SUMMARY

• Six years of experience in Healthcare and Retail in full Software Development Life Cycle (SDLC), Waterfall, RUP & Agile methodologies.
• Experience in preparing business requirements documents (BRD), system requirements specifications (SRS), scope, business processes, business rules, functional specifications
• Experience in requirement elicitation techniques such as questionnaires, brainstorming sessions and focus groups to document, forecast, budget, and report
• Experience in updating architectural framework, business process and flowcharting to support the business, functional or technical needs.
• Conducted Joint application design (JAD) sessions and interviews, written correspondence, reports implementation requirements, project status reports, oral presentation and email, to keep executive staff and team members apprised of goals, project status and resolving issues.
• Experienced in all stages of projects, Business Process Analysis, As - Is and To-Be designing, Business Blueprint Mapping, Gap Analysis to customization, Go-live, post live production support
• Proficient in creating Use Case Diagrams, Activity Diagrams, Use Cases & UML Diagrams
• Knowledge of Software development, Quality Assurance, Metrics, and Standards.
• Experience to define and develop application software test strategy, test plans and test cases and executes test cases.
• Experience in Change Control Management and creating a Use Case for the Content Management giving the customer every detail attributes of the changes that’s possible for CRUD (Create, Read, Update, and Delete)
• Collaborative team player with Customer Relations experience and
• Proven ability to communicate with Business Stakeholders (Payers & Providers) and Peers.
• Five - system development experience
• Oracle Database experience.
• Proficient in developing charts and flows using MS Visio.
• Possess excellent interpersonal skills, effective written and verbal presentation skills.

TECHNICAL SKILLS

Business Tools: Rational Suite (Requisite Pro, Rose, Clear Quest, Clear Case), MS Visio, MS Projec, MS Office Suite (2003/2007/2010 ), EDIFECS, Facets, HIPAA

Business Skills: Business Definition Requirements, Business Process Analysis, Gap Analysis, Use Case Modeling & Analysis, Business Environment, Market Research Analysis

Quality Management: Concept and Tools of Quality Management, ISO Concepts, Lean Methodology, Six Sigma Techniques

Defect tracking tools: Test Director, Rational Clear Quest, HP Quality Center

Operating Systems: Windows XP/95/98/NT/2000, DOS, UNIX

Databases: Oracle; SQL Server; Access 2000, MS SQL Server, DB2

Languages: HTML, Visual Basic Script, SQL, and Java

Methodologies: SDLC, RUP, Agile, waterfall

UML: State Diagrams, Sequence Diagrams, Process Flows etc.

PROFESSIONAL EXPERIENCE

Confidential, Irvine, CA

Business System Analyst

Responsibilities:

• Elicit requirements using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, business analysis, task and workflow analysis.
• Critically evaluated information gathered from multiple sources, reconcile conflicts, 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.
• Proactively communicated and collaborated with external and internal customers to analyze information needs and functional requirements and deliver functional requirements, use cases, and user interface designs as necessary.
• Experience with health insurance, UB04 claims processing and 837i transactions
• Experience with claim testing, creation of test scenarios and execution/documentation of outcome
• ICD-9 to ICD-10 Mapping and Modeling Implementation process
• SDLC of specimen transportation for Diagnostic and Prognostic procedure.
• Developed Use Cases using MS Visio, and a detailed project plan with emphasis on deliverable.
• Acted as Subject Matter Expert when performing Business Process/Activity analysis for projects.
• Conducted routine SCRUM as a Scrum Master
• Specifications (URS) based on existing procedures, SOP’s and/or business life cycles.
• Experienced with application and data migration into new environments.
• Worked on designing EMR with UI/UX team to replace the paper based record.
• Interpreted the defined scope and business requirements in the creation of technical specifications.
• Viewed filed ADT, Order, and Result data and validating they have filed properly in the receiving systems.
• Trained, prepared and oversaw staff with respect to the validation of end user filed ADT, orders, results and billing.
• Experienced in preparingwire frames, and mock ups using in house tools.
• Worked with Web based application.
• Collaborated with multiple technical entities in the design and build for all interface components in scope.
• Interfaced between the lab end users and the development team.
• Carry out project co ordination activities including the development of project scope, project plans, management of project resources and project close-out activities.
• Successfully engage in multiple initiatives simultaneously.
• Serves as the conduit between the customer community (internal and external customers) and the software development team through which requirements flow.
• Be the liaison between the business units, technology teams and support teams.
• Develop requirements specifications according to standard templates, using natural language.
• Collaborate with developers and subject matter experts to analyze tradeoffs between usability and performance needs.
• Experience creating workflows using formal notation such as the Business Process Modeling Notation (BPMN).
• Responsible with safeguarding confidential information in data processing systems.
• Carry out or design user roles and access to the records and report in parallel to securing the information.
• Drive and challenge business units on their assumptions of how they will successfully execute their plans.
• Provide input into Test Plan creation and support test plan validation as required for QA.
• Creating and designing various business relationship diagrams.

Environment: LIS, Unified Modeling Language (UML), Agile, MS Visio, Oracle 10i, GAP Analysis.

Confidential, Denver, CO

Sr. Business Analyst

Responsibilities:

• Modified and used Project Templates to gather the requirements and carry on the project.
• Facilitated the requirement gathering work sessions with stakeholders, SME’s and Business owners to understand and in corporate the potential requirements in the BRD.
• Coordinated the project team for JAD and BRD Sessions.
• Created Cases and flows using MS Visio.
• Contributed in implementation of transition in accordance with HIPAA standards.
• Experience in Medicaid Management Information Systems
• Claims Resolution and support provider testing with select hospitals, representing a cross-section of geographies, Medicaid population and variables anticipated to impact payment with new DRG methodology.
• Created 837(P, I, D) claims, and maintained data mapping documents in reference to HIPAA transactions primarily 837(P, I, D), 835, 270/271, 276/277 and 278.
• Worked on 837 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets.
• Performed System testing, Regression testing and UAT for several claim types and test scenarios.
• Compared and validated 5010 system test results with 4010 results for the same test scenarios.
• Executed Step-down testing from to validate the EDIFECS results.
• Created X12’s for 4010 and 5010 standards to meet test scenarios.
• Followed a structured approach to organize requirements into logical groupings of essential business processes, business rules, information needs and insured that critical requirements are not missed.
• Frequently resolved the issues with EDIFECS and ACTTNow, primarily the generation of 997, 999, 824, 277CA reports.
• Coordinated activities between business unit and technical staff, developed new methods, policies, and procedures to meet the business needs.
• Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology.
• Prepared Functional Design Specifications (FRS) employing Use case scenarios, sequence diagrams, DFDs and class diagrams.
• Identified and clearly defined functional issues and supported IT development staff throughout the design, development, unit testing, and implementation phases of the software development life cycle.
• Documented and assisted the QA Team with the Test Plan.
• Assisted Project Manager to complete the project approval process.

Environment: MMIS portal, EDIFECS, Facets, HIPAA, Oracle, SQL, QTP, Caliber, MS Office, MS-Visio, RUP

Confidential, Lincoln, NE

Business Analyst

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validated the needs of the business stakeholders.
• Conducted user interviews and documented business and functional requirements.
• Performed Requirement Analysis and developed Use Cases, Activity Diagrams using Rational Rose.
• Completed the documentation of Claims Scenarios for the source system.
• Analyzed the existing claims process and specific business rules logic applied in the ACP model.
• Created High Level Design document for the new process, integrated with legacy and Facets.
• Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).
• Created Use Case scenarios using MS Visio and documented work flow and business process using Rational Rose.
• Wrote Test Cases and Test Scripts for the User Acceptance Testing (UAT).
• Identified documented data sources and transformation rules required for populating and maintaining data warehouse content.
• Used Rational ClearCase for version control.
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Served as conduit for managing system requirements between the business and the software development team.
• Queried database using SQL for backend testing.
• Used Rational ClearQuest for defect management.

Environment: Rational Enterprise Suite (Rose, RequisitePro, ClearCase, ClearQuest), Casewise modeller,, XML, MS Office, Oracle, SQL Server Reports, Quick TestPro.

Confidential, Menomonee Falls, WI

Business Analyst

Responsibilities:

• Developed an improved system whereby the members could share and communicate information easily.
• Served as the primary liaison between the business and IT for E-Commerce Project (internal search).
• Gathered Business Requirements, through constant interaction with the Users, Designers and Developers, Project Manager and SMEs to get a better understanding of the Business Processes. Developed business process models in RUP to document existing and future business processes.
• Analyzed and optimized the process, prepared Business Requirement Document (BRD) and Functional Specifications.
• Followed Waterfall Software Development Methodology and gathered the requirement and interviewed stakeholders and end users.
• Worked in automating, controlling, capturing, creating, managing, and distributing and archiving of documents that supported compliance with the industry specific requirements and regulations pertaining to SOX.
• Identified Use Cases from the requirements.
• Created UML Diagrams including Use Case Diagrams, Activity Diagrams, Sequence Diagrams, Collaboration Diagrams, Data Flow Diagrams (DFDs), ER Diagrams using MS Visio and Web Page Mock-Ups using Rational Rose thus defining the Business Process Model and Data Process Model.
• Performed Feasibility, Adaptability and Risk Analysis to identify the business critical and high-risk areas of the application.
• Provided technical assistance in identifying, evaluating, and developing systems and procedures that were cost effective and met business requirements.
• At an individual project level, worked cross functionally to define plans and schedule timelines to meet project objectives.
• Assisted the Manager in developing process and procedures for E-Commerce Project Management
• Knowledgeable in Product Lifecycle Management (PLM).

Environment: Unified Modeling Language (UML), Agile, MS Visio, Six Sigma, GAP Analysis, Kronos, Rational Requisite Pro, Rational Clear Case, Clear Quest, MS Project.

Confidential, New York City, NY

Business/System Analyst

Responsibilities:

• The project is to make daily changes in the staging site of Confidential and work on web production in a day to day basis to make changes in general items, and more in particular items on the special days. The project was concentrated on performing the Content Management on the site of Confidential, to formulate the offers and discount from the board meeting for e.g. instant discount, web only discount, refurbished phone discount, stores discount.
• Collect information to analyze and evaluate existing or developed Verizonproduct catalog/offers management applications or systems, prepare detailed flow charts (work flow, activity, and sequence diagrams), outlining systems capabilities and processes following SDLC guidelines.
• Translate business and user requirements into accurate system requirementsspecification documents through systems and data analysis.
• Responsible for working on the specification on the Content Management in a functional Use Case using Visio.
• Thoroughly demonstrate knowledge of the business processes in their area of responsibility and work with the Business to define requirementsthat will drive efficiencies in the business taking into account the entire picture as well as the details.
• Thoroughlydemonstrated knowledge of application systemsin their area of responsibility and identify, evaluate and define impacts of changes, and provide alternatives both to the application changing and all upstream and downstream systems, or identify if a change is a manual process taking into account the entire picture as well as the details.
• Generally assigned to Enterprise cross-functional and cross-departmental projects with high complexity and cross-system impacts.
• Thoroughly demonstrated working knowledge to conceptualize, document and communicate innovative solutions to meet or exceed business objectives.
• Applied modeling techniques to Analyst deliverables.
• Interact regularly with Business Analysts, Architects, Developers, Application Support, Enterprise Test, Operations, and Senior Management.
• Plan, facilitate, and participate in working sessions with cross-functional resources.
• Team's vision into the overall system designs through design and analysis on projects.
• Assist in definition, design, and management of Enterprise Architecture components and low-level technical Architecture design documents for core systems.
• Ability to conduct peer reviews to solicit feedback on materials created.
• Provide accurate estimates of effort and timelines for completion of assigned tasks and workload to achieve deliverables and goals, delivering on time and on estimation for medium to complex projects.
• Take initiative to determine the need and to design and deliver training to department and business.
• Initiate and execute initiatives to improve the processes, procedures, and tools utilized by the team.
• Reviews deliverables and provides input for other analysts.
• Create, deliver and articulate and effective oral presentations to a variety of audiences, large or small, internal or external.
• Effectively manages analyst expectations and deliverables in large and complex projects through the software development lifecycle.
• Reviews and reconciles project delivery to strategic EIT capability roadmap.

Environment: Rational RequisitePro, Rational Rose, Agile, RUP, Axure RP Pro 5.6, MEGA Modeling Suite, Enterprise Architect, Hp Quality Center