Agile Business Analyst Resume

SUMMARY

Over 5 years of experience as a Business Analyst eliciting business requirement from stakeholders to define project scope and improving business process by serving as intermediary between business and IT.

TECHNICAL SKILLS

Agile/Waterfall Methodology Microsoft Office Professional JIRA SharePoint
MS Visio/Lucid Charts Snipping Tools Caliber Requirements Management Tool
Lean Six Sigma Facilitator Communication Detailed Oriented Team Player

PROFESSIONAL EXPERIENCE

Confidential

Agile Business Analyst

Responsibilities:

Responsible for working with product owners and business subject matter experts to elicit business requirements and translate business requirements into technical requirements.
Work across various lines of business which include the state of Tennessee to translate stakeholder requirements into several deliverables such as use cases, user stories, workflow/process diagrams, data flow/data model diagrams.
Participate in all aspects of scrum framework including product backlog, sprint backlog, burndown charts sprint planning, daily stand - ups, sprint reviews and retrospective meetings.
Facilitate JAD sessions for project definition involving analyzing requirements and creating mockups.
Transform business needs into user stories and acceptance criteria in an Agile development environment.
Create user story documents with reference to the traceability matrix created.
Integrate Testing for project and provide support for user acceptance testing.
Critically evaluate information gathered from multiple sources, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true needs.
Prepare Workflow diagrams, Gap Analysis - 'As-Is' and 'To-Be' scenarios, designing new process flows and documenting the existing business processes and scenarios.
Manage Team deliverables and other work items using JIRA.
Experience managing Software Change Requests Process (SCR)
Utilize MS Visio/Lucid Charts to create various flow charts, use-case and swim lane diagram.

Confidential

Utilization Management Representative /Subject Matter Expert

Responsibilities:

Provide oversight of clinical product review, analytics, and evaluation in support of Materials Management.
Document clinical information in the system regarding authorizations and assign to the appropriate team.
Assist providers with authorization issues, member eligibility, member benefits, and complex cases.
Serve as a Liaison between the Medical Management Operations and internal departments.
Maintain and update departmental SharePoint trackers and other related databases.
Conduct analysis of medical records and provider claims to identify incorrect ICD-10 codes to mitigate authorization and claims issues.
Conduct a thorough radius search in provider Finder and follow up provider on referrals given.
Ability to understand and explain specific workflow processes, departmental priorities, and guidelines.
Responsible for monitoring quality assessments, outcomes, and training.
Participate in various workgroups that supports the company's change network and implementation of all LTSS Choices and Consumer Direction
Verify benefits and/or eligibility information and act as liaison between Medical Management and internal departments.
Work closely with Care Coordinators to resolve diverse and complex inquiries/situations.
Develop and maintained positive customer relations and coordinates with various functions within company to ensure customer requests and questions are handled appropriately and in a timely manner.
Processed incoming requests, collect required information needed for clinical review from providers.
Knowledge of contracts and strong knowledge of Managed Benefit Programs

Confidential

Provider Data Specialist

Responsibilities:

Entered new provider demographic information into provider database, as well as any updates necessary to existing provider's demographic records, including but not limited to issuing of termination date information to a provider's demographic record.
Partnered with IT, Provider Relations and Credentialing to ensure timely and efficient operations.
Reviewed and researched provider agreements and disclosure of ownership records for completeness
Conducted data analysis and quality assurance review of network lists.
Enrolled par and non-par providers and practitioners into the provider data management system.
Processed Change of Information (CIF) request received via fax, email or mailbox in accordance with established SLAs.
Completed large volume system provider upload and/or termination, as necessary.
Processed assigned monthly reconciliation report related to data integrity projects.
Provided general customer service both internally and externally related to provider inquiries and network status.

We provide IT Staff Augmentation Services!

We'd love your feedback!

Resume Categories

Client Services

Job Seekers

Visa Sponsorship