SUMMARY

• More than 7 years of extensive experience in the field of Business Analysis, working with the technical staff to implement management and staff's business requirements into the software application in Healthcare Industry.
• Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross - platform environment.
• Experienced as a Business Analyst in using the iterative software development life cycle principles of Rational Unified Process to manage, develop and test distributed client/server, internet and intranet applications on heterogeneous environments.
• Highly proficient in working with users to gather requirements, analyze them and subsequently use the Rational project and design tools to model the requirements.
• Extensive experience in Business Requirements gathering and writing skills with expertise in developing and documenting Business Requirement document (BRD), Functional Requirement Document (FRD),Software Requirement Specification (SRS) across the deliverables of a project.
• In-depth knowledge of creating use cases, functional design specifications, activity diagrams, logical, component and deployment views to extract business process flow.
• Mapping X12 standards (810, 812, 820, 832, 850, 852, 855, 856, 858, 860, 864, 870, 875, 878, 879, 889, 997) transactions
• Used Query Analyzer, Execution Plan to optimize SQL Queries.
• Strong experience in developing Use Case Diagrams and creating Use Case Specification document (USD), BRD(business requirement document), FRD(Functional Requirement document)
• Involved in testing of highly complex software applications and systems in healthcare for Benefits and Enrolment transaction processing from Federally Facilitated and state based Exchanges for ACA plans and OFF exchange membership enrolments.
• Strong understanding of project life cycle and SDLC methodologies including RUP, RAD, Waterfall and Agile.
• Interviewed SMEs and Stakeholders to get a better understanding of client business processes and gather business requirements. Expertise in System Integration (X12 EDI-HIPAA-835, 820,834) with Health plans eligibility and claim (CPT, ICD 9, ICD 10 codes).
• Extensive knowledge and experience in health care industry specialization in the areas of computer system Validation Testing and profound knowledge of FDA 21 CFR Part 11, 21 CFR Part 820, and other GXP regulations
• Excellent knowledge of HIPAA (Health Insurance Portability and Accountability Act) transaction codes such as 270/271 (inquire/response health care benefits), 276/277 (claim status), 470 (benefit codes), 835 (payment or remittance advice), 837 (health care claim) and 834 (benefit enrollment)
• Proficient in healthcare EDI systems and electronic claim transaction technology
• Excellent Analytical & Problem Solving skills and a good team player
• Conducted JAD sessions, created Use Cases, work flows, screen shots and Power Point presentations for the Web Applications Extensive experience with HIPAA regulations, and EDI standards (X12 and HL7).

TECHNICAL SKILLS

Operating Systems: Windows 95/98/NT/XP/Vista, Linux

Languages: C, C++, SQL, HTML, XML

Database: SQL Server, Oracle, MS - Access

Testing: WinRunner, LoadRunner, Quick Test Pro, Test Director, Rational Tools

Methodologies: Rapid Action Development (RAD), Joint Application Development (JAD), Rational Unified Process (RUP), Unified Modeling Language (UML), System Development Life Cycle (SDLC), Waterfall Model, Crystal Reports, Visual Source Safe.

Documentation Tools: MS - Office Suite (Word/Excel/Power Point), MS - Visio, MS - Project

Other Tools: Informatica, Adobe Photoshop, Dreamweaver4.0.

PROFESSIONAL EXPERIENCE

Confidential, CA

Sr. Business Analyst

Responsibilities:

• Participated in CA-MMIS (California - Medicaid Management Information System) knowledge transfer in preparation for Implementation and Operation of the ICD 10 enhancement
• Serving as a lead for requirements team and subject matter expertise (SME) with healthcare systems.
• Worked closely with the customer to detail and convert business requirements into system and operations requirements while working with external partners to complete the design, development and implementation of the requirements.
• Addressed requirements work as a liaison among stakeholders in order to elicit, analyze, communicate, and validate requirements and business processes.
• Lead and scheduled JAD sessions to gather requirements from business user and write effective BRD's and FRD's
• Leaded the development of Business Requirements Documentation (BRD) for analysis related to the ICD 10 mandate.
• Worked with different lines of business to understand the ACA and HIX policies and developed a process to implement them from IT perspective by developing necessary artifacts.
• Maintain all HL7 standards and under HIPAA.
• Working skills on Health Level 7 Interface (HL7)
• Manage HL7 integration projects and support HL7 data processes/interfaces.
• Interacted with the Development team to help write technical specifications to describe Functional Requirement Documents(FRD),Business Requirement Documents(BRD), design specifications and module specifications
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Lead the changes on ASC X12N 834 for the Inbound Enrollment and Maintenance
• Familiarity with many types of X12 doc types (204, 820, 834, 315, etc.)
• Implemented HL-7 integration for HIS with NCEDSS, NCIR and State Lab usingPHIN-MSand Cloverleaf.
• Confirmed secured patient information exchange, routing, and receiving by the CT DPHPHINMS.
• Prepared Business Requirement Documents (BRD’s) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.
• Incorporated HIPAA standards, EDI (Electronic data interchange), transaction syntax like ANSI X12.
• Develop canonical mapping specs for X12/EDIFACT and canonical schemas.
• Used the Agile-Scrum Methodologies for the Software Development Life Cycle (SDLC)
• Participated in CA-MMIS (California - Medicaid Management Information System) knowledge transfer in preparation for Implementation and Operation of the enhancement.
• Supported System Testing, User Acceptance Testing (UAT), and Operational readiness testing as required.
• Gathered Business Requirements, conducted interviews and discussions with Stakeholders.
• Analyzed the client's applications to determine the impact of the Enhancements onEDI Transactions Set and Code List implementation and defined the changes to bring the affected systems into compliance.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Worked onEDItransactions. Interacted with Claims, Payments and Enrollment teams, hence analyzing and documenting related business processes.
• Collected Business requirements (BRD) from Business owners for applications

Environment: RUP, Rational Requisite Pro, PHIN-MS, Rational Clear Quest, MS Office, Visio, Project, Windows XP, UML, SQL.

Confidential

Business Analyst

Responsibilities:

• Closely involved in defining project scope and identifying discrete enhancement efforts as individual tasks or sub-projects and prioritizing them.
• Worked extensively with Cobol
• XML order header and order detail data transfer; inventory/supply chain management modules
• Performed in-depth analysis and gathered business requirements for clients website redesign project
• Documented existing business process using UML based activity diagrams.
• Analyzed web site usability using data gathered from the existing website.
• Analysed User Requirement Document, Business Requirement Document (BRD), Technical Requirement Specification and Functional Requirement Specification (FRS).
• Implement the interface API required for each major Hospital Systems to source healthcare data over to the secure CDC'sPHINdata network
• Confirmed human cases are automatically sent to CDC viaPHIN-MS(a third party messaging system provided by CDC).
• Migrated pre-existing project data into Salesforce to create a canonical repository of HL7 interfaces and relevant configurations.
• Managed HL7 Interface Projects integrations with 3rd Party Vendors
• Developed Prototypes and conducted requirement walkthroughs with technical team to communicate requirements to them.
• Gathered requirements, organized team meetings requirements from business users, generated business process models, & use-case models, and created business requirements document (BRD) & functional requirements document (FRD).
• Responsible for preparing Business Requirement Document (BRD) and then translating into functional specifications and test plans. Closely coordinated with both business users and developers for arriving at a mutually acceptable solution.
• Documented Requirement Traceability Matrix in Excel sheet for traceability of requirements through test cases.
• Very closely involved in all phases of SDLC from gathering requirements to testing.
• Created User Acceptance Test Plan and coordinated UAT for the site redesign project
• Used Cognos BI for operational reporting.
• Worked closely with developers for analysis of the application.
• Created test plans/scripts and performed UAT and batch testing
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, Object Oriented Design (OOD)
• Worked on Forward Mapping and analysis of ICD 9 - ICD 10 Conversion, for CM (Diagnosis Codes) and PCS (Procedure Codes)
• Actively worked with quality control teams to develop test plans and test cases.
• Developed tables, Views, Stored Procedures and Triggers using SQL Scripting.
• Worked closely with the overall project team in planning, coordinating and implementing QA methodology on various phases of project.
• Analyzed results of System and Regression Testing performed by Test team and held meetings with Client and Management for Deliverable Approvals, Project closure and Sign off.

Environment: Load Runner, Windows NT /2000, SQL, MS Word, MS Excel, MS PowerPoint, Ms-Visio, Cognos BI, MS Project, Clear-Quest, Rational Test Manager, GIS Tools, Lotus Notes R6 client, XML, Notes SAS.

Confidential, Milwaukee, WI

Business Analyst

Responsibilities:

• Conducted user interviews, gathered requirements, analysed the requirements using RUP methodology and documented the requirements using Rational Requisite Pro.
• Used the DataStage Designer to develop processes for extracting, cleansing, transforms, integrating and loading data into data warehouse database
• Created Business Requirement Document (BRD), Functional Requirement Specification (FRS) document, User Requirement Specification (URS) and Change Request (CR) document for system application development.
• Created Process Flow diagrams, Use case diagrams (UML) using MS-Visio
• Created Process Flow diagrams, Use Case Diagrams, Class Diagrams and Interaction Diagrams using Microsoft Visio and Rational Rose.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Authored various Use Cases and Activity diagrams, Sequence diagrams using Rational Requisite Pro and used UML methodology to define the Data Flow Diagrams (DFD).
• Planned and documented procedures for data processing and prepared data flow diagrams for the application.
• Performed GAP analysis for the modules in production, conducted feasibility study and performed impact analysis for proposed enhancements.
• Design HL7 interface specifications between the client hospital downstream systems
• Built and maintained HL7 interfaces on the integration engine, participated in unit and integration testing for all builds and upgrades.
• Coordinated JAD session with system analysts, development team, project manager for application development and Pre-validation specifications.
• Generated complex reports using business object XI and web intelligence
• Coordinated various kinds of User Acceptance Testing (UAT) including regression testing, system testing, integration testing, functional testing, alpha & beta testing.
• Authored test plans, test cases for various test scenarios and helped testing team to better understand the test scripts.
• Used Test Director which is a Mercury tool to help manage defects and issues log during the testing phase..
• Involved in the creating the User Interface Specification Document and User Training Manual as per project specification with the help of development team
• Participated in Bug-Review meetings with software developers, QA engineers, managers, and suggested enhancements and solution to the existing application problem from business perspectives.
• Worked as a User/Customer advocate and negotiated with user as well as the technical team and management staff to resolve any outstanding requirement conflict during the whole SDLC process.

Environment: Data Stage 5.2, Oracle 8i, Windows NT, SQL Server, Ms Word, MS Excel, MS PowerPoint, MS Project, MS Visio, HTML, XML, UNIX, GIS Tools, Windows NT, Sybase.

Confidential

Business Analyst

Responsibilities:

• Facilitated Joint Requirement Planning (JRP) sessions with SME’s in understanding the Requirements pertaining to Loan Origination to Loan Processing.
• Extracted the Business Requirements from the end users keeping in mind their need for the application and prepared Business Requirement Documents (BRD) using Rational RequisitePro.
• Reviewed Design Documents, Requirements Analysis Specifications with Project Lead, Business Owners and the Technical Lead.
• Created and managed Project Templates, Use Case Project Templates, Requirement Types and Traceability Relationships in RequisitePro.
• Created wireframes to present the features of the application to stakeholders and business owners
• Responsible for gathering requirements from users in operations group and performing data mapping for the application, confirm and vacillating the requirement at time of BA testing.
• Worked on data modeling and produced data mapping and data definition documentation
• Developed and managed Project Plans and Schedules. Managed resolution of Project issues and conflicts.
• Conducted Functional Walkthroughs, User Acceptance Testing (UAT), and supervised the development of User Manuals for customers.
• Worked as a User/Customer advocate and negotiated with user as well as with developers and management staff to resolve any requirement conflict to bridge the Gaps between IT and Business.
• Various versions of the documents generated during the project were maintained and managed using Rational ClearCase and performed defect tracking using Rational ClearQuest.
• Tested the final application for Usability testing to verify whether all the User Requirements were catered to by the application.