SUMMARY

• A highly dynamic result oriented professional with strong analytic and technology expertise with almost 6 years of experience as Business Analyst / Project Consultantin Health Care, possess the ability to think out of the box and develop innovative business solutions which offer maximum business value to projects; to develop perfectly detailed result by working with dynamic teams.
• Strong computer expertise with MS Office; Excel; Word; Project; PowerPoint; Visio, MSP and SharePoint
• Strong skills in dealing with software development lifecycles (SDLC), both Waterfall, and Agile/Agile scrum, Rational Unified Process (RUP).
• Expertise in defining and documenting Business process flows and “As - Is” & “To-Be” processes.
• Experience in data collection from multiple sources, interpretation, presentation, and management of reporting and decision making.
• Experience in updating MSP project plans and taking status from all levels of management.
• Expertise in creating Business Requirements Documentation (BRD), Requirements Traceability Matrix (RTM), Business Rules Spreadsheet (BRS) and Functional Requirements Documentation (FRD).
• Expertise in project management activities like defining/managing project scope, planning various activities for execution, estimating business value/impact and providing a periodic status report to management.
• Experience with Enrollment, Claims, Customer Service, Member Out of Pocket and Billing.
• Experience in working with cross functional and cross-cultural team environments, different levels of management and liaison between system users, management and development teams.
• Experience in Healthcare Application Facets in different modules like Claims, Membership, Billing & payer and Provider.
• Extensive knowledge and working experience on Federally Facilitated Marketplace (FFM) and State Based Marketplaces (SBMs) and Health Benefit Exchange (HBX) systems.
• Extensive knowledge on Medicaid and Small Business Health Options Program (SHOP) Enrollment processes.
• Extensive experience and knowledge on all stages of the Software Development Life Cycle (SDLC)
• Specialized in documenting Processes, Job aid, User Guide, check list, Policy and Procedures, Project Plans and Training slide decks.
• Knowledge and experienced on Health Insurance Portability & Accountability Act (HIPAA 4010 and HIPAA 5010), Affordable Care Act (ACA), Health “Level Seven” HL7 Standards, International Statistical Classification of Diseases and Related Health Problems, 9th Revision and 10th Revision (ICD-9 and ICD-10),Current Procedural Terminology(CPT).
• Proficient in Medicaid, Medicare (Part A, B, C, and D), Procedural and Diagnostic codes, and Claims Process.
• Strong understanding on Electronic Data Interchange(EDI), both in 4010 and 5010 formats.
• Extensive experience in organizing and facilitating joint application development (JAD) sessions, interviews and workshops with user(s), subject matter experts (SME’s), and business stakeholders.
• Developed business Process flows for different department functions using MS Visio.
• Expertise on website Wireframes and Business Process Modeling with excellent skills on Use Case, Activity, Sequence, Data-Flow diagrams using Unified Modeling Language (UML), in MS Visio and Rational Rose.
• Proficient in handling functional and non-functional requirements with exceptional understanding and skill set in writing Test Scenarios, Test Conditions, Test Cases, and Test Scripts.

TECHNICAL SKILLS

Project Methodologies: RUP, SDLC, Agile Methodology

Business Modeling: Rational Rose, MS Visio, Mockups, MS Project

Requirement Management Tools: Test Director (Quality Center), Rational Requisite Pro, Clear Quest, SoapUI

Programming Languages: C++, .NET, SQL, PL/SQL, UML, HTML, VB Script

Project Management Tools: MS Office Suite, MS Project, MS SharePoint

PROFESSIONAL EXPERIENCE

Confidential, MD

SME Business Analyst

Environment: Microsoft Office Suite, G-Suite, Version One, JIRA, Confidential Cognito, RTM, Microsoft Visio.

Responsibilities:

• Worked on capturing requirements for multiple projects namely, the Maryland's Total Human-services Integrated Network (MD THINK) project, HBX service request project requirements, Small Business Health Options Program (SHOP) project, and Master Person Index (MPI) redesign to merge duplicate applications into a single application.
• Captured requirements for the Smarty Streets Address Validation Service API requirements.
• Worked closely with the SHOP Administrator and Plan and Policy Management team to document the policies for Small Business Health Care Tax Credits (SBHCTC), captured the analytical requirements for the automation of Full-time Equivalent (FTE) calculator tool, Minimum Participation Rate Calculator (MPR), Plan Management and Plan Shopping requirements.
• Worked on capturing the Business Requirements Document (BRDs) and Design Documents (FRD), created mockups and wireframes, Requirements Traceability Matrix documents (RTMs) and created user guides/training material.
• Conducted JAD sessions, meetings, workshops to gather requirements from various stakeholders and SMEs.
• Used JIRA for creating the product backlog and tracking the progress of requirements and the issues.
• Created the Release Notes/Production Notes Documents for every release of the scope items before production.
• Captured the Coronavirus Special Emergency Enrollment (COVID SEP) Requirements.
• Scheduled inter state agency meetings with the District of Columbia (DC Health Link) and State of Connecticut (Access Health CT) HBX systems to understand their billing aggregation system used for Small Business Billing Implementation.
• Assist in developing the framework, approaches, and processes using well-designed requirements or user stories, supporting screenshots and documentation.
• Formulate and define project scope and objectives using knowledge of information technology and industry knowledge or requirements.
• Develop acceptance criteria that can be easily adapted to modern commercial rules engines and structured in a manner that is scalable and sustainable.
• Act as a liaison between business stakeholders and Information Technology team, using strong communication skills to elicit, document, analyze and validate business processes, systems, and solution requirements.
• Direct or participate in studies of new and existing programs and special projects to determine feasibility, resolution of problems including organizational, procedural, technical and fiscal research and analysis.
• Develop policies and procedures to improve efficiency, cost-effectiveness, and/or to improve internal and external customer service.
• Supported onsite deployment activities for COTS system including gathering site-specific information, end user training documentation, change management/user adoption.
• Develop information system documentation to support Confidential IT operations.
• Involved in analyzing and understanding Business Epics.
• Document requirements and specifications using high-maturity methods, processes and tools.
• Support requirements management, work management and change management processes.
• Work closely with Confidential stakeholders to develop business and functional requirements for HBX system modifications and enhancements.
• Assist with use case development and ensure that contractors understand and in corporate business requirements in their development.
• Assists in preparing requirements, evaluating products, and selecting relevant software such as commercial off the shelf software (COTS).
• Review and provide written comments for deliverables designed by contractors and ensure the deliverables address all business and functional requirements as expected.
• Adhere to all security, Project Management Office (PMO) change control, work management and service delivery policies, processes, tools and methodologies.

Confidential, VA

Business Analyst

Environment: Microsoft Office Suite, Enterprise JIRA, GBD FACETS, PegaNexGen, ODW, Confluence, JIRA Production, SQL, SharePoint, SQL Server Management Studio, Service Marketplace, Outlook.

Responsibilities:

• Worked closely with SMEs, Stakeholders to identify, and analyze the core requirements and key features of the ongoing project.
• Worked in the Reporting team analyzing the source systems and mapping the data end to end and create the associated User Stories.
• Analyzed all of the CMS Protocols for ODAG and CDAG Universes for various entities like AIM - SOD and EOD Universes, GBD NCC Call Logs Part C and Part D universe, PegaNexGen Application and created the Template Mapping documents for all these Universes.
• Conducted and facilitated the Requirements Kick-Off Meetings to define the scope of the requirements for individual protocols, the changes in the process and the type of data to be sent by the Business Owners.
• Interacted with Business Owners and Product Owners to understand the business process, identify enhancements and gather Business Requirements and create User stories and Mapping documents.
• Convert high level business requirements into executable, detailed user stories to enable development.
• Facilitated Sprint Planning, retrospective and Sprint Demos.
• Tracked the efforts for individual requirements for every Universe by creating and updating SharePoint ER tasks on a daily basis.
• Created the JIRA Change Notification Requests (CNRs) in deploying the Universes and transitioned all the universes to the associated Operational team for further support.
• Participated in Elaboration and grooming sessions with Product owners and assigned story points to User Stories.
• Provided an analysis of COTS products technical capabilities and costs.
• Developed a COTS Evaluation Scoring Document including a scoring methodology and a requirements matrix.
• Interacted with various stakeholders to collect their user stories; document, manage and ensure real- time tracking of them as project proceed.
• Performed extensive GAP Analysis to understand the As-Is and To-Be conditions and determine the feasibility of the new project with the existing system.
• Consulted with business team to identify, define and document business needs and objectives, current operational procedures, problems, input and output requirements.
• Studied the current system functionalities & behavior and documented “As-Is” process; later upon business requirements and identifying the application shortcomings developed “To-Be” processes.
• Carried out User Acceptance Testing and extensively used SQL to perform Backend Testing to verify data integrity.
• Provided all support to the team using a servant leadership style whenever possible.
• Analyzing, defining and grooming user stories using grooming/refinement/elaboration sessions with the concerned product owners, development and the testing team.
• Created User Stories into Product Backlog Items (PBIs) and actively participated in PBI grooming sessions for Prioritization and Sprint planning.
• Participated in daily stand-up calls and provided BA support in each Sprint.
• Closely worked with the Scrum Master and Product Owners in creating Scrum meetings for internal teams to discuss project progress, blockers, and needs.
• Ensure all issues are handled in timely matter.
• Ensure appropriate communications to customers related to upcoming changes and impact.
• Create project plans and business cases for enhancements to existing functionality.
• Update documentation and reviewed new functionality with customers to ensure successful roll out of change. Capture and track the bugs to the resolution as they arise in the QA and UAT testing phases.

Confidential, CA

Business Analyst/ Project Coordinator

Environment: Microsoft Office Suite, Microsoft SharePoint, Microsoft Visio, JIRA, HP-ALM, Oracle SQL Developer, Facets, Citrix Receiver, Service Marketplace, Source Deliverable Repository(SDR), Outlook.

Responsibilities:

• Worked on developing the requirements (BRDs) based on discussion with Business teams during Joint Application Requirements (JAR) sessions, develop Business Process modelling (BPMs) & technical specification documents/ System Use case (SUCs).
• Developed technical specifications, Business rules, diagrams and flowcharts based on the functional requirements to meet the Business goals.
• Analyzed the business and functional requirements, attend design review meetings and walkthroughs for new requirements with Systems Analysts, development team and mentor the QA team in understanding the requirements.
• Involved in providing estimations on various testing activities, impact analysis, requirement analysis, design, testing and implementation.
• Conduct the Requirements gathering sessions and understand the Service Requests submitted in the JIRA dashboard.
• Interacting with the Technical Leads, Design Leads and QA and conduct review meetings for SUC documents.
• Performed extensive GAP Analysis to understand the As-Is and To-Be conditions and determine the feasibility of the new project with the existing system.
• Analyzed the Technical Design Document to understand the technical design, stored procedures, technical logics, files and record specifications, and updating the SUC for the same.
• Worked in close collaboration with the QA team in writing and reviewing the test cases and conduct test case walkthrough sessions.
• Worked closely with Training and Communications Team to develop Training documentation
• Upload the BRDs and SUC documents in the SharePoint and perform High-Level Designs HLD mapping for traceability using HP-ALM and track the approvals for BRDs and SUCs and get them published in the Source Deliverable Repository (SDR).
• Updated the b for the status of Service Request, tracked the defects, resolved and closed the defects in the JIRA workflow.
• Worked closely with the EDI reporting team to redesign the files conversion to HL7 standard and share it to the providers via SFTP path.
• Analyzed the change requests (CRs) and provided test estimates based on the complexity, resource load, timelines and the cost involved.
• Tracking of the deliverables and report the daily status of the project to Manager, organize periodic status meetings with client teams to discuss on the progress of the project.
• Responsible in creation of daily defect report, perform root cause analysis, attending the defect review meetings with Business, triage the defects with the developers.
• Updated the Project Manager on the timelines, deliverables and status of critical issues.
• Created Epics, user stories, business requirements documents and technical design deliverables, process flows, and mockups for all business applications.
• Used the MS-Visio to create the Use Case Diagram and Process Flow Diagram.

Confidential, CT

Business Analyst

Environment: UML, MS Word, Rational RequisitePro, Rational ClearQuest, Quality Center, SQL, FTP, TelNet, Facets, Microsoft SharePoint.

Responsibilities:

• Interacted with various stakeholders to collect their user stories; document, manage and ensure real-time tracking of them as project proceed.
• Performed extensive GAP Analysis to understand the As-Is and To-Be conditions and determine the feasibility of the new project with the existing system.
• Consulted with business team to identify, define and document business needs and objectives, current operational procedures, problems, input and output requirements.
• Studied the current system functionalities & behavior and documented “As-Is” process; later upon business requirements and identifying the application shortcomings developed “To-Be” processes.
• Carried out User Acceptance Testing and extensively used SQL to perform Backend Testing to verify data integrity.
• Interacted with the QA team to perform Unit and Integration.
• Worked with Vitec’s EU teams to resolve the issues identified at analysis state while building the Custom components for retrofitted accessories.
• Collected, documented, organized, and tracked the business requirements using Rational RequisitePro.
• Made business requirements document, change requests, and use cases available to all teams using MS Visio.
• Documented the results of the COTS Evaluation detailing how each product scored against each requirement area.
• Conducted Gap and Impact analysis to ensure that the commercially available off-the-shelf(COTS) solution is meeting the business needs.
• Developed business flow diagrams, activity diagrams, and interaction diagrams so that the development team and other stakeholders could understand the business process clearly.
• Maintained project milestones, schedules, and project progress using MS Project.
• Defined the scope of the project and created Work Breakdown Structure (WBS) using Microsoft Project tool.
• Developed the schedule, set the budget for allocated resources and conducting project status meetings.
• Conducted the User Acceptance Testing and documented the entire project report from initiation through closure.
• Held presentations and participated in walkthroughs with the development team and the QA team to help them understand the requirements and formulate test plans and test scripts.
• Maintained Requirement Traceability Matrix (RTM) to check whether the requirements of the system were met accordingly and to produce RFPs.

Confidential

Business Process Analyst/ Documentation Specialist

Environment: Test Manager, Clear Quest, RUP, MS Visio, MS Project

Responsibilities:

• Act as a technical liaison between business stakeholders, sales representatives, clients, management, and development staff.
• Gather and create requirements for custom business applications, billing applications, reporting, IVR, Web and contact center solutions.
• Project Manager/Business Analyst for projects implementing new vendor-supplied client-server applications and upgrading existing applications.
• Gathered Business and Functional Requirements from the IT staff and other stakeholders and elicited them in the form of Use Cases and other Requirements Documents.
• Analyzed and optimized the Business Requirement Documents and then converted the business requirements into Functional Requirements.
• Supported Confidential .co.uk as a blended agent in various skill sets including the retail, digital and Kindle device technical support.
• Listen to the customer voice and respond to queries and issues with an empathetic view and resolve them at the earliest.
• Assess and evaluate potential COTSapplicationsthat meet the desired functionalities of an optimal Desktop and Server Management system to meet the needs of remote software deployment.
• Successfully researched, analyzed, documented, tested and assisted in the integration of social media technology tying social media to the IVR, web, email and contact center solutions; thus creating a multi-media/multi-modal product solution.
• Provide recommendations by offering product and order related support, provide technical troubleshooting when needed and ensure customer satisfaction.
• Team member of the Kaizen team, gathering requirements from various stakeholders including the customer support team, development team and the feedback team and building consensus, raising tickets in critical scenarios thereby directly involved in the continuous improvement.
• Tracked defects in JIRA found at various software release phases and develop negative test data as well as updating regression test suite to check the impact of new changes on the previous data.
• Used the Unified Change Management (UCM) tool, BPM Remedy to maintain and track the Stakeholders requested enhancements and changes.
• Operative report management for data analysis and problem-solving platform.