SUMMARY

• Experience in BusinessAnalysis and agileprojectmanagement skills and an understanding of the Software Development Life Cycle (SDLC). Successfully implemented system life - cycles (analyze, design, build, test, implement, support) in agile environment
• Function as the liaison between the business line, operations, and the technical areas throughout the project cycle
• Experience inbusinessanalysis and project management, various SDLCs- Agile, Scrum and Waterfall, UML Use Cases and Focus Groups.
• Facilitating Specification walk-through and Joint Application Design (JAD) sessions with stakeholders as required.
• Develop and documentBusinessRequirement Documents (BRD), Functional Requirement Documents (FRD), System Requirement Specification (SRS),Requirement Traceability Matrix (RTM), Gap analysis "AS-IS" and "TO-BE", process workflows etc.
• Extensive experience in gatheringbusinessrequirements,businessprocesses, identifying risks, GAP analysis and UML modeling.
• Developing hyper-scale multi-tenancy data use and consent service portal supporting consent and assent flows, pedigrees and panels, FHIR interchange & FHIR data model
• Experience in Designing, developing, testing, and implementing HL7 interfaces. Good understanding of SDLC (methodology) with waterfall and Agile methodologies.
• Strong knowledge of managed claims management process, Knowledge of Medicaid and Medicare Services. CMS, Health Assessment Systems, Hl7 Standards, HIPAA, PPACA(Patient Protection and Affordable Care Act), Compliance issues, LO INC and SNOMED Mapping, HL7 Message Validation, ICD 9, Electronic Health Records, Electronic Medical Records.
• Broad in - depth industry knowledge spanning health informatics, bioinformatics, computational biosciences, population health, HL7 FHIR, FHIR, EMRs, clinical/research portals and next generation clinical / R&D data platforms.
• Strong understanding and hands on experience working with HL7 (traditional version) and (xml based version) and FHIR.
• Experience in various software issues tracking tools like JIRA, HPALM, and Rally. Experience in using testing tools like SOAP UI and Postman for testing rest API services.
• Experience in using SQL queries and performed backend testing for Database reliability and validity.
• Expert at using Microsoft Office Tools like MS Word, MS Excel, MS project and Power Point for Documentation, Reporting and Presentation
• Experience in writing SQL queries while working with databases-SQL, MS Access, SQL Server for data verification and manipulation
• Experience in writing complexSQLQueries like Stored Procedures, triggers, joints, and Sub queries.
• Experience in the documentation of system andbusinessrequirements and specifications, design and development of use and test-case scenarios and root-cause analysis, GAP analysis, developing test plans, test scripts using SQL, conducting System Integration testing (SIT), user acceptance testing (UAT).
• Strong technical and communication skills, ability to take direction, handle multiple-tasks and work well in a team environment

TECHNICAL SKILLS

Project Methodologies: Agile, Waterfall

Business Modeling Tools: MS Visio

Requirement Management Tools: JIRA, HP ALM

Operating Systems: Windows, UNIX

Databases: SQL Server, MS Access, Oracle

Languages: Java, C#, XML

Quality Assurance: HP Quality Center/ALM, Software Application Testing Life Cycle

Business Applications: Microsoft Office Suite, G Suite, Azure Devops, Cisco Webex

API Tools: SoapUI, Postman

Design Tools & Languages: Microsoft Visio, HTML

PROFESSIONAL EXPERIENCE

Confidential, VA

Business Systems Analyst

Responsibilities:

• Gathered, Analyzed and Translated systems requirements into technical specifications utilizingUML and RUPmethodology. Responsible for creating different sessions and workflows to load the data to Data Warehouse.
• Involved in business process Modeler reengineering, including gathering and documenting requirements, documenting workflows and developing functional specifications for the programmers
• Discovered & managedBusiness Stakeholder functional systems requirements through the complete SDLC, using Agile/ SCRUM
• Used Agile software development methodology in defining the problem, gathering requirements, development iterations, business modeling and communicating with the technical team for development of the system.
• Created the BRD, FRD, and SRS Artifacts after gathering input from the business owners and other stakeholders.
• Documented business workflows textually as well as in UML diagrams captured in RUP for project review
• Composed and detailed theGAP Analysisof the new system and producedAS-ISandTO-BEdocuments.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives, resolve issues, and reach agreements.
• Messaging, FHIR, middleware principles concepts, APIs, REST, SOAP, Web Services etc.
• Implemented SOAP and FHIR based Web Services in Cloverleaf Integration Engine using Web Services adapter.
• Involved in creating requirements that comply with HIPAA, HL7, and ANSI X12 format regulations to protect the privacy of the employee insured under any policy.
• Developed test cases including unit, integration and user acceptance; validating the HL7 message data as per the business requirements and ensuring all proper translation done.
• Responsible for designing, testing and implementing HL7 interfaces utilizing HL7 and user-defined message sets.
• Developed Use Case diagrams with MS Visio and also createdBusinessFlowDiagrams, Activity/State diagrams, and Sequence diagrams, which enabled developers and other stakeholders to understand the businessprocess.
• Performed System Testing and Integration Testing & Functionality Testing of the application. Responsible for entering, Tracking bugs in Quality Center/ALM and reporting the defects to the developers for Modification Request
• Exposed to using ICD 9/ANSI/HL7 coding standards in Medicare and Medicaid domains of the healthcare systems and industry
• Understanding the prior authorization process and configuring business rules that will be applied to multiple Prior Authorization Intake Channels
• Serves as a clinical resource for an assigned work stream unit - Intake, UM, CM, DM, Reporting or Appeals
• Integrated HL7v2 Interfaces with FHIR REST API’s to develop interoperable solutions.
• Performed Backend/Database testing to ensure that data is properly stored in tables by creating effectiveSQLQueries to retrieve or create test data from different tables usingSQL databases.
• Involved in writinguse casesand other design documents likeData Flow diagrams, and Activity diagramsfor better understanding of the system.
• Facilitated (UAT) User Acceptance Testing with Business Owners prior and deploy codes for configuration.

Confidential, Hartford, CT

Business Systems Analyst

Responsibilities:

• Gathered requirements, analyzed and documentedbusiness requirements based on the analysis of existing systems.
• Worked through the entire System Development Life Cycle (SDLC) starting from the proposal to the implementation of the system.
• Identified and documentedbusinessneeds and created detailedUseCasesusingUML, and collaborated with production team to identify system gaps and developed functional requirements documentation (FRD) and Business requirement documentation (BRD).
• Conducted JAD sessions with stakeholders, business users at various phases of software development Life Cycle (SDLC) to discuss and resolve issues.
• Involved in UML (class diagrams, object diagrams, GAP Analysis, use case diagrams, state diagrams, sequence diagrams, activity diagrams, and collaboration diagrams) as a data analysis methodology for application functionality designs.
• Modeled the present ‘As is’ system and performed a complete Gap Analysis to map it to the ‘to be’ developed system.
• Created message flows for validation, routing, qualification and transformation of HL7 and non-HL7 messages.
• Translated the HL7 Federal Health Interoperability Resources (FHIR) data and case models
• Created business process mapping document, analyzed the as-is business processes and created a to-be process using MS Visio.
• Involved in intensive system level testing of analyzing the HL-7 messages coming out and in of EPIC Bridges.
• Responsible for the mainframes that receive the HL-7 message in pre-approved format from the middleware as disclosed in the documentation.
• Created an HL7 message testing web application using HL7 that creates and uploads HL7 analyzes and displays test results.
• Introduced Micro services design concepts, define production ready standards, and implemented RESTful services API resources in multiple microservices.
• Worked extensively with MS Excel and MS access Assisted in building a Business Analysis Process Model using Rational Rose and Visio Performed extensive Requirement analysis and developed use cases and workflows.
• Used HP Quality Center for creating and executing test cases, for defect tracking and for generating reports.
• UsedSQLto execute queries against the Oracle and DB2 / UDB databases towards data analysis and data extraction into, among others, MS Access, MS Excel, and Text files.
• Utilized SQL for querying database tables during testing.
• Conducted performance tuning to primarily focus on writing efficient SQL Queries to generate reports.
• Responsible for preparing and executing the Test Cases for different reports.
• Given extended support to UAT testing in order to resolve user queries in production environment.

Confidential, Bloomington, MN

Business Systems Analyst

Responsibilities:

• Conducted user interviews at both in-house and client locations, gathering and analyzing requirements using Requisite Pro and Requisite Web
• Responsible in gathering business requirements in the form of user stories and documenting them in business requirement document by eliciting and brainstorming the same in interview sessions with the product team.
• Extensively used Scrum/Agile Methodology in the process of the project management based on SDLC.
• Gathered and documented Business Requirements, created Functional specifications and translated them into Software Requirement Specifications.
• Prepared Business Object / Business Process Models that included modeling of all the activities of business from conceptual to procedural level.
• Involved in FACETS Implementation, involved end-to-end testing of FACETS Billing, Claim Processing and Subscriber/Member module.
• Involved in HIPAA EDI 834, 270/271, 837/835 transactions according to test scenarios and verify the data on different modules. Tested HIPAA regulations in Facets HIPAA privacy module.
• Set claim processing data for different Facets Modules.
• Conducted UAT walk through meeting with different Stakeholders on Claims Processing, GUI Modifications, Extract and Report validations.
• Performed Gap Analysis for new functionality requirements, as well as prioritized them based on actualbusinessneeds so as to align them with the product releaseroadmap.
• Responsible for fullEDIdocumentation including the 835 and 837.
• Involved in integration of FACETS with thirty party vendor applications.
• Developed flow diagrams for Business process of the company, UI Wireframes and Mockups using Microsoft Visio.
• Experience in using Microsoft Excel and employing functions like H-LOOKUP, V-LOOKUP, Pivot Tables, Macros.
• Performed software testing involved Quality Assurance (QA) testing, development of test cases & test scripts, and user acceptance testing (UAT).
• Worked on Data migration, Reports Implementation, letters, Inbound/outbound Interfaces and Facets Extensions. Implemented EDI transactions 835, 270/271, 276/277 and 834.
• Wrote complex SQL queries to extract and validate the data from the Facets database
• Responsible for checking member eligibility, provider enrollment, member enrollment for Medicaid and Medicare claims.
• Worked on Unix Platform and experienced in back end testing by executing SQL Queries
• Developed test cases and test scripts and assisted Quality Assurance activities, with system integration testing and user acceptance testing (UAT), developing and maintaining quality procedures and ensuring that appropriate documentation is in place.
• Performed in depth analysis in data and prepared weekly, biweekly, monthly reports by using SQL, SAS, MS Excel, MS Access, and UNIX
• Designed, tested and debugged custom queries using Microsoft SQL
• Provided daily project status report to project manager and project presentation to the high-level management on weekly basis.
• Involved in writing extensive SQL Queries to retrieve the data for the purpose of data analysis.
• Implemented Agile approach for requirement gathering continuously prioritized requirements as per needs.
• Worked on different modules ofFacetssuch as Members/subscriber, commissions, provider, billing.

Environment: AGILE/SCRUM, Microsoft SharePoint, MS Visio, UML, ETL, HP ALM/Quality Center, UAT, Oracle, Facets, MS Office (Word, Excel, Access, PowerPoint, Outlook) and SQL.

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Worked with all the stakeholders to designBusinessTechnicalrequirementDocument (BTRD) and produce necessary documentation for implementation and Quality team.
• Assisted in the elicitation and authoring ofrequirements, therefore,BusinessRequirements, User Requirements, FunctionalRequirements, Non-FunctionalRequirements, Systems Design Specification (SDS) and User Stories.
• Implemented the full project lifecycle SDLC phases including requirements gatherings, development and quality assurance.
• Followed HL7 standards to develop web APIs and used Postman to test API calls.
• Created BRD documentation along with various workflow diagrams and Functional diagram forbusinessprocess on MS Visio to provide a deeper understanding of the various systems involved.
• Documented existing and proposed process flow and conductedGAP analysis.
• Authored variousUML diagrams,Activity flow diagrams, Use-case diagrams, Use-case Narratives, Data flow diagrams, Communication Diagrams, Sequence Diagramsandstatic prototypesusingMS-Visio.
• Provided education on HL7 interface and system functionality, and configuration of new tools to increase end user productivity within the application
• Prepared workflow use-case diagrams and analyzed AS IS and TO BE scenarios, designed new process flows and documented the business process and various business scenarios.
• Created workflow rules and defined related tasks, email alerts and field updates.
• Develop micro service and API platform using express, REST API, Docker. The service allows generating single page healthcare applications.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, using UML and Business Process Modeling
• Converted HL7 data to FHIR resources (Patient, Medications, Organization, Location and Practitioner) to exchange data with Pharmacy systems Integrated with FHIR. created a RESTful web service for allergies department using FHIR coding standards.
• Analyzing and testing systems employing Web Services (SOAP, REST), EDI (HL7, X12), Message Queues, and Workflow components.
• System also includes facade for external 3rd party EMR softwares to send automatic case check service using FHIR
• Work with SQL queries for data manipulations, responsible for data mapping
• Followed HIPAA, HL7 standards to transfer data between applications.
• Uploaded Test Scenarios and Test Cases inHP Quality Centre.
• Designed and implemented SQL queries for QA testing and report / data validation.
• Involved in designing Test scenarios and Test Cases based on Functional Requirement Specification document.
• Developed test scenarios and test cases for functional testing and also performed UAT testing to make sure the system meets the end user's requirements. Also maintained RTM to ensure none of the requirements are missed.

Environment: MS Office Tools, MS Project, MS-PowerPoint, MS Visio, MS SQL Server, XML, ALM, Agile framework, Oracle