
  • Single point of contact for swift for the enterprise and responsible for managing certificates.
  • Formulated the ER diagrams of Property and Casualty data and data flow diagrams to interact with database developers.
  • Supported in Replaced existing financial software with a new ERP system. The new system included Sage MAS500 for accounts payable and general ledger, for order processing, accounts receivable and inventory tracking.
  • Created scripts for training all internal users, support personnel, and external customers on ERP system changes and new procedures.
  • Imported/exported data in to the ERP system tables (data conversion). loaded data into the mandatory table of major modules
  • Managed B2B relationships and legacy promotions forecommerce.
  • Elicited, documented, modeled, validated and prioritized functional and non-functional requirements using interviews, data analysis, and different modeling tools.
  • Owned the creative process; worked cross-functionally with outside creative agencies, and Confidential partners to obtain,review and approve digital assets for theecommercesite.
  • Worked on MS Visio for designing Activity Diagrams and Sequence Diagrams, after accessing the status and scope of the project and understanding the business processes.
  • Developed and implemented cross-functional, strategic and tactical marketing avenues to increase Confidential Ecommercesales.
  • Performed analytical functions for the Policy Decisions Suite (CommercialLines Policy Rating and Workflow System) for allCommercialInsurancelines ofbusiness, Premium Audit, Experience and Composite Rating.
  • Worked closely with System Architects and Quality Assurance Analysts in creation of various tests.
  • Assured that all artifacts are following corporate SDLC policies and guidelines.
  • Assisted in deletion of defects and bugs, to meet specific requirements and deadlines for successful execution of the project.
  • Worked on Agile methodology and checked, monitored sprint release is meeting Specified deadlines.
  • Coordinated UAT of the product with Business Users.

Environment: MS Outlook, O365, K2, Agile Scrum, UML, Balsamiq, JSON, Oracle, MicroStrategy, XML, Balsamiq, TFS, MS Visio, Pega (BPM), MS Project, Windows 7.

Confidential, NJ

HEALTH CARE ANALYST

Responsibilities:

  • Involved in defining scope of the project along with vision statement using Agile Methodology.
  • Worked on HIPAA rules and regulations to draft business rules and claim processes.
  • Created business workflows on the claims module for the client to get a better understanding of the software and prepared a detailed BRD including all functional and nonfunctional requirements
  • Worked onhealthcareEDIsystems and electronic claim transaction technology and facets.
  • Identified and documented the dependencies between the business processes.
  • Provided EDI interfaces with Commercial and Government Insurance Payers that included Medicare and Medicaid.
  • Researched claims issues for theeligibiltyteam to ensure the accurate processing of claims.
  • Created and documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views using MS Visio, MS Office and Rational Rose for providing a clear understanding of the requirements for the development team.
  • Worked with Medicare operational management to monitor, trend, and report on operational metrics such as timeliness, workload, staff trending, customer satisfaction and other key measures to facilitate performance excellence.
  • Involved in gap analysis in changing old MMIS and testing new MMIS.
  • Worked with the QA (Quality Assurance) team for designing Test Plan and Test Cases for the User Acceptance testing- Defined test cases, creating test scripts, analyzing bugs, interacting with QA / development teams in fixing errors and User Acceptance Testing (UAT).
  • Used Rally to maintain the project schedule and track its status.
  • Responsibilities involved interface with end-users, obtaining approval, identifying information, procedures and decision flows, evaluating existing procedures, methods and technical documentation.

Environment: SQL, Scrum and Waterfall Methodologies, Rally software, TriZetto, POS, MicroStrategy, Quality Center, Rational Clear Quest, Rational Clear Case, Balsamiq, SSRS, Rational Rose, MS Visio.

Confidential

ASSOCIATE BUSINESS ANALYST

Responsibilities:

  • Involved in Gathering and writing theBusiness Requirements for different functionalitiesof the web-based application, including creation of an account online.
  • Worked to develop artifacts with an emphasis on the Rational Suite including: Vision, User requirements specifications, Functional specification quality assurance plan, product Acceptance plan, and test plan, test case.
  • Wrote high-level use case and generatedUMLuse case diagrams using Rational Rose.
  • Designed prototypes for development and maintenance processes to explore the feasibility of ideas.
  • Participated inJADworkshops, refined prototypes and use cases.
  • Wrote requirements management plan document using Rational Requisite Pro.
  • Extensively used AGILE methodology in all phases of the project.
  • UsedClear Case and Clear Questfor data management and defect tracking.
  • Assisted insystem testing and user acceptance testingworked with System Test Review team and developers to resolve system test issues and re-test.
  • Developed timelines for project delivery, and managed projects and resources to successful completion.
  • Assisted in development of training materials for new technology and process improvement.

Environment: Rational rose, Rational Requsite pro, Agile, Jira,HTML 5, HTML5, Angular JSMS Project, MS excel, MS Word, Clear Quest, JSON, MS visio, Jscript.

Confidential

BUSINESS SYSTEM ANALYST

Responsibilities:

  • Documented use case specifications based on requirements gathered from stakeholders.
  • Prepared vision document for defining the scope of the project and the various functional and non- functional requirements involved in it.
  • Responsible for design, information architecture and user experience of newly proposed websites portals and web-based applications.
  • Technical and Functional experience in Data warehouse implementations ETL methodology using Informatica Power Center 9.0.1/8.6/8.1/7.1 ,
  • Created new user-interface designs, mock-ups, wire frames and prototypes.
  • Analyzed and collected business requirements, identified system interfaces and created the requirements specification document.
  • Developed Requirement specifications and process diagrams including context diagram and dataflow diagram.
  • Used questionnaire, surveys, JAD sessions and Brainstorming sessions as requirement elicitation techniques.
  • Framed a detailed agenda and facilitated JAD sessions. Took aggressive efforts towards completion and finalization of documentation towards the end of JAD sessions.
  • Actively Involved In project deliverables.
  • Studied carefully all the organization's policies and procedures relating to insurance.
  • Conducted walkthroughs with development team and stakeholders.

Environment: MS Office, MS Visio, MS Project, Windows, Rational Rose, Balsamiq, Rational Clear Case,XML, UML, Rational Suite, UML, Rally.

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