SUMMARY:

• Versatile Business Analyst with more than 7 years of experience with strong domain knowledge in Healthcare industries.
• Strong understanding and working knowledge of MMIS(Medicaid Management Information System) subsystems like Claims, Pre - Admission Screening, EDI, TPI, RMS.
• Worked on complete lifecycle of leading-edge technologies Software Development Life Cycle (SDLC), waterfall, agile-scrum, spiral,iteration methods, including gathering information, planning, business analysis, system analysis, development, testing and implementation of projects.
• Extensive knowledge about various medicare standards such as ACA(Patient Protection and Affordable Care Act), HL7, HIPAA 4010/5010, ICD 9/10, EDI(electronic data interchange ) 834, 835, 837.
• Proficient in BRD/FRD & conducted testing, SIT/UAT, Test-Plan development/Test-Cases development/Test-Data creation,Use Cases, Requirements Traceability Matrix (RTM), system Requirement Specification (SRS) and Test Requirement Document (TRD),Rational Unified Process(RUP).
• Worked on UML based methods like MS Visio to create Business flow diagrams, Use Case diagrams, Activity diagrams, sequence diagrams, and Collaboration Diagrams.Conducted Joint Application Development (JAD) sessions with Subject Matter Expert (SME)sessions.
• Experience in QA Test plan development and User Acceptance Testing (UAT) using Cucumber automation tool.
• Posses profound understanding on Salesforce CRM, marketo and CRM business processes like account management, lead management, order management, forecasting etc.
• Experience in using Requirement Gathering & Defect tracking tools like JIRA & HP QC.

AREAS OF EXPERTISE:

Agile, Waterfall, UML, SDLC, Scrum, RUP, V-shape modeling, BRD(Business Requirement Document), FRD(Functional Requirement Document), JAD sessions, RTM, UML, Facets, ERP(Enterprise resource planning), SCM(Supply chain management), CRM(Customer Relationship management), TRD, JIRA & HP QC.

EXPERIENCE:

SR. Business Healthcare Analyst

Confidential, New Brunswick, NJ

Responsibilities:

• Experienced in working in project platforms such as SalesForce (CRM), Agile, SCRUM, and Waterfall(SDLC).
• Gathered business requirements for CRM, Inventory and Quotation modules of ERP system through detailed discussions with business stakeholders.
• Developed and managed the documents for RMS (Regulatory Medical System) including CPSE(Consumer Product Safety Commission), EPA (Environmental Protection Agency) and EEOC (Equal Employment Opportunity Commission).
• Directed the deployment Implementation project teams consisting client associates focused on installing and implementing Healthcare solutions (Kiosk Check-In Systems, Patient Portals) both nationally and internationally.
• Expertise with 5.30 Facets Applications
• Performed HL7 GAP Analysis in order to investigate HL7 data and document integrity and determine documentation is code ready format.
• Analyze, Troubleshoot, Maintain all EDI Transactions - File types 850, 870, 810, 856, 864, 855.
• Read and interpret EDI implementation guidelines.
• Created Use Case Diagram, data flow diagram(DFD), Entity Relationship Diagram, Activity Diagram using using Ms Visio.
• Experience in developing and imparting pre and post implementation training, conducting GAP Analysis, JAD sessions, User Acceptance Testing (UAT), SWOT Analysis, Cost Benefit Analysis and ROI analysis.
• Extensive experience in producing documents like Business Requirements Documents (BRD), Functional Requirement Specifications (FRS) defining healthcare Medicaid/Medicare security information and privacy event monitoring systems.
• Worked on medicare Plan Changes based on the CMS approved changes.
• Create Software Requirement Specifications (SRS), Request for Proposals (RFP), Requirements Traceability Matrix (RTM)
• Managed and led the team of 6-8 people with the entire effort from analysis to validation phase of the SDLC.
• Created use case diagrams, dataflow diagrams,activity diagrams,functional diagrams,flowcharts using Ms. Visio.
• Conducted Requirement analysis and Design Walkthroughs with the designers, developers and management teams.
• Responsible for gathering CRM information and developing a comprehensive report once a month for management.
• Facilitated GAP Analysis, Impact Analysis (Business/Technical), SWOT Analysis, Cost-Benefit Analysis, Root Cause Analysis and Risk Analysis along with creating As-Is and To-Be Business Models.
• Proficient in using Requirement Gathering & Defect tracking tools like JIRA & HP QC.
• Conducted various JAD sessions with PM, SMEs; facilitated interviews with end users and hospital administrators to collect business requirements
• Extensive knowledge of Medical Management Information Systems (MMIS), National Provider Identification (NPI), Health Insurance Portability & Accountability Act (HIPAA 5010) standards, Electronic Data Interchange (EDI), ICD-9/10 coding, HL7, HIX (Health Information Exchange), EMR/EHR, Health Care Reform and Patient Protection and Affordable Care Act (PPACA)
• Worked with QA and software testing team in developing test plans and test cases from functional and business requirements for Integration testing, Quality Assurance and User Acceptance Testing.
• Participated in eliciting business requirements and translating them into Business and Functional Requirements.

Environment: MS Office (Word, Excel, PowerPoint, Visio),Kronos ERP, Salesforce (CRM)

SR.Business Analyst

Confidential, Indianapolis, IN

Responsibilities:

• Good experience in requirement-gathering, analysis for application development projects involving Agile, Rational Unified Process (RUP).
• Worked with waterfall processes and creating Use Case Models, Activity Diagrams and State Chart diagrams.
• Experience in Joint Application Design (JAD) and Rapid Application Development (RAD) sessions, brainstorming sessions, agile, prototyping,requirement reviews, system walkthroughs and customer interviews for various business processes.
• Organized meetings and led JAD sessions to ensure legal and compliance deadlines of CMS (Centers for Medicare and Medicaid Services) are met.
• Extensive knowledge of Object Oriented Analysis and Design (OOAD) using Unified Modeling Language (UML), Rational Unified Process (RUP), Waterfall, CMMI, Six Sigma (DMAIC).
• Proficient with full Software Development Life Cycle (SDLC) including Feasibility Study/Gathering Requirements, Analysis, Design, Development, Testing, User Acceptance Testing (UAT), Implementation and Post-Implementation Validation.
• Full ownership of the HIPAA Compliance program overseeing appropriate program tasks.
• Reviews vendor and business associate contracts to ensure HIPAA compliance towards contractual objectives.
• Define HL7 interface requirements; GAP analysis and develop detailed specifications for ADT (Admit- Discharge-Transfer), Lab orders, results & charges.
• Performed extensive HL7 message reviews in order to troubleshoot, and confirm HL7 interfacing and message compliance.
• Work directly with Healthcare Medical Director’s, Doctor’s, Office Mangers, and Billers as a consultant throughout the EDI Enrollment and Implementation process.
• Proficient with ICD 10 Coding Initiative.
• Worked on various modules of MMIS.
• Understanding of the Medicaid Enterprise Certification Toolkit (MECT).
• Analyzing, recommending, and implementing efficient business solutions to meet the changing demands of our client's businesses.
• Primary job role of planning, directing and analyzing the business problems to be solved with software solutions.
• Provide business and technical assistance in identifying, evaluating, documenting processes to achieve the targets.
• Excellent Understanding of Entity Relationship Diagrams (ERDs).
• Good with supervised testing efforts for Functionality, Usability, Reliability, Performance and Regression testing.
• Articulated UML through Use Cases, use case document by specifying actors, normal flow, subflow, alternative flows for each and every use case.
• Experience in conducting GAP analysis, User Acceptance Testing (UAT), SWOT analysis, Cost benefit analysis and ROI analysis.
• Writing use cases/user stories, software requirement specification (SRS), business requirement document (BRD), business rules, traceability matrix, workflow diagrams, or other business or system requirement artifacts.
• Involved in managing the Daily Standup meetings and also ensured that quality standards were enforced as per the build-release schedule.
• Responsible for regression testing of the tools.
• Analyzed various business problems related to data consistency/data integration to come up with tactical and strategic solutions to ensure effective project management.
• Extensive experience in producing documents like Functional Requirement Specifications (FRS),, Request for Proposals (RFP), Requirements Traceability Matrix (RTM).

Business Analyst

Confidential, Chicago, IL

Responsibilities:

• Interacted with stakeholders and collected requirements as per the business needs.
• Implemented RUP(Rational Unified Process) methodology for iterative and incremental development of the system.
• Created Process Flow Charts, Business Requirements Documents(BRD), Functional Requirement Documents(FRD),software requirements specification(SRS).
• Gather requirements and estimate effort for HL7 interfaces.
• Conducted GAP analysis by understanding the AS-IS system and the TO-BE system requirements by having discussions with the SME's.
• Prepared Functional Design Specifications (FRS) employing Use case scenarios, sequence diagrams, DFDs and class diagrams.
• Developed Flowchart and process diagram using Microsoft Visio.
• Experience on Required Traceability Matrix (RTM) in Rational RequisitePro for traceability of requirements through test cases.
• Hands on knowledge of Object Oriented Analysis and Design (OOAD) using Unified Modeling Language (UML), Waterfall, CMMI, Six Sigma (DMAIC).
• Worked on different projects using various methodologies such as Agile, Rapid Application Development (RAD), Joint Application Design (JAD) and Prototyping.
• Reviewed OCR and HIPAA 4010 standards to ensure compliance and security are in accordance with government and industry regulation.