SUMMARY

• Possessing 8+ years of experience as a Business Analyst wif diverse IT implementation experience in Health Insurance, Investments and Banking domains.
• Very strong noledge of SDLC and Agile methodologies and project life cycle
• Experience working wif business users to analyze and document business requirements and system functional specifications.
• Excellent analytical skills and understanding of business processes and functionality requirements and ability to translate them to System Requirement Specifications.
• Thorough noledge of industry standard SDLC practices and UML tools.
• Thorough understanding of HIPAA EDI transactions such as 835 (medical claim payments), 837 (222A1/223A2 Medical Claims), 276 (claim status), 277 (claim status response), 278 (Health care service review information).
• Coordinated and facilitated daily and weekly meetings wif offshore team and apprised onshore team of project related updates.
• Served as a liaison to communicate precisely wif teh stakeholders and offshore QA team members regarding integration, system, and user acceptance testing.
• Strong analytical, and problem - solving skills wif emphasis on clear, detailed Business Requirements and Functional Specifications, as well as reports for management.
• Experience in Data Warehousing projects in Collecting Client requirements, Data modeling, Workflow manager, Workflow monitor.
• Experienced in loading data, troubleshooting, debugging mappings, performance tuning of Informatica (Sources, Targets, Mappings and Sessions) and fine-tuned transformations to make them more efficient in terms of session performance.
• Working noledge of data warehouse techniques and practices, experience including ETL processes, dimensional data modeling (Star Schema, Snow Flake Schema & Dimension Tables), OLTP and OLAP
• Direct responsibilities include experience wif planning, organizing, and Change Management.
• Expertise in Business Modeling using MS Visio, Rational Rose.
• Provide business expertise in teh design, development and implementation of business plan for existing and new health plans to meet new Federal and State mandates.
• Work directly wif Marketing, Finance and Compliance Teams and updated and created Group Apps (Benefit Design Documents).
• Created new Policy and Procedures (PnP) for EDI, Claims and Benefit related transactions.
• Able to master new concepts and applications wifin a timeframe.

TECHNICAL SKILLS

Business Modeling Tools: Rational Rose, MS Visio, MS Office.

Methodologies: Agile, RUP, Waterfall.

Requirement Management Tools: Rational Suite (Requisite Pro, Clear Quest, Rose), NASCO, Informatica 9.0, QNXT 5.3, HSP 10.6.4 (Health Solution Plus).

Applications: MS Office (Word, Excel, PowerPoint, InfoPath, OneNote, Publisher, Outlook) MS Project 2000, WorkFront, TFS (Team Foundation Software).

Operating System: Windows NT/ 98/2000/2003 , Windows XP

Databases: SQL Server

PROFESSIONAL EXPERIENCE

Confidential, CA

Sr. Business Analyst

Responsibilities:

• Identified and defined business needs; identified opportunities for improvement and developed teh business plan.
• Determined requirements using interviews, document analysis, surveys, business process descriptions, user stories, scenarios, and task and workflow analysis.
• Consulted wif subject matter experts, technical experts, end users and other stakeholders to gather information about functions, features, data requirements, input requirements, output requirements, interfaces wif other systems etc.
• Developed relationships wif upstream and downstream business partners to understands teh business processes and recommended changes.
• Evaluated information gathered from multiple sources, reconciled conflicts, segmented high-level information into details, and abstracts up from low-level information to a general understanding.
• Documented business, task, and workflow processes using industry standard methods including business process descriptions, use cases, scenarios, diagrams, flow charts, etc., ensured dat these deliverables can be used to design a solution to teh stated business problem.
• Assessed solutions to ensure dat goals were met, and requirements were satisfied, including assessment of request for proposal responses, internal designs, and manual procedures.
• Served as liaison and resource to project managers, developers, and other project team members throughout each phase of teh process to help clarify and/or resolve issues related to requirement, design, testing and acceptance specifications.
• Confirmed dat stakeholders had a shared understanding of requirements; managed conflicts and issues to resolution. Obtained needed approval of solution requirements. Ensured dat stakeholders has access to business analysis work products. Uses communication methods appropriate to departmental stakeholders.
• Worked directly wif Finance, Marketing and Compliance Teams to update and create Group Apps (Benefit Design Documents).
• Monitored Change Requests and documented requirements, integrated them wif Use Cases.
• Worked between IT, Marketing and Compliance to created new Policies and Procedures (PnPs) related to EDI transactions.

Environment: Diamond/CRM, HSP MediTrac 10.6.1, M S Visio, Microsoft Office, SharePoint, MSP Project, TFS (Team Foundation Software), Work Front, Optum and McKesson.

Confidential, Long Beach, CA

Sr. Business Analyst

Responsibilities:

• Implemented SDLC, which included requirements specifications, design, analysis and testing.
• Recommended promotion of software to production based on satisfactory test results.
• Defined and documents business and IT system processes. Models AS-IS and TO-BE processes.
• Conducted and facilitates JAD sessions to develop and coordinate teh requirements, specifications, design, and testing efforts for medium to large projects
• Analyzed business workflow and system needs for conversions and migrations; assists in data mapping
• Developed business processes dat ensure developed application meets all project requirements, ensures dat projects are completed on time, accurate to defined specifications and wifin budget
• Translated business and IT requirements by reviewing, analyzing and evaluating needs into functional specifications.
• Interacted wif system developers to resolve questions and discrepancies in BRDs.
• Developed teh Requirements Traceability Matrix, prioritized and determined Impact of all applications.
• Developed and maintained RAID (Risk Assumptions Issues and Dependencies) for all defects and outstanding issues wif vendors, developer, testing team and configuration team.

Environment: QNXT5.3, M S Visio, Microsoft Office, SharePoint, MSP Project.

Confidential, Detroit MI

Sr. Business Analyst

Responsibilities:

• Conducted JAD sessions wif extensive involvement from Business, Development, Testing teams, Architects, SME’s (Subject Matter Experts) and Managers of various Business Units to gather teh requirement
• Created and updated Business Use Cases, and extracting Stakeholder and SMEs requirements.
• Supported full traceability among all artifacts throughout teh software development life cycle.
• Realized Use Cases and their corresponding activity flows wif complete entity relationship, recording all flows in Rational Rose and using Clear Case for Version Control
• Organized one to one interview sessions wif Directors (sales & marketing, underwriters for large & small group renewal packages), create questionnaires, brainstorm sessions, research wif teh business, underwriters, marketing and sales to track, analyze, review and document clear, concise and feasible detailed business requirements in BRD, Group Apps (BDD) and PnPs.
• Possess in-depth understanding and experience in using Visio to trace and update business requirements throughout teh lifecycle of a project and keep stakeholders informed about teh progress of teh project utilizing Requirement Traceability Matrix (RTM)
• Created User stories by taking inputs from business users and mapped it to teh requirements in High Level Requirement Document
• As a member of teh Benefits File team, was responsible for Analysis, Research and benefit coding
• Extracted / Tested in Model Office wif test data
• Analyzed teh Benefit / Procedure file to determine teh specific POS/TOS conditions for Column routing
• Analyzed and documented teh Level / Set / Division / Column routing for Groups to particulars and sub-particulars
• Developed Use Cases, Activity Diagrams, and System Context Diagrams entailing grandfathering process, preexisting condition exclusions, dependent coverage age increase & other required provisions
• Developed business flow diagrams, activity diagrams, and interaction diagrams so dat teh development team and other stakeholders could understand teh business process clearly.
• Extensively involved in performing Gap Analysis in teh upgrade of teh existing Claims
• Processing system and highlighting related issues.

Environment: NASCO, HIQK, HEHK, HRBK, HRRK, HURK, MS-Excel, MS-Word, SharePoint