SUMMARY

• Business Analyst with 7+ years industry experience in business analysis, software requirement analysis, process modelling, process flow and quality assurance skills using different methodologies, mainly OOA, OOAD and UML.
• Strong knowledge of Healthcare industry including HIPAA, insurance and Financial Industry with emphasis on Business Requirements and Functional Requirements.
• Extensive knowledge of all phases of the software development life cycle (SDLC) and the iterative Rational Unified Process (RUP). Deep understanding of enterprise data warehouses.
• Organized many Joint Application Developments (JAD) sessions and Joint Requirement Planning sessions (JRP), walkthrough, Interviews, Workshops and Rapid Application Development (RAD) sessions with end - user/clients/stake holders and the IT group.
• Proficient in using UML in behavioural, structural and architectural modelling - in creating Use Case, State, Activity, Class and Sequence diagrams using Rational Rose.
• Used Microsoft Visio for Business Process Modelling and Data flow diagrams.

TECHNICAL SKILLS

• Rational Suite (Requisite Pro Rose Clear Quest Clear Case)
• MS Visio
• MS Project
• MS Access
• MS Office Suite
• Doors Erwin Data Modeller 4x
• Business Objects
• Business Definition Requirements
• Business Process Analysis
• Gap Analysis
• Use Case Modelling & Analysis
• Business Environment and Market Research AnalysisRUP
• OOAD
• UML & Business/Data Modeling
• Win Runner
• Load Runner
• Test Director
• Quick Test ProWindows XP/95/98/NT/2000
• DOS
• Linux
• MS Office Suite
• MS Project
• TOAD
• Adobe Photoshop
• Oracle 8i/9i; SQL Server 7.0 & 2000; Access 2000
• MS SQL Server
• DB2

PROFESSIONAL EXPERIENCE

Confidential, Waltham, MA

Business Systems Analyst

Responsibilities:

• Requirement gathering by interacting with Internal/External Client/Consumers.
• Arranging sessions with SMEs and Stakeholders for better understanding of requirements,
• Document Requirement & conducting requirements walk-through with the Business to ensure that all their needs are met and gathered.
• Worked in creating and integrating Microstrategy Reports and objects with the data warehouse.
• Business Signoff to baseline the requirements. Develop Logical and Physical data models that capture current state/future state data elements and data flows.
• Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans. Loaded an EDI file in convert-to-xml.
• Performed GAP analysis of business rules, business and system process flows, user administration to be used for the new migration platform.
• Developed HL7 messaging for bi-directional case and disease report exchange, in text and XML formats, in accordance with HL7 specifications.
• Worked with the components of Data Warehousing like components model, ETL tools.
• Preparing data mapping & field mapping to assist development teams.
• Worked as Business Analyst for the 2014 Government Programs Call Letter project.
• Loading the data into Oracle Database to verify data integration by using SQL plus.
• Worked with Claims, enrolment, eligibility verification for members and providers, benefits setup, and backend payment cycle in facets.
• Involved in business process reengineering, eliciting and documenting user needs, use cases, and workflows.
• The work demanded JAR/JAD sessions to understand the impact to different applications and created new Business rules for new requirements.
• Created a detail level requirement for operational, development and quality assurance teams.
• Presented Design Implementation Approach to Business & Technical Leads.
• Analyzed, and built an Enterprise Information Model consisting of Primary Subject Areas which will be utilized to identify and prioritize Data Quality and Master Data Entities, Metadata classifications and nomenclature, and Data Integration Roadmap.
• Used the Informatica Designer to develop processes for extracting, cleansing, transforming, integrating and loading data into data warehouse database.
• Develop parameter driven ETL process to map source systems to target data warehouse with Informatica complete source system profiling.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Scope Master ID creation. Reviewing Test Cases & Test Results presented by QA team.
• Assisted the PM in performing Risk Assessment, Management and Mitigation.
• Used the BPMN to GAP Analysis to bridge the gap between business processes.
• QA Application stats sharing with Service Owner & QA teams.
• QA Signoff & Prod Validator follow-up.
• HLD creation & approval. DP Audit sheet & back-out plan updates. Prod Release monitoring.

Confidential, Manhattan, NYC

Business Analyst/Data Analyst

Responsibilities:

• Gathered the requirements for Phase2 implementation of a Web-based application DawnAC.
• Arranged meetings with the Client (Anticoagulation Management Services) in Mass General Hospital to understand the business requirements.
• Documented the requirements and forwarded to the vendor (4S) for implementation. Conducted meetings between cross functional teams for the AMS icon and discussed the technical aspects of the project.
• Developing data models and designing data warehouse in view of the project requirements.
• Performed Project Requirements Gathering, Requirements Analysis, Design, Development, Testing for the ETL, Data warehousing and Reporting modules of the project.
• Analyzed trading partner specifications and created EDI mapping guidelines.
• Done research to understand some facts behind the AMS icon requirement.
• Documented requirements associated change requests with requirements and connected requirements with Use cases.
• Identify the source tables from which the Data Warehouse extracts data.
• Established questionnaires and resource levelling required for implementing HIPAA 5010 and upgrading ICD9 to ICD-10 diagnosis codes.
• Created and effectively executed comprehensive Test Plans and Test Cases for Data Integration's architectural and functional development including high end logic analysis and ongoing enhancements and fixes
• Experience with TriZetto Facets 4.21/4.31 and TriZetto HIPAA Gateway 4.11 - supported new business requirements by extending the functionality of the core Facets system using the Facets extensibility architecture feature.
• Trouble shooted file transmission problems and assisted customers in a call center environment with EDI and Medicaid Insurance claim related inquiries explained and enforced guidelines in the X12 Implementation guides
• Developed plan for data feeds and data mappings for integration between various systems, including XML, to followICD 10Code set andANSI X12 5010formats.
• Worked in Business Process Management (BPM) and gather requirement for the clients.
• Met with users and stakeholders to understand the problem domain, gathered customer requirements through surveys, interviews (group and one-on-one) along with JAD sessions.
• Worked on HL7 and xml interface messaging. Assisted in monitoring ancillary data transactions and addressed problems with HL7 messages.
• Developed operational model and patient flows focused on patient satisfaction with area hospital partners for a new multi-organization health care campus to provide an array of health care services to a new sector within the market.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Used flowcharts for internal business processes for process improvement and help implement changes. Worked with the components of Data Warehousing like components model, ETL tools.
• Worked with the interface teams and MGH lab when the lab changed the work flow from Sun Quest to CDR direct. Tested the interface workflow from the lab to AMS clinic after the change.
• Initiated, designed & facilitated development & implementation of a simple, Microsoft Office suite & VBA 2007 (Visual Basic for Applications) based Intra Departmental Medical Records Management System.
• Tested the interface with other labs (BWH, DFCI etc.) to verify if the MGH lab interface change did not affect the normal work flow with DawnAC application.
• Came up with the Requirement document for the new reports needed for Dawn.
• Translated the requirements to the vendor (4S) for the development.

Environment: PL/SQL, MS Visio, MS Project, MS OFFICE (MS Word, MS Excel, MS PowerPoint, MS Access), ClearCase, WINDOWS XP, Requisite Pro, RUP, ClearQuest, HL7, Test Director, LoadRunner, QTP.

Confidential, Round Lake, IL

Business Analyst/Data Analyst

Responsibilities:

• Interviewed SMEs and Stakeholders to get better understanding of client business processes and gather business requirements. Requirement gathering, Business Process flow development, Business Analysis.
• Conducted controlled brainstorming sessions with project focus groups for collecting high level business requirements.
• Developed and tailored a lean Rapid Application Development (RAD) process utilizing Agile concepts the development and testing of small projects.
• Conducted several Requirement Gathering Sessions for gaining detailed requirements and finalizing Business Requirement Document (BRD).
• Involvement of overseeing quality assurance process, data integration mapping for exports of data from citation to client records management system and implementation software training for the client.
• Involved in data mapping, field mapping of the data elements responsible for the migration BRD.
• Performed GAP analysis of business rules, business and system process flows, user administration to be used for the new migration platform.
• Conduct complex documentation and user needs analysis. Interface with team and staff to develop HL7 integration. Participated in the application scrum meetings and the sessions.
• Created and maintained a project schedule using MS Project showing all target dates for deliverables.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Captured requirements around Outpatient hospital pricing methodologies like Flat rate per revenue code, and Percentage of charge per revenue code.
• HIPAA and HIPAA2 naturally became the inclusive elements in the package to address the X12 4010A1 as well as 5010 transaction solutions. Analysed results and EDI ANSI X12 file mapping and reported on standard analysis spread sheet.
• Worked with the project manager for planning and organizing the project activities, and in communicating with other business Center mangers and stakeholders of the project.
• Documented the server farm requirements and requirements related to security within Share Point and using Windows Active Directory.
• Documented high level requirements by writing migration BRD, Prepared Provider Migration BRD.
• Established questionnaires and resource levelling required for implementing HIPAA 5010 and upgrading ICD-9 diagnosis codes to ICD-10 codes.
• Troubleshooted file transmission problems and assisted customers with EDI and Medicaid Insurance claim related inquiries explained.
• Facilitated transition of logical data models into the physical database design and recommended technical approaches for good test data management practices.
• Planned and documented procedures for data processing and prepared data flow diagrams for the application. Worked in close co-ordination with the testing team in developing test plan and test cases from functional and business requirements.
• Used MS-Visio for flow-charting, Use- Case process model and architectural design of the application.
• Developed as-is and to-be business processes using BPMN standards.
• Generated data element matrix encompassing all the data element report wise including the data mapping for the data warehouse.

Confidential, Lincoln,NE

Business/Systems Analyst

Responsibilities:

• Wrote Business Requirements, analysed them and tested them. Prepared business requirement documents (BRD), Use cases, UML, Process Flows (BPM), Test Plans, Test cases, Data Mapping, etc.
• Created HL7 compliant script for proprietary Oracle messaging system.
• Conducted Requirements walk- through with the Business Team to ensure that all their needs are met and gathered sign off on the requirements for SOX compliance after the requirements were base lined.
• Developed Test Plans and Test Cases according to Business Requirements.
• Managed the development of a Business Intelligence (BI) data mart and reporting system within the corporate Oracle data warehouse.
• Troubleshooted file transmission problems and assisted customers with EDI and Medicaid Insurance claim related inquiries explained.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrolment hence analyzing and documenting related System processes.
• MMIS can handle the HIPAA transactions such as 835, 837 (P, D, I) 276, 277, 278. The Inbound and Outbound is run through JCL in batch mode.
• Performed Data mapping, logical data modelling, created class diagrams, ER diagrams and used SQL queries to filter data. Reverse-engineer several databases, such as research, business, clinical in order to extract metadata to leverage it for ETL design and reporting.
• All of the HIPAA transactions need to be upgraded from the 4010 standard to the 5010 standard.
• Developed Report Models, Ad hoc reports and distributed reports in multiple formats using SQL Server Reporting Services (SSRS) in Business intelligence development studio (BIDS).
• Facilitated review of Enrolment, Claims, Commissions, membership portlets designs with architects and developers to ensure that the goals of the portal requirements were satisfied.
• Recommended changes for system design, methods, procedures, policies and workflows affecting Medicare/Medicaid claims processing.
• Produced UML Activity diagrams with defined swim lanes using MS Visio as part of claims process analysis.
• Used MS Project to manage project time lines. Tracked the defects in legacy reports as per account managers and end users. Compared the results and tracked the differences in excel.
• Worked with SQL queries using MS Access for data manipulations.