SUMMARY:

• 5+ years’ experience as
• Business Analyst with solid understanding of Business Requirements Gathering, Evaluating Data Sources, Translating Requirements into Specifications, Application Design in various domains like Healthcare, Finance.
• Proficient in Technical and Business Writing, Business Process Flow, Business Process Modelling, Business Analysis and Testing various methodologies.
• Strong knowledge of HL7, HIX (Health Insurance Exchange), EMR/EHR, Health Care Reform and Patient Protection and Affordable Care Act (PPACA) and Facets.
• Extensive knowledge of Healthcare Insurance including Medicaid. Medicaid Information Technology (MITA), Medicare (Part A, B, C, D), Procedural and Diagnostic codes, Claims Process and Medicaid Management Information Systems (MMIS)
• Managed complex business initiatives to balance requirements for functionality, efficiency and quality.
• Developed business requirements by analyzing the As - Is system and designing the To-Be system to streamline business strategies. Suggested improvements to business processes through better use of existing technology.
• Exceptional Documentation Skills for writing Use Cases and Functional Requirement Documents, non-functional requirement documents as well as for creating Use Case diagrams, Activity diagrams, Data Flow Diagrams (DFD), Sequence diagrams, State diagrams, Diagrams based on UML Methodology and business process flow diagrams using MS Visio/Enterprise Architect/Rational Rose.
• Extensive risk management experience conducting fraud and risk investigations for financial institutions and payment processing organizations
• In depth knowledge Rational Unified Process (RUP) methodology, Use Cases, Software Development Life Cycle (SDLC) processes.
• Competent in Creating Unified Modelling Language (UML) diagrams such as Use Case Diagrams, Activity Diagrams, Class Diagrams and Sequence Diagrams.
• Extensive experience in developing Use Cases, creating Screen Mock-ups, conducting Gap Analysis and Impact Analysis, SWOT analysis, Cost Benefit Analysis, Risk Analysis.
• Facilitated Change Management across entire process from Project conceptualization to Testing through Project Delivery, Software Development and Implementation Management in diverse Business and Technical Environments.
• Expertise in broad range of technologies, including business process tools such as Microsoft Project, MS Excel, MS Access, MS Visio, technical assessment tools,
• Involved in Test Planning, Test Preparation, Test Execution, Issue Resolution and Report Generation to assure that all aspects of a Project are in Compliance with the Business Requirements.
• Strong experience in conducting User Acceptance Testing (UAT) and documentation of Test Cases. Expertise in designing and developing Test Plans and Test Scripts.
• Highly motivated team player with excellent Interpersonal and Customer Relational Skills, Proven Communication, Organizational, Analytical, Presentation Skills, and Leadership Qualities.
• Develop the Test plan, Test conditions and Test cases to be used in testing based on business requirements, technical specifications and/or product knowledge.
• Prepare status report to senior management to do the daily reporting and as is assessment of the project.
• Experienced in interacting with business users and executives to identify their needs, gathering requirements and authoring Business Requirement Documents (BRD), Project Charter and Project Approach Documents
• Knowledgeable on the Software Development Life Cycle (SDLC) phases such as Planning, Analysis/Design, Development, and Testing for the software/system development process.
• Proficient in Agile, Waterfall, JAD, Business Process Improvement, Business Automation, Business Process Reengineering, and Dataflow diagrams.
• Very sound knowledge in HP-ALM QC for Test Planning and Test Asset Management throughout the Software Development Life Cycle.
• Proven skills in creating Business Requirement Documents (BRD), Functional Requirement Documents (FRD), Business process documents, user manuals.
• Experience in intensively checking the data flow in Web based, Client/Server, Mainframe and Networking and Mobile environments.
• Knowledge of Data Warehouse life cycle, Data Mart design concept, SHARES ACI and PNR .
• Strong expertise in employing Rational Unified Process (RUP) methodology throughout the SDLC process
• Conducted JAD Sessions, brainstorming sessions to develop an architectural solution that the application meets the business requirements, resolve open issues, and change requests.
• Experienced in performing Business Process Reengineering/Gap Analysis to check the compatibility of the existing system infrastructure with the new business requirements.
• Coordinated with the testing team during the formulation of Test Plan and Test Cases for Functional, System, Integration, UAT and Regression Testing based on the Design Document and User Requirement Document for the Functional and Performance Testing.
• Used SQL queries for the arrangement of customer data. Created and maintained end-to-end data mapping and data conversion spreadsheet.
• Extensively worked on some phases of data warehousing and business intelligence projects like data mining, data cleansing, data modeling for data mart, ETL, Indexing, data updating plan, data presentation to business users, auditing, backup and recovery.

TECHNICAL SKILLS:

OPERATING SYSTEMS: Windows 7, 8, 10, UNIX, LINUX

METHODOLOGIES: Rational RUP, RAD, JIRA, Waterfall (SDLC), Agile, Scrum, Incremental.

CASE TOOLS: Rational RequisitePro, ERWIN, UML

QA TRACKING TOOLS: QualityCenter, Rational ClearQuest, HP-ALM(All Project Life Cycle management)/ Quality Center (QC),Team Foundation Server( TFS), Microsoft Test Manager(MTM), TriZetto Facets, Claredi, Ultra Edit, Edifecs, WTX, QNXT

LANGUAGES: SQL*Plus, SQL, Fiddler, SoapUI, C, Java,, HL7 Interface, Cerner-Mckesson, SQL, FACETS, COBOL

TOOLS: MS-Project, MS Access MS-Excel, MS-Word, MS-PowerPoint, WordPerfect Productivity tools, MS-Visio

DATABASES: MS-SQL Server, ORACLE, MySQL, MS-Access

PROFESSIONAL EXPERIENCE:

Confidential, Jacksonville, FL

Business Analyst

Responsibilities:

• Gathered Business Requirements, analyzed data/workflows.
• Facilitated collection of Functional Requirements from system users, and prepared Business Requirement documents
• Responsible for claim adjudication like Medicare claims, professional claim, institutional claims
• Worked closely with Business users to determine the workflow of the product
• Followed the UML based methods using MS Visio to create Use Case Diagrams, State Chart Diagrams and Sequence Diagrams.
• Prepared Logical Process and Data Models that contained set of diagrams and supporting documents containing the essential business elements, detailed definitions, and descriptions of the relationships between the data elements to analyze and document Business Data Requirements
• Propose different strategies to implement HIPAA 4010 in the new MMIS system.
• Conducting meeting with the client on a daily basis and reporting on daily progress
• Specifications, Documentation and Construction of systems heavily relied on UML modeling.
• Worked closely on 834 transaction code for Benefit Enrollment and was involved in Validation of HIPAA for 837, 270/271, 276/277,835, 834 EDI transactions
• Act as a liaison between the business stakeholders and delivery team through the project life cycle to communicate and validate requirements, and ensure that technical delivery team has full understanding of business goals and objectives as stated in the requirements.
• Accountable for project deliverables like Work Breakdown Structure (WBS), Functional Decomposition Diagram, Business Requirements Document (BRD), Functional Specification Documents (FSD), RACI Matrix and RTM.
• Work closely with the project manager to assist in the definition of project scope and objective, involving all relevant stakeholders and ensuring technical feasibility.
• Identify, communicate and facilitate resolutions for any user requests or changes based on business and IS feedback.
• Communicate complex analysis and insights to stakeholders and business leaders, both verbally and in writing.
• Work closely with Quality Assurance (QA) team to assist with System Testing and User Acceptance Testing (UAT).

Environment: UML, RUP, MS-SharePoint,Fiddler, SoapUI MS-Project 2000, MS-VISIO, CMMI, testDirector7.6, WinRunner7, JIRA, Agile, windows 2000, EDI, HIPAA compliances.

Confidential - Cleveland, OH

Business Analyst

Responsibilities:

• Prepared and analyzed AS IS and TO BE in the existing architecture and performed Gap Analysis and created workflow scenarios, designed new process flows and documented the Business Process and various Business Scenarios and activities of the business from the conceptual to procedural level.
• Acted as the primary liaison between the client departments and the Information systems department and interacted with internal as well as external clients, to collect requirements and business process information, documented them in Business Requirement Document (BRD) post analysis of the business requirements by analyzed the Risks associated with MBS and strategies used to assess and mitigate them.
• Interacted with Subject Matter Experts of different divisions (Information Technology, Risk and Operations) and established a business analysis and design methodology around the RUP (Rational Unified Process).
• Facilitated collection of User Requirements and Business Requirements from Business User Group such as to document Business/User/Functional/Technical Requirement Specification using MS Word and MS Visio that provided appropriate scope of work for technical team to develop prototype and overall system.
• Prepared graphical depictions of Narrative Use Cases, Use Case Diagrams, Activity Diagrams, and Sequence Diagrams, using MS Visio.
• Implemented Software Quality Assurance development strategies, test procedures and testing methodologies, wrote Test Plans according to Business Specifications and design documents.
• Helped in planning test cases for the system. Develop and implement test cases on the GUI interfaces to ensure that requirements were met; Implementation of system enhancements and conversions, which included developing detailed documentation for and testing.
• Heavily involved in Project post go-live; Production Support, troubleshoot issues.

Environment: MS Office Suite, MS Visio, Windows XP/NT, Oracle 10g, Business Objects, SQL Server, PLSQL, XML, ASP.NET. SAP Business Objects Data Services XI 4.0 (ETL), SAP Business Objects XIR3, SAP Streamworks, Microsoft Visio, Microsoft Project, Microsoft office, Mercury Quality Center, DB2, ASAP Methodology (SDLC).

Confidential

Business Analyst

Responsibilities:

• Manage end-to-end processes for large scale projects from gathering requirements to user sign-off. Liaison between business and IT to achieve project objectives and provide SME services.
• Elicited, communicated & validated requirements to & from the required business process, policies & information system; investigated, identified & improved the business system.
• Document and analyze current business processes, as-is, to identify gaps and inefficiencies. Work with cross functional teams to formulate future business processes, to-be.
• Scoped the business system & model, translated business needs & technical issues, modeled & translated technical requirements & issues.
• Extensively maintained the existing application & constantly developed new modules; was engaged on-site for product demo, deployment & UAT across states; educated team members; organized meetings with high level management on required product functionalities.
• Prototyped the quintessential business model as requested by direct/indirect clients; specialized in client interaction & business model proliferation across domains; introduced & sold product family suites to new customers; acquired many new customers.
• Wrote & modeled in UML various graphical, textual representations & artifacts; ensured requirements traceability; developed the testing requirements to enhance the user experience & the overall GUI; reviewed the business processes, assessed the business needs employing a structured requirements process (SRP) involving gathering, analyzing, documenting, & managing changes.
• Employed extensively the AGILE Development Methodology that constantly included -continuous delivery of useful software; ensured that working software is delivered frequently & is the principal measure of progress; welcoming late changes in requirements; removing an existing feature or moving a deadline forward to accommodate late/unplanned feature requests; close, daily cooperation between business people & developers; continuous attention to technical excellence & good design; simplicity; regular adaptation to changing circumstances
• Met with users and stakeholders to understand the problem domain, gathered customer requirements through interviews (group and one-on-one) along with JAD sessions.
• Used Visio to create process and work flow diagrams. Created Prototypes and Mockups for Web screens using Snag-it Editor
• Prepared project plans for BRD deliveries and UAT testing releases. Perform gap analysis with BRDs and FSDs to flag any inefficiency.
• Documenting ETL details and processes for the projects.
• Extensively interact with end users/project managers and several business area experts, asking detail questions and carefully recording their issues.
• Organize and facilitate meetings with the management and development team.
• Conduct the requirements gathering sessions with the purpose of creating BRDs and FSDs.
• Coordinate business review and walkthrough meetings to discuss the project status using Power Point presentations.
• Drive and maintain project work plan, track and report on progress to stakeholders.
• Understood, analyzed, evaluated process & program specifications of database structure to gather & generate technical data converting into specs that would integrate with the design & development of the Data warehouse (Universe), generation of queries at all levels, including ad-hoc querying, sustainable requests, query-flow schemas, query handling universes, & the generation of final reports.
• Interacted extensively with the client & provided support & participated actively in peer reviews; initiated & followed CMM practices pertaining to Development & Unit Testing; deployed client side deliverable & prepared module release documents; migrated a part of the application from VB 6.0 to VB.Net 2.0.
• Generated test cases and test plans from the requirements gathered, and facilitating application testing. Coordinated with the development and testing teams to ensure that the defects are properly logged, tracked and processed from detection through to the resolution phases, using Test Director.
• Prioritized outstanding defects and system enhancement requests based on business requirements and allowing sufficient time to ensure accuracy while reevaluating deadlines.
• Facilitated software evaluation, vendor presentations,, and deployment (roll-out) activities and ensuring that the systems are properly implemented and supported towards end-user satisfaction.
• Heavily involved in Project post go-live; Production Support, troubleshoot issues.

Environment: Oracle 9i, SQL PLUS, Informatica 7.x, VB.Net, Crystal Reports, HP Quality Center, Test Director, MS Visio, MS Project, and MS Office 2007 (Word, Excel, Power Point, Outlook), MS Project Plan.