SUMMARY

• Sr. Business Analyst with 7+ Years experience in IT industry
• Involved in diverse Software projects like Application configuration, Warehousing, Reporting, Integration, Migration/Conversion etc
• Worked extensively in Business/Data Analysis - Enterprise Analysis, Business Analysis, Requirements Elicitation, Requirements Analysis & Documentation, Data integration Analysis, Gap Analysis, Requirements Traceability Matrix etc
• Extensive noledge and experience in Healthcare business processes and systems
• Thorough noledge on Claims processing, Eligibility, Authorization, Medicaid, Medicare, Provider, Group, Membership, Billing and Enrollment, Care Management, Disease Management, Utilization Management etc
• Provided enrollment, member eligibility, contact management, claims processing, web portal and AVRS call flow, System testing, requirement analysis decision tables and Rule Discovery
• Thorough noledge on HIPAA, EDI transactions - 837, 835, 277, 270, 271 and HIX
• Worked on and ICD 9 to ICD 10 conversion projects
• Thorough noledge on Unified Modeling Language (UML) and Rational Unified Process (RUP)
• Extensive exposure to tools like MS Visio and Rational tools
• Thorough exposure to Use case diagrams, Sequence diagrams and activity diagrams
• Exposure to all aspects of Software Development Life Cycle (SDLC)
• Exposure to Waterfall, Scrum and Agile methodologies
• Knowledge on Reporting tools like SAS, Cognos, Crystal Reports & SSRS
• Experience in coordinating with cross-functional teams and Vendors (Trizetto, Alere, AIM, Prime)
• Supported projects warranty period post release by triaging incident/ticket management via Service Express
• Provided in-depth analysis to resolve production and application issues
• Willingness to work individually and as part of a team to achieve business objectives
• Ability to work in a fast-paced, flexible environment, and comfortable with change
• Ability to quickly gain familiarity with systems and projects assigned

TECHNICAL SKILLS

Processes/Modeling Tool: Software Development Life Cycle (SDLC), MS Visio, Rational Rose, Rational RequisitePro, Rational ClearQuest

Methodology: UML, RUP, Agile, Business Modeling

Databases: MS Access, SQL Server, Oracle

Languages: SQL, PLSQL

Tools: MS Word, Excel, PowerPoint, Access

Testing tools: QTP, Test director, Mercury

PROFESSIONAL EXPERIENCE

Confidential

Sr. Business Analyst

Responsibilities:

• Owned, enabled and practiced the “SOA Engagement and Governance Process”
• Managed Stakeholder expectations from initiation till implementation of SOA project.
• Projected the SOA hours through effort estimation.
• Participated in Airline agent and consumer booking flows of air and Loyalty service sales
• Gatheird requirements from Virgin Airlines related to all the Loyalty service sales.
• Prepared Use cases for Loyalty services related of a Loyalty Member and their amenities they are eligible for .
• Gatheird requirements from Virgin Airlines to collect payment from an unpaid seat by processing the FOP through Realex.
• Gatheird requirements to retrieve all the SSR’s from the PNR for all the seat Map retrieval transactions.
• Responsible for Client Engagement through the lifecycle of the Project.
• Gatheird and prioritized requirements though JAD sessions with SME’s and other stakeholders and through document analysis.
• Collaborated with the client to prepare the SOA requirement document by filtering out the SOA requirements from the project level requirements.
• Performed Gap anlaysis based on the business requirements, functional requirements and supportive documents and efficiently communicated with the project team to finalize the requirements.
• Created Use cases and Service Contracts as part of project artifacts.
• Contacted Clients to resolve missing and updated current usage patterns for all service operations.
• Conducted internal and Client (IT, Services) review of use cases and service contracts.
• Updated IT, Catalog and IT, Repository to synchronize service and client information.
• Updated Air4 Service Migration effort service contracts and use cases
• Planned and coordinated with QA team for SI and facilitated user acceptance testing (UAT)
• Scheduled, monitored and coordinated Requests for Change (RFC) for code promotion to SI and Prod environments and closely worked with Active matrix team, Policy Management team and RFC support team for the successful implementation
• Worked extensively on SOAP UI to understand and review SOA Web Services.
• Conducted Use Case Surveys to ensure use cases are applicable on enterprise level and to avoid duplication.
• Designed Process Flow Diagrams on Visio for Complex services with multiple partner calls.
• Actively documented SOA artifacts in sync with Governance standards.
• Created SOA use case document with inputs from application channels, QA team and Enterprise Architects.
• Collaborated with IT Policy Management team to implement X509 certificates for internal application channels and EXFR for external application channels.
• Assisted in troubleshooting defects raised by channels in HP Quality Center
• Maintained the Document version control, Requirement Traceability Matrix, pre-Go-live cutover plans per SOX audit requirements.

Confidential, Baltimore, MD

Sr. Business Analyst

Responsibilities:

• Gatheird information about the PCMH work processes and information flows.
• Translated business requirements into functional specifications for the IT organization, managed changes to such specifications, and educated the IT organization on the direction of the business.
• Developed high level wireframes of PCMH provider portal to halp assure the screen met business expectations.
• Analyzed, defined and interpreted business needs required for Care Plan Card generation by gathering, analyzing, documenting and validating the Business area(s) and user(s) technical (functional/non-functional) requirements
• Identified where new SOPs and training are necessary and acted as a key resource and liaison with Training department
• Participated in creation of Requirements Management Plan (RMP) for all the triggers and business rules required for PCMH services
• Developed key project deliverables including requirements specifications, use cases, system test cases, training and documentation and user manuals for projects
• Maintained communications with technical counterparts to adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.
• Lead testing efforts by defining, developing and implementing practices and procedures for complete end user test plans.
• Ensured all user acceptance tests are conducted and documented according to standards.
• Identified and documented system deficiencies and recommended solutions.
• Participated in overall success of user acceptance testing, including results verification and release.
• Worked closely with system analysts to halp create Proof Of Concepts (POCs) and alternative.
• Supported the production of Requirements Traceability Matrixes (RTM) via ALM
• Managed assigned enhancements, automations and implementations from concept through implementation.
• Supported projects warranty period post release by triaging incident/ticket management via Service Express
• Analyzed production support related issues, inquiries and requests.
• Participated in classify technical problem over phone and formulate a solution

Confidential

Sr. Business Analyst

Responsibilities:

• Acted as a liaison between the project group and the operations group.
• Helped design scope document and coordinate with top management for the approval process.
• Interviewed various personnel including system analysts to understand the current process and the future requirements.
• Followed Agile frame work for the whole life cycle.
• Gatheird Requirements from business area stakeholders and created Use Case diagrams and scenarios.
• Analyzed and discussed the business and functional requirements for the application under construction.
• Translated requirements via CHOP’s approach dat is based on IIBA standards; functional and non-functional.
• Mapped functional and business requirements.
• Conducted requirement verification and validation sessions to gain approval from business and technical stakeholders.
• Translated and documented requirements into Redmine for all Agile projects.
• Worked with the vendors (Igate, Imorgan, RSAM, Olea) in understanding their products/services and implementation.
• Created RFP documentations for the vendors based on the business needs.
• Reviewed and revised RFP results based on the calculations with the team for selection.
• Validated proposed technical designs to ensure alignment with business needs.
• Reviewed test plans, test cases, and traceability to ensure high quality products are delivered; managed the defect remediation process.
• Created spreadsheets to document requirements and upload in ALM.
• Worked with the quality assurance team so as to test different releases and to develop test plans and test cases.
• Conducted training sessions for the end users and documented various training manuals.
• Acted as a liaison between the technical group and business users (staff and management).
• Responsible for communications between the vendor development team and onsite Project Team and other related departments.
• Played a supporting role for the Project Manager in managing the project.
• Created detailed user guides, presentations and other training materials for the application developed and led the training sessions in training users.
• Worked extensively in data analysis and migration of the existing data to the new application.
• Provided project support during release and implementation period.

Confidential, Madison WI

Sr. Business Analyst

Responsibilities:

• Conducted elicitation sessions to gain an understanding of the business problem being addressed
• Analyzed and create detailed requirements definition documentation which included process flows, user interface mock-ups, reports and data models
• Translated assignments received in the form of objectives to specific tasks
• Conducted requirement verification and validation sessions to gain approval from business and technical stakeholders
• Facilitated workshops with employees from all levels within the organization to identify and implement process improvement opportunities
• Evaluated and presented recommendations for process improvement initiatives
• Followed through the processes to ensure dat customer needs were met
• Validated proposed technical designs to ensure alignment with business needs
• Developed test plans, test cases, and traceability to ensure high quality products are delivered; managed the defect remediation process
• Provided project support during release and implementation period
• Understand and follow DHP’s Solution Delivery and Project methodologies
• Constantly collaborated with business stakeholders, Project Office leadership, vendors and IT staff to resolve issues

Confidential, Durham, NC

Sr. Business Analyst

Responsibilities:

• Worked on Care Management system replacement project from Discovery phase to successful development and implementation
• Agile Methology for backlog, tasks, user stories and Sprints exection
• Developed business and Data flow diagrams in the Discovery phase to estimate the impacts and level of efforts
• Identified the downstream applications and systems dat use Care Management data from the current Care Management system, MaxMC
• Analyzed downstream reporting requirements dat are dependent on MaxMC
• Worked on requirements related to current Care Management data flow and remediating the same from Trizetto’s Care Advance Enterprise (CAE)
• Worked on outbound extracts, defined the rules for the Claims extracts sent out to the Vendors - Trizeto and AIM
• Worked with webservices and other file transfer processes associated
• Worked on mapping documents for the Vendor claims extracts
• Developed Functional requirements documents for each of the downstream application dat are dependent on Care Management data - Segmentation process, Disease Registry, Model practices, Member contacts, Reports etc
• Documented source and table specifications to be used by ETL developers and Quality Assurance Analysts in the construction phase of the project
• Performed testing and estimation of test cases in RQM(Rationale Quality Management)Ingestion of business rules and requirements into JIRA repository
• Worked with the Data stewards to identify and document business rules dat need to be applied to the Care Management data in the warehouse
• Worked closely with Data analysts, ETL Developers and Quality analysts throughout all phases of the project
• Worked on projects like HRA and Blue 20-20 in the Discovery phase to analyze the impacts of the new products on downstream data usage and level of efforts

Confidential, Newark, NJ

Sr. Business Systems Analyst

Responsibilities:

• Gatheird, analyzed, documented business and technical requirements and validated the needs of the business stakeholders
• Collected, tracked and analyzed the trends in data
• Analyzed data and investigated service related issues to identify root cause of problems
• Created, reviewed and followed-up on data reporting for internal and external sources
• Identified and communicated business needs as necessary, participated in internal and external project workgroups
• Contributed in defining the scope of the project and defined functional specifications
• Translated Business Requirements into Functional specifications understandable to the project team
• Reviewed requirements and understood the technical recommendations and constraints, and developed comprehensive and accurate functional specifications
• Worked with SFTP,NDM file transfers
• Worked on data Mapping and process flows
• Analyzed the systems from both Technical and Business perspectives and prepared functional and technical specifications requirements documents
• Analyzed the impacts of HIPAA conversion, specifically on EDI ANSI X12 transactions, 837 I and P, 278, 270 and 271
• Developed Gap Analysis documents for HIPAA 5010 and ICD-10 conversion projects
• Developed Use Case Diagrams, Activity Diagrams, Class Diagrams, and followed UML methodology to define business processes
• Supported data warehousing, data mining, and reporting
• Recommended solutions based on data analysis to increase business efficiency and improve existing processes
• Worked closely with the Business users and Product Owners in User Acceptance Testing (UAT)

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Worked on GL Interface design and development project from the development of Project Vision document through successful go-live
• Performed a cross-functional role involving Enterprise Project Management Office, Business Users, SMEs and IT team
• Closely interacted with the Enterprise Project Management Office and Business Area Owners to assess and document high-level Business requirements
• Prepared the Project Vision document reflecting the stakeholders’ view of proposed solution
• Closely worked with and assisted the Project Managers to understand the complexity of work, assess timelines
• Worked closely with the Solutions Engineer to arrive at a high-level design of the new GL Interface based on the inputs from Business Users and Development team
• Coordinated with the Business Users and SMEs to understand the existing GL processes and define the requirements
• Incorporated the Business process enhancements into the requirements
• Documented the Business requirements as Business Information Requirements (BIRs), Story Cards, Application Use Cases (AUCs), Physical Data Mapping (PDMs) and Logical Data Mapping (LDRs) documents depending on the suitability of the artifact to the requirement
• Worked on the BSA documentation according to AGILE Project Methodology
• Developed the data mapping documents to extract data from Mainframe files to GL Interface, transform and load into Finance Data Mart (FDM) so as to establish FDM as the primary source of all financial data for analysis and reporting
• Coordinated with Mainframe Developers, analyzed the copybooks in order to map the data into Oracle databases - Staging tables of GL Interface and tan to FDM
• Conducted Walk-through meetings all along the project with the stakeholders to seek feedback and approval for the project documents
• Closely worked with the Business Users to scrutinize existing GL reports and prepared an inventory of reports dat would be required in the future
• Conducted several walk-through meetings with the Development and QA teams to assist them in understanding the Business requirements
• Acted as a liaison between the Development team, Business Users and SMEs throughout the Development process
• Worked closely with the QA team in reviewing the EPD documents, Test cases and prioritizing and resolving the defects with enrollment issue resolution
• Played a key role in all stages of the project lifecycle till successful Go-Live