SUMMARY

• An IT Business/System Analyst with over 6+ years of experience in the HealthCare Insurance space.
• Good understanding of SDLC and have worked on different methodology such as Agile/Scrum and waterfall.
• Experience in requirement gathering. business requirements, functional requirements technical requirements, with a penchant for detail & ability to deliver work on time.
• Strong understanding of Business Process Flows, Project Management, Program Management, Case Tools. Facilitation, Elicitation/Gathering, Documentation, Design, Testing, Writing and Reporting SQL Queries, Conducting UAT, JAD etc.
• Extensive experience creating Epic Agile User Stories, Business Requirement Document (BRD) & System Requirement Specification (SRS) / Functional Requirement Document (FRD).
• Conducting Joint Application Development (JAD) sessions with Subject Matter Experts (SME) to extract & understand business objectives.
• Expert in Data Extraction, Transforming and Loading (ETL) using various tools such as Informatica and profiling.
• Good knowledge and experience with ETL Data Warehousing and reporting tools such as SSRS.
• Excellent experience in troubleshooting SQL queries, ETL queries, data warehouse /data mart/ data store models.
• Extensive experience in XML Web Services, XML, XSD, XSLT and Design Pattern.
• Experience in developing XML requests for Web Service Testing and validate response XML
• Good knowledge of Web Technologies (SOAP, RESTful APIs, XML, JSON, web services, etc.).
• Developed Test Cases for Deployment Verification, ETL Data Validation, Cube Testing and Report testing.
• Experience working inMedicareandMedicaidprojects.
• Experience in writing SQL queries for data gathering and generating reports.
• Good understanding of data mapping, data profiling, datamodeling.
• Excellent analytical, organizational, communication and documentation skills along with good project management skill to gather requirements to bring out the quality product.
• Effectively used various elicitation techniques to gather requirements like JAD sessions, brainstorming, prototyping, one and one sessions, workshops, surveys, interviews and conferences.
• Performed roles of scrum master following sprint sessions and used JIRA extensively to write concise user stories and precise acceptance criteria which is used by developers, QA and product owners.
• Good knowledge of Project and Portfolio Management tools (PPM) for Project Management such as MS Project, Clarity.
• Conduct interview sessions, process - analysis walkthroughs, requirement review sessions, questionnaires, brainstorming sessions etc.
• Experience in working withMedicarepart A, B andMedicareadvantageincluding prescription drugs.
• Experience in creating UML based Use Case Diagrams& Data Flow Diagrams using MS - Visio.

TECHNICAL SKILLS

Methodologies: Agile-Scrum and Waterfall

Requirement Management/ Defect Tracking Tools: HP ALM/ Quality Center, JIRA

Business Modeling/Project Management Tools: Microsoft Visio, Clarity

Database: Oracle, SQL

Web Technologies: HTML

Database / Business Applications: MS SQL Server, MS Visio, MS Word MS Excel, MS PowerPoint, MS Project, MS SharePoint

PROFESSIONAL EXPERIENCE

Confidential

Business System Analyst

Responsibilities:

• Worked closely with the client services and business for requirement gathering, business requirements, functional requirements, technical requirements and the overall goal of the projects which involves working with the project for CVS, Lockheed Martin, WellMed, Molina Healthcare and so on.
• Actively involved in project analysis, planning, coordination and conduct the discovery session with CRM.
• Validate the Specification document and Layouts as per the Carenet standard and add the addendum file as per the requirements of the Clients.
• Created the project implementation chart and questionnaire to BA’s for better understand and analyze the projects before conducting an interview with the business.
• Prepare Test Plans and Test Cases for Reports testing and ETL jobs from the requirements.
• Involve In developing Test Plan, Test Requirements, Test Cases and detailed test cases in JIRA.
• Developed Test Scenarios, Test Plans and reviews to ensure requirements coverage according to the source to target mapping document. Ensure Test Execution and defect management.
• Develop user defined functions to support automated scripts.
• Developed mapping spreadsheets for ETL team with source to target data mapping with physical naming standards, data types, volumetric, domain definitions, Transformation Rules and corporate meta-data definitions.
• Documented scripts, specifications, other processes and preparation of Technical Design Documents (TDD).
• Interact with Business users and Technical team in providing clear solutions to requirements.
• Worked on large scale and enterprise level Data Warehouse and Analytic projects providing status, risk, and issue identification and mitigation, as well as functional specific tasks
• Created database Design of Fact & Dimensions Tables, Conceptual, Physical and Logical data Models using Erwin tool.
• Perform SQL queries for retrieving and organizing the database using Select, Create, Update, and Joins.
• Analysis of functional and non-functional categorized data elements for data profiling and mapping from source to target data environment.
• Worked on HIPAA claim master integrated with the Microsoft SQL server utility to process the data from thedata warehouse.
• Coordinated with IT Data Modeling team to develop dimensional model for Data Warehouse applications by identifying required facts and dimensions.
• Creating a mockup forms for the client’s services for their better understanding of projects using MS Visio and Balsamic.
• Interacted with the call center manager’s and the agents to create the inbound and outbound call reports and changed the presentation, interaction and end scripts for a better process.
• Performed estimate and technical handoff with the Dev team to ensure they understand about the project and provide the estimate hours to complete the projects.
• Conducted UAT session with CRM and business, documented UAT scripts and coordinated with QA testing for test cases.
• Created the project release and lead release meeting to notify the teams about projects being moved for the production environment.
• Perform system testing and enter test cases in HP ALM to ensure data is loaded and mapped correctly to Data warehouse/ Data mart models according to the source to target mapping document
• Documented API'S and Web Service specifications.
• Lead the daily stand-up meetings and provide updates regarding the projects progress and upcoming projects from client’s services.
• Interacted with development and QA Team to ensure overall quality and scalability of the software.
• Create the project for BA’S, DEV. production support, business intelligence and telecom to upload their working effort and project progress on Workfront.
• Executing SQL queries to make a un-callable call to callable for UAT testing.
• Follow up with production support team to run the extract after products being release and validate the extract as per the client request.

Confidential, OR

Business System Analyst

Responsibilities:

• Interacted with client and the Technical Team for requirement gathering and translation of Business Requirement to Technical specifications.
• Attend regular meetings with team members to discuss steps taken and needed, along with roadblocks faced, to be taken towards resolving Incidents and Inquiries.
• Gather requirements of various interfaces like Wage Match, New Hires, Death Match, State Hospital admit and discharge,SNAP,TANF and Medicaid Benefit Issuance.
• Attend regular meetings with the Production Support Management team to discuss issues, concerns, and reasons contributing towards discrepancies in File Exchange, Date Exchange and Claim Posting metrics.
• Created Use Cases / Activity Diagrams / State Chart Diagrams, Sequence Diagrams thus defining the Data Process Model and Business Process Model.
• Experience in Integrated Eligibility in order to determine eligibility and deliver Health and Human services through programs such as TANF, Food stamps (SNAP), Development disability, Child care, Adult and protective services, and Employment First Programs
• Worked with the development team to resolve all the defects and updated the results of re-testing of defects in JIRA.
• Performed testing for Medicare and Medicaid claims for Medicaid Management Information System (MMIS).
• Working with the data warehouse teams to gather requirements and analyze all data elements needed for the data migration.
• Developed User Stories throughout theAgileLifecycle as well as created UML diagrams such as Use Case, Activity, ER diagram and Chart diagrams with MS Visio.
• Supported Users in understanding the ALM Test Management Process during User Acceptance Testing (UAT)
• Did source identification,datacollection,datamanipulation and normalization and rule administration fordataconsolidation.
• Worked extensively on risk calculation and model development, path/scenarios generation and valuation model.
• Worked on the claims and utilization management application to set parameters and linked claim processing to UML to ensure accurate processing of claims for review, referrals and authorizations.
• Was involved in mapping spreadsheets that will provide theDataWarehouse Development (ETL) team with source to targetdatamapping, inclusive of logical names, physical names,datatypes, domain definitions, and corporate meta-datadefinitions.
• Conducted numerous JAD sessions with Business users, developer and SMEs.
• Used JIRA Tools for bug tracking.
• Involved in designing and developing Data Models and Data Marts that support the Business Intelligence Data Warehouse.
• Answered and fixed questions or issues from the clients regarding the current Texas MedicaidMMISsystem process.
• Responsible for creation of Collaboration Diagrams, Activity Diagram, Project Flow Diagram in MS Visio.
• Monitored client expectations through client involvement and communication throughout the lifecycle of the project; educate clients and stakeholders on the benefits and risks associated with the project.
• Developed and documented test scenarios including narrative Use cases.
• Performed Data Profiling of current state of data in the Data Warehouse by doing Data Analysis using advanced SQL Queries and Microsoft Excel, finding Gaps in Data and formulating solutions for the same.
• Deliver reports and ad-hoc analysis focused in the area of client behavior and profiling using SQL and Excel.
• Developed Requirements Traceability Matrix (RTM) to trace each software requirement.
• Worked on claim processing module which involved Receipt and Verification of Claim Forms (837) and Claims Adjudication, Health Claim Payment/Advice (835) as per HIPAA guidelines.
• Work on SQL queries in a dimensional data warehouse as well as a relational data warehouse.
• Validated data quality of the reports by writing customSQLqueries.
• Create and execute database queries for Medicaid,SNAP, TANF programs
• Supported in collecting HIPAA related EDI transactional data from data warehouse.
• Designed and implemented basic SQL queries for reports and data validation.
• Incorporated agile methodology to create BRD, FSDs using MS Visio and MS Word.
• Validated and analyzed EDI outbound and inbound Transactions.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 5010; 837, 835, 270/271, and others.
• UtilizedSQLserver for select statements needed to access data from different schemas containing data stored.
• Reviewed functional requirements documents and high-level design documents.
• PreparedUATMaterials, including theUATProcess,UATTest document which would include step-by step process forUATas well as all the tests that would cover all requirements.
• Documented the UAT Plan and work with the UAT Team to ensure the acceptance criteria for every requirement has been included in the UAT task plan.

Environment: Agile/Scrum, JIRA, MS Visio, SNAP, MS Project, MS SharePoint, MS SQL Server, HTML, XML, SOAP UI, MS Office (Word, Excel, PowerPoint, Outlook), UAT, Windows.

Confidential, Atlanta, GA

Business System Analyst

Responsibilities:

• Prepared the Business Requirement Document (BRD) and System Requirement Document (SRD).
• Facilitated Provider Enrollment, Setting up Provider profile & Trading Partner Agreement.
• Set up Provider's Access to the System. (Security Setup).
• Helped creating Provider Reports i.e. Financial, Claims processing.
• Prepared the Business requirement Document for the enhancement of the existing services.
• Created user stories with use cases in Quality Center to have enhanced traceability and visibility to the entire team.
• Validated the requirements & user stories in Quality Center and ensured its traceability in various applications like Google Docs and session recordings.
• Wrote FRDs for the defects and enhancements and got approval from business for the developers.
• Worked on Technical Design Documentation (TDD) of the claims processing system.
• Performed task estimations and documentation of procedures.
• Designed, prepared and implemented test cases for system testing as well as for User Acceptance testing.
• Followed Agile methodology for the SDLC.
• Involved in the testing of web portal of New MMIS system.
• Conducted integration testing and regression testing with developers in development and QA, also conducted user acceptance testing with UAT team. Safety reporting on system-based projects, acted as a liaison, writing documentation and increased project coordination.
• Analyzed and documented system release/deployment issues according to version management, backward compatibility, load balancing of components in production environment.
• Created user stories and managed their workflow starting from grooming to development until deployment and after deployment for future references.
• Did impact analysis for changing requirements and coordinated with business users for prioritizing the testing/release of the changes.
• Maintained a very close interaction between business users and developers to avoid any gaps in understanding or implementation of requirements.
• Did data analysis, created data mapping and data interface documents and kept the documents updated with changes in requirements and functional specifications.
• Performed Risk Analysis based on defect severity and priority.
• Tested User Interface inconsistency and application functionality.
• Developed Reports and Graphs to present the Stress Test results to the management.
• Created BPR charts for AS IS and TO BE processes of different business functionalities.

Environment: Windows XP, SQL, MS-Visio, SDLC, Quality Center, SOAP UI, Clear Quest, UML, Java, Agile.

Confidential, Bronx, NY

Business Analyst

Responsibilities:

• Developed detailed Technical Requirements Document for envisioning the development effort.
• Conducted and performed analysis of EDI transactions, documents and develop reports.
• Facilitated communications between solution architects, developers, quality assurance analysts and business users as required throughout the requirement analysis, design and testing phases to ensure the defined requirements are interpreted correctly.
• Created high-level Use Cases from Business Requirements and created diagrams like Use Case and Activity diagrams using MS-Visio.
• Supported in developing the Data Conversion program/projects .
• Met with Senior Management and discussed program and project plans for the whole year.
• Thoroughly communicated day-to-day status of current projects to stakeholders.
• Planned, estimated and tracked the progress of portal projects.
• Used MS Visio for Process Flow and Workflow diagrams.
• Creating functional requirements and source-to-target mappings including data transformation rules to the development team for implementation.
• Researched EDI claims and claims adjustments data to determine root causes of data errors.
• Designed and implemented basic SQL queries for QA Testing and Report / Data Validation.
• Used Microsoft Word, Excel, Access and Visio as working tools.
• Worked with 834,835,837(medical claims), 270, 271,276 (claim status), and 277 (claim status response).
• Worked on developing thebusinessrequirements and use cases forFacetsbatch processes.
• Was responsible in testing the Member Enrollment, Eligibility Enquiry, Eligibility Response, Claim Status Enquiry, Claim Status Response and conversion of Financial Claims.
• Participated in various meetings and discussed enhancements and modifications request to resolve issues and expand capability of the systems.
• Interacted with stakeholders to get a better understanding of client business processes and gathered requirements.
• Assisted Business User during deployment in formulating User Acceptance Testing (UAT) for customized application and getting confirmation for product Release.

Environment: Agile, MS Visio, MS Office, SharePoint, Quality Center, UAT, SQL, PowerPoint.