SUMMARY

• Passionate, detail - oriented, results-driven Business Systems Analystwith 8+ years’ experience in Healthcare Information Technology domain with focus on Business Analysis, Software Development Life Cycle (SDLC) and Business Process Reengineering. Certified Scrum Master with proven ability to work with self-organizing and cross functional teams.
• Experienced in waterfall methodology and agile methodologies like Scrum, Scaled Agile Framework (SAFe 4.0), hybrid methodologies like Water-scrum-fall methodology. Knowledge of Extreme programming (XP), Spiral, lean- agile, Kanban, Scrumban and RUP methodologies.
• Possess excellent business, analytical, and interpersonal skills with the ability to communicate with Developers, Architects, Subject Matter Experts (SMEs), Business Stakeholders, Testing team and Senior Executives.
• Experienced in Medicare and Medicaid domains of the healthcare systems and industry for inpatients, outpatients, Reimbursement Methodology and Medicaid Management Information System (MMIS).
• Expertise in Claims Processing and Claims Scrubbing in HMO, PPO, POS, Medicaid and Medicare.
• Well versed with current healthcare industry standards such as CMS, MMA, HL-7, ICD9, ICD10, HIsPAA (4010 and 5010) EDI X12 standard Transaction sets (834, 835, 837, 820, 270/271 and 276/277) HHS, SOX and FDA.
• Experienced in Facet Implementation and conversion of 4.21, TriZetto Facets and TriZetto HIPAA Gateway 4.11.
• Designed and documented Business Process Re-engineering, Business Process Modeling, Historical Data Reports Analysis accompanied by conducting and facilitating elicitation sessions such as survey/questionnaires, Interviews sessions, Brainstorming sessions, Focus group sessions, Requirement workshops, Interface analysis, Document analysis, and Joint Application Development (JAD) sessions with internal as well as external stakeholders
• Proficient in authoring Project Charters, Business Requirement Documents (BRD), Functional Specifications Documents (FSD), Software Requirement Specification (SRS), Use case Document, and Software Design Specification (SDS).
• Experience in conducting SWOT Analysis, Cost Benefit analysis, Gap analysis (As Is-To Be analysis) and ROI Analysis.
• Experience in building Unified Modeling Language (UML) diagrams including Use Cases, Activity Diagrams, Sequence Diagrams, Class diagrams, Data Flow Diagrams, and transforming the requirements gathered into functional specifications focusing on Workflow Analysis and Design, User Interface Design, Data flow, Process flow and ER Diagram.
• Extensive experience in retrieving data and data validation using SQL queries like Joins, Views, Sub queries and Aggregate functions like max, min, sum and average with good understanding of Stored Procedures, Functions and Triggers.
• Skilled in Data Warehousing implementation including OLTP, Data Marts, ODS, Staging, Data sources, Normalization and Dimension tables, Data Profiling, Data Integration, Data Migration, Data Organization, Data Conversion, Data Quality and Data Modeling concepts like conceptual model and logical model.
• Good knowledge of the Star and Snowflake Schema, OLAP operations such as Slice, Dice, Rollup, Drill Down and Pivot.
• Widespread knowledge of extraction of data from source systems, transformation and load process (ETL) for a Data Warehouse using Business Intelligence (BI) tools like Informatica.
• Extensive knowledge of Continuous Integration and Continuous Deployment (CICD) using Jenkins and Bamboo.
• Liaised with QA team to design & implement Test plans, Test cases and performed Black-box Testing, System Testing, Integration Testing, Regression Testing, User Acceptance Testing (UAT), Load/Stress Testing & Performance Testing.
• Experienced in tracking user stories, Defects, issues with the help of project management tools like JIRA & HP ALM.
• Experienced in Application Program Interface (API) testing using Postman and SoapUI to check if the API response data is in JSON or XML format as required by workflow and resolve discrepancies. Used Swagger for API documentation.
• Strong exposure to SAS programming for Clinical Study Report (CSR), Integrated Summary of Safety (ISS), and Integrated Summary of Efficacy (ISE).
• Expertise in using various SAS report generating procedures like PROC REPORT, PROC SQL, PROC FREQ, PROC MEANS, PROC TABULATE, PROC TRANSPOSE, PROC PRINT and knowledge of SAS/BASE, SAS/MACRO, SAS/ODS, SAS/SQL, SAS/STAT, SAS/GRAPH, SAS/ACCESS, and SAS/CONNECT in UNIX and Windows environments.
• Experienced in creating interactive dashboards and reports like heat maps, bar graphs, pie charts and pivot tables using Tableau.
• Knowledge of Cloud Computing platforms, specifically Amazon Web Services (AWS), products like Amazon Web Services Lambda, Amazon S3, Amazon VPC, Amazon API Gateway, and Amazon Cognito.

TECHNICAL SKILLS

Project Management tools: MS Project 2016, Web conferencing, JIRA 7.0, MS SharePoint, MS Office 365 online, Trello, Workfront 18.1

Requirement Management Tools: Jira 7.0, HP ALM/QC 12.0, Rally 2015.2, Confluence 6.0, Rational DOORS 9.4, Team Foundation Server (TFS), SharePoint, ServiceNow, Smartsheet, Slack, JAMA

Business Modeling Tools: MS Visio 2016, Balsamiq, Mockup screens, Google Drawings, Rational Rose 7.0, Lucid Chart.

API and Testing Tools: HP Quality Center, Selenium, Load Runner, Cucumber, Swagger, QTP (Quick Test Professional), HP ALM (Application Life Management), Postman, Bugzilla,JAMA

Languages: HTML5, CSS, XML, JSON, JavaScript, PHP, SAS, SQL/TSQL, PL/SQL, jQuery, Bootstrap

Business Intelligence / Reporting Tools: SAS Base 9, Informatica 10.0, Tableau 2018, MicroStrategy, MS office 365 online, Google Analytics, QlikView 12, Cognos Analytics v11

Data Modelling, Data Mining and Data Migration: RapidMiner, erwin, Orange, MuleSoft, Alooma, R studio, Informatica 10.0

Database and Data Analysis Tools: SQL Server 2008 R2/2012/2014, Oracle SQL v19.1, MS Access, Teradata, MySQL Workbench, Sybase, Postgres.

PROFESSIONAL EXPERIENCE

Confidential

Technical Business Systems Analyst

Responsibilities:

• Facilitated Requirement Analysis Sessions with Technical teams and business for requirement clarification.
• Analyzed business requirements, captured and authored Requirement Analysis Document in JAMA.
• Used Rally for User Story Management, Requirements Traceability, Defect Management and Prioritization.
• Assisted Product Owner in communicating with the development team for clarification of requirements, development of acceptance criteria, prioritization of User Stories
• Actively participated in creating the user stories and prioritizing user stories along with tracking of burn up, burn down charts to estimate sprint delivery.
• Reverse engineering and System analysis of existing Legacy systems including Advantage Suite, Data Probe and Business Objects used to store data from different data sources such as DXC, OPTUM and 30 other data sources.
• Prepared and analyzed UML diagrams like Process Diagrams, Sequence Diagrams and Activity Diagrams using MS Visio to analyze and design structure, behavior and interactions in the system design
• Created data mapping document which consists of source data, target data and transformation rules for the application after finalizing the attributes and tables with business users and communicated dependencies and potential risks.
• Worked with Data Analyst and Data Architect in defining the business rules for development and in the extraction, transformation, and loading (ETL) phases of the project.
• Worked with Development, QA, and Production Support teams to communicate, verify, and test the desired functionality changes.
• Worked the Testing team in creating and reviewing Test Plans, Test Scenarios, Test Cases and collected Test Data for successful completion of Regression testing, System testing, Integration testing and Functional testing.
• Worked on EDI 270/271 (Claim Eligibility Inquiry), 276/277 (Claim Status Check), 837(Claim Submission), 835 (Claim Remittance) files.
• Developed understanding for different financial models including Capitation and Fee for service on different subject areas including Members, Providers, Claims.
• Wrote SQL scripts for creating performance evaluation reports by pulling data from different databases and migrated data back and forth. Used various functions such as joins, triggers, aggregate, and union
• Created various Standard Reports, ad hoc reports and Dashboards with COGNOS Analytics.

Environment: Waterfall-Hybrid, Informatica, JAMA, Rally, SharePoint, Cognos Analytics v11, MS Visio, Lucid charts, MS Project, Oracle SQL v19.1.

Confidential, Bronx, NY

Sr. Business Systems Analyst

Responsibilities:

• Responsible for Business Analysis, gathered Business Requirements from Business Clients, SMEs, Stakeholders and IT Partners through brainstorming sessions, interviews, documenting Epics, User stories, assisting developers to break them down to tasks.
• Worked closely with the compliance team to validate that requirements were in accordance to HIPAA 5010.
• Assisted Product Owner in communicating with the development team for clarification of requirements, development of acceptance criteria, prioritization of User Stories.
• Used Jira for User Story Management, Requirements Traceability, and Defe ct Management and Prioritization.
• Identified and analyzed trends in EDI failures and assisted to develop innovative solutions.
• Collaborated with UI/UX team to develop information/interaction architecture, user flows, wireframes, and visual design.
• Worked with Information Architects (IA) and other representatives from the User Experience (UX) team to design wireframes, mock ups, mobile app prototypes and process flows.
• Involved in designing future state processes for HIPAA 5010 transaction processing EDI's 834,837,835, 270, and 271.
• Wrote and implemented SQL queries. Used functions like joins, unions, outer joins, group by, order by and aggregate functions to extract data for storage in the Amazon Simple Storage Service buckets.
• Created data mapping document which consists of source data, target data and transformation rules for the application after finalizing the attributes and tables with business users and communicated dependencies and potential risks.
• Assisted Data Analyst in development and in the extraction, transformation, and loading (ETL) phases of the project.
• Worked with Development, QA, and Production Support teams to communicate, verify, and test the desired functionality changes. Helped the Testing team in creating Test Plans, Test Scenarios, Test Cases and collected Test Data for successful completion of Regression testing, System testing, Integration testing and Functional testing.
• Assisted the Test Strategy Document in accordance to the Business Requirements Document.
• Performed Manual testing, Integration testing, System testing, User Acceptance Testing including writing UAT cases.
• Generated detail report, summary report on monthly, quarterly and yearly basis based on business requirement using PROC REPORT, PROC SQL and PROC TABULATE for predictive analysis.
• Analyzed key performance indicators using PROC FREQ, PROC MEAN, PROC UNIVARIATE, PROC TRANSPOSE, and DATA NULL .
• Created various charts, graphs, storyboards, reports for business analysis using Tableau Business Intelligence tool.
• Performed API testing using Postman to check if the API's are returning the data in JSON format as defined in the API documentation required by workflow.
• Conducted Knowledge Transfer for newly-hired team members to make them understand the functionality of the system.

Environment: Agile/Scrum, Amazon Web Services, Virtual Private Cloud, Amazon Simple Storage Service, Amazon Lambda, Amazon Cognito, API Gateway, Balsamiq, SAS Viya, Tableau, Jira, Postman and HP ALM

Confidential, Dallas, TX

Sr. Business Systems Analyst

Responsibilities:

• Worked at the Team Level in a SAFe@ environment. Assisted Project Manager in drafting the Project plan; defining scope, establishing work breakdown structure, defining critical path analysis and project milestones using Microsoft Project.
• Involved in PI Planning and all aspects of scrum framework, including product backlog, release backlog, sprint planning session, daily scrum meeting, sprint reviews and sprint retrospectives.
• Manage company's EDI catalog for prospective EDI customers. Worked on FACET claim processing system and gathered requirements for Medicare Systems as part of Patient Protection Affordable Care Act (ACA).
• Created BRDs and FSDs documents with elaborate Use Cases and process flows.
• Actively participated in creating the user stories and prioritizing user stories along with tracking of burn up, burn down charts to estimate sprint delivery.
• Created documents for the wireframes using MS Visio and documented data dictionary.
• Developed understanding of various transactions involved in transition from HIPAA like enrollment eligibility, benefits, claim submission transactions in Facets tables.
• Implemented new services and programs via MMIS for the Medicaid Program by directly interfacing with the customer and the system engineers on a regular basis.
• Worked on EDI 270/271 (Claim Eligibility Inquiry), 276/277 (Claim Status Check), 837(Claim Submission), 835 (Claim Remittance) in Facets lifecycle.
• Created Summary tables using PROC SQL procedures like PROC TRANSPOSE, SORT, FREQ, MEANS, SUMMARY, UNIVARIATE and TABULATE.
• Created electronic datasets (i.e., SAS Transport Files) for submission by using PROC EXPORT for FDA submission.
• Created data mapping documents for the movement of data from production databases to the warehouse.
• Assisted QA and Developers team in process flow testing, regression testing on EDI 835 and formats in Facets.
• Worked with QA and Developers to understand functionality, resolved issues and provided feedback to nail down the bugs.
• Wrote User Acceptance Testing (UAT) scripts and led testing for both HL7, ADT interface and the application.
• Analyzed and documented Medicaid EDI transactions issues related to implementation of HIPAA 5010 and ensured these issues were documented and addressed in the approach to the HIPAA 5010 version.
• Used previous knowledge of Service-Oriented Architecture (SOA) to decide the orchestration of various internal and external Web services using REST and SOAP API to save the cost and time of the project.
• Responsible for the mainframes that receive the HL-7 message in pre-approved format from the middleware as disclosed in the documentation.
• Used Swagger to design and document the RESTful Web Services.
• Analyzed reports on AE (Adverse Events) and SAE (Serious Adverse Events) Demographics, Laboratory shift tables by referring to the Statistical Analysis Plan and the Mockup Shells in RTF, PDF, Excel and HTML formats using ODS statements.

Environment: Scrum- SAFe, FACET, MS Office, MS Project, MS Visio, MuleSoft, MS Visual Studio 2013, Selenium, JIRA 5.2, Confluence, Tableau, Swagger, Rest API, XML, Facets, SAS/SQL.

Confidential, Minneapolis, MN

Sr. Business Analyst

Responsibilities:

• Interacted with key stakeholders and end users for gathering business requirements using elicitation techniques like Document Analysis, Focus Groups, Interviews, and Joint Application Design (JAD) sessions to create Business Requirement Document (BRD) and Functional Requirements Document (FRD).
• Developed clinical records of the department and provided documentation of proposed workflow for conversion of 1CD9 - ICD10 by using MS Excel.
• Worked with Project Sponsor, Project Team and other Stakeholders to determine project milestones and report on progress; prepared communication and managed project documentation using Confluence.
• Managed workflows and user security requirements to optimize claims operational efficiency.
• Identified, investigated, analyzed, defined and documented business processes and Use Case Scenarios.
• Involved in HIPAA 5010 GAP Analysis of ANSI X12 4010 and ICD-10 initiatives.
• Analyzed and validated requirement for HIPAA 5010 and gathered requirement for ICD-10.
• Created UML diagrams such as Sequence diagrams, Use Case diagrams and Activity diagrams using MS Visio.
• Wrote SQL scripts for creating performance evaluation reports by pulling data from different databases and migrated data back and forth. Used various functions such as joins, triggers, aggregate, and union.
• Performed logical data modeling and created ER diagrams and used SQL queries for manipulating and extracting data.
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
• Validated Technical data mapping of ICD 9 to ICD 10 conversions for clinical modification.
• Worked with Development, QA, and Production Support teams to communicate, verify, and test the desired functionality changes. Helped the Testing team in creating Test Plans, Test Scenarios, Test Cases and collected data for successful completion of Integration Testing and Functional Testing.
• Wrote the Test strategy document in accordance to the Business Requirements Document.
• Performed Manual testing, Integration testing, System testing, including writing UAT cases and resolved issues with the users.
• Performed User Acceptance Test (UAT) for HIPAA 5010 and ICD 10 codes.
• Worked on API documentation using Swagger tool. Analyzed domain specific APIs while conducting the Interface analysis, to interpret the data formats in their WSDL/WADL for a thorough understanding of business requirements and supported integration of compliance REST APIs with Business Rules Engine.
• Utilized Tableau for identification of changes to the organization, prepared various reports, dashboards and balance score card.

Environment: Waterfall-Hybrid, MS Visio, Informatica, MS Word, MS Excel, Jira, SQL Server 2008, HP ALM/QC, Confluence, Swagger, Tableau.

Confidential

Jr. Business Systems Analyst

Responsibilities:

• Worked as primary liaison between business partners and clients and conducted Impact analysis of the current functionality with the to-be business processes to provide recommendations and finalize business requirements.
• Facilitated Joint Application Design (JAD) sessions to focus on defining Health Claims Processing and gathered requirements by conducting Questionnaires, Requirement workshops and Interface analysis.
• Used Jira to create issues and issue logs, configure work request template, change request template and problem request template for the users.
• Designed and reviewed various documents including the Business requirements document (BRD), Use Case Specifications, Functional Specifications Document (FSD) and Requirement Traceability Matrix (RTM).
• Documented business processes for the creation of the enterprise mobile application.
• Actively participated in wireframe and storyboard creation for the application and facilitated the numerous feedback iterations with stakeholders and end users.
• Worked with Business users to create UML diagrams like use case, sequence and activity diagrams using MS Visio.
• Performed CRUD operations on SQL & stored procedures using SELECT & JOIN for drill downs to pull data while being actively involved in reading data from varied file types, created standard and ad-hoc reports using SQL.
• Developed Conceptual and Logical data models and created data dictionaries for the data models.
• Data cleansing and data mapping were done for validating the database structure in OLAP.
• Involved in updating system Test Plans and guided Software Quality Team in Developing Test Strategies during various Test Cycles. Assisted in Developing Test Scenarios and Deriving Test Cases based on Business Requirements, Technical Specifications in Test Director.
• Coordinated with the UAT testing group and provided technical assistance in planning and implementing Test Schedule for UAT. Worked with Application Development Team on Test Issues and conducted daily status meetings with Development and User Team during UAT.
• Involved in systems integration testing, web services API testing using SOAP UI and Postman API testing tools.
• Created various Reports & Dashboards with Tableau & Power BI to create reports according to user requirements.

Environment: Waterfall-Hybrid, MS word, MS Visio, MS PowerPoint, Confluence, SQL, Oracle DB, Postman, HP QC, UML, Tableau, iOS.

Confidential

Jr. Business Analyst

Responsibilities:

• Elicited requirements using techniques like interviews, document analysis and JAD sessions and analyze requirements.
• Conducted Gap analysis (As Is-To Be) to document requirements for existing system enhancements.
• Created Business Requirements Document (BRD) and Functional Requirements Document (FRD), Requirements Traceability Matrix (RTM).
• Worked closely with the development team to verify that business requirements deliverables are produced are fulfilled, and within the deadlines concerning budget, quality, and time.
• Worked on GUI development by creating mockups to review requirements, provide feedback on the screen design using MS Visio.
• Worked with different database connections like SQL server, Oracle using SQL cardinalities, joins, views, aliases, aggregate conditions, parsing of objects and hierarchies.
• Coordinated with the testing team during the formulation of Test Plan and Test Cases for Functional, System, Integration, UAT and Regression Testing based on Design Document, User Requirement Document for the Functional and Performance Testing.
• Created visualizations such as reports, graphs, dashboards using Power BI tool.

Environment: Waterfall, MS word, MS Access, SQL Server, MS Power Point and Outlook, MS Visio, Power BI.

Confidential

Healthcare Analyst / SQL developer

Responsibilities:

• Performed data conversions from flat files into a normalized database structure.
• Created tables, indexes, and design constraints.
• Wrote several SQL Scripts such as finding long running queries, blocking sessions, archiving data from production to archive server and populating reporting data.
• Created complex Stored Procedures, Triggers, Cursors, Tables, Views for application Developers and SQL Joins and other statements for various applications, maintained referential integrity and implemented complex business logic.
• Created and modified Stored Procedures and T-SQL Queries for efficient data retrieval and data management.
• Installation of SQL Server 2008 and service packs on Windows Server Clustered environment.
• Prepared maintained and modified SQL server installation and configuration documents.
• Created various reports using MS Services and deploy public reports in dynamic web portal. Used SQL Server Profiler to tune the performance of the stored procedures and functions to improve the report generation time.
• Created SQL scripts for tuning, improved performance, availability and scheduling of jobs.
• Created SQL Server Reports using SSRS 2008 for the manager and the brokers involved. Generated periodic reports based on the statistical analysis of the data from various time frame and division using SQL Server Reporting Services (SSRS).

Environment: Waterfall methodology, MS SQL Server 2008, Windows Active Directory, Windows XP, MS Office 2003/2007, Crystal Report 8.5, SSIS, SSRS, SSAS, MS Access, MS Excel, HTML, XML.