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Resume

Business, AnalysT

SUMMARY

  • Proven ability to work with all levels of management, Product / Project Managers, Product Owners, Implementation specialist, Internal / External stakeholders, cross - functional departments, Subject Matter Expert (SME), Development Teams.
  • Experienced in leading project teams working on several Release Management and strategic change initiatives involving cross-functional teams, IT analysts, SMEs and vendors of size ranging from five to twenty.
  • Experienced at designing, developing and implementing strategic communication plans and collaterals for internal clients and project teams on collaborative change initiatives.
  • Experienced at preparing detailed FRS comprising workflows through requirements gathering at various levels of the process and business levels; through different modes such as workshops, questionnaire, brainstorming sessions etc.
  • Proficient in design and execution of Test Strategy, Test Plan, Test Scenarios, Test Cases, UAT based on the requirements.
  • Performed Scope Analysis, Stakeholder Analysis, Gap Analysis, Traceability Matrix and used Visio for Business Process Modeling.
  • Good understanding of as-is and to-be business processes and skilled at representing the business modeling through use case diagrams, activity diagrams, sequence diagrams and business process diagrams.
  • Proficiency in using MS Project, Excel, PowerPoint, Visio, OneNote.
  • Better understanding about Care Management business processes: Medical Referrals, Intake, Authorizations, Utilization Management, Case Management, Disease Management, Appeals, Reconsideration, Physician Review, etc.
  • Better Understanding about EDI X12 270/271 (Eligibility), 278 (Authorizations) standards, Health Level 7 (HL7), Healthcare estimation tools, Consolidated Clinical Documentation Architecture (C-CDA), Admission, Discharge & Transfer Systems (ADT), Population health System and Health Information Exchange System (HIE) tools.
  • Effective communicator and problem solver. Enjoy supporting the efforts of multiple departments.
  • Excellent oral and written communication skills.
  • Worked in Project Coordinator role to facilitate resources, schedule timely meetings with off-shore and on-shore teams.
  • Ability to monitor and report project progress to management.

PROFESSIONAL EXPERIENCE

Confidential

Business Analyst

Responsibilities:

  • Gathering both custom & configuration requirements for the application. Majorly focus on Integration, Interface, Rules Engine, Application Configuration and Web Service. Working closely on the sub-modules of Care Management such as; Utilization Management (IP, OP, LTSS and BH) Case Management and Disease Management. This further stretches out to Medical Referrals, Intake, Authorizations, Appeals, Grievances and Physician Reviews
  • Work with clients to review AS-IS workflow to generate TO-BE workflows.
  • Perform the Requirement Analysis and document the requirements in Functional Requirement Specification (FRS) document.
  • Eliciting and analyzing customer data and user requirements through brainstorming JAD sessions, onsite visits, lead interviews, observation and follow ups, understanding and interpreting user needs and goals into solutions as industry best practices
  • Discovered requirements, developed workflows, document business requirements, system gap analysis, estimations, configuration management and develop functional requirements specifications with mock up screens
  • Performing implementation projects of care management application for various clients including AmeriHealth Caritas, Blue Cross Blue Shield (Florida & Alabama), Community Health Choice, Cardinal Innovations, Group Health Corporation, MDwise & HealthSmart.
  • Perform batch Interface load process and real-time API testing using Postman in SaaS model (Hosted) and Installed client environments.
  • The focus is shifting from Payer market to Provide market as well. This creates an opportunity to work on Health Information Exchange systems. Currently, also involved in EMR and ADT to HIE system integration to translate the HL7 and CCDA feed into xml in order to display Lab Results, Problems, Allergies, Medication, Clinical Summary in Patient Portal and Provider Portals.
  • Worked with various tools including Extract, Transfer & Load (ETL), WSO2, Postman for Restful (Web-Services) testing and Single Sign-On (SSO) for Integration and Interface data load.
  • Worked with various third party proven technologies or solutions such MEDai, 3M, Health Language Integration (HLI), Milliman Care Guidelines (MCG) and McKesson’s InterQual to Integrate with Product based on client requirement.
  • Produce visual models for the application enhancements using MS Visio to create Workflow Diagrams.
  • Perform tests on the test cases before providing the functionality to the client in the UAT Environment.
  • Working with Delivery Managers, Subject Matter Experts, IT professionals, and Software developers to define project scope and objectives
 

Environments & Tools: Win 7, Bizapp, MS Biztalk, JIRA (Karmic), F5 Network, VPN tunnels, MS OneNote, MS Visio, MS Project, SQL Server, MS Office, EDI X12, HL7, Citrix, WinScp and XML.

 

Confidential

Business Analyst

Responsibilities:

  • Interacted with clients to finalize the Business Requirements for the application.
  • Performed the Requirement Analysis and documented the requirements in BRD.
  • Closely interacted with designers and software developers to understand application functionality, navigational flow and updated them about end-user sentiments.
  • Analyzed system requirements, developed detailed Test Plan and test scripts for testing the functionality and UI.
  • Collaborated with clinical peers to define product workflow and user experience.
  • Extensively worked on EDI X12 transactions in order to improve the current Eligibility and Benefit application and launch a stand-alone Eligibility Application.
  • Coordinate with development team to map data points with relevant properties to populate tables with information.
  • Produced the visual models for the application using MS Visio to create Sequence, Workflow Diagrams and Activity Diagrams.
  • Performed Risk Analysis of the requirements to identify the key business risk areas for the project and prioritized the application development and testing.
  • Facilitated weekly meetings with the review teams to continuously improve the process.
  • Used PowerPoint presentations for conducting walkthroughs with the stakeholders.
  • Followed a structured approach to organize requirements into logical groupings of essential business process, business rules, information needs and insured that critical requirements are not missed.

Environment & Tools: Windows XP, Win 7, Rally, SharePoint, Sales Force, Ms Visio, Ms Project, SQL Server, MS Office, Balsamic.

Confidential, Texas

Graduate Assistant

Responsibilities:

  • Maintained and organized the administrative notes for different department.
  • Assisted Faculty member with Publishing various articles and books.
  • Maintained the Student and Student Organization Handbooks to ensure they were up to date with current university policies and procedures.
  • Compiled and organized Faculty class documents and reports.
  • Assisted in planning and executing College of Business events.
  • Provided full secretarial and administrative support to the numerous faculty members.
  • Manage customer requests for information

Environment: Window XP, Vista & 7, Microsoft Excel, Access, Word and Project.

Confidential

Sr. Executive

Responsibilities:

  • Worked with multiple Global Distribution Systems (GDS) including Amadeus, Galileo and Apollo.
  • Technically sound with the all the GDS and reservation systems to generate tickets, change or update travelers information.
  • Help in User Acceptance Testing in order to check the end users response and collect feedback data.
  • Providing detailed documentation and status reports.
  • Check requesting system with seating requirements, meal request and requesting for any special handling requirements on GDS and Airlines Database.

Environment: Windows XP, Microsoft Project 2000, Global Distribution Systems Consoles (Amadeus).

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