Over 7 years of experience in Software Development and Business Analysis using both iterative software development life cycle principles, classic waterfall to Agile methodologies in the Healthcare industries. Adept in interacting and coordinating between end-users, expert teams, development and QA teams and drawing key changes to the business architecture. Able to discover the appropriate resources in the organization, extract information, develop alternatives and obtain level of effort estimates from impacted work groups. Worked with users to gather, analyze, model and subsequently apply various tools to capture, link, trace, and manage requirements changes. Proficient in using Visio Enterprise Architect and Rational Suit to model Use cases business process flows by utilizing activity diagrams, logical, component and deployment views. Knowledge of tools that assist in creating Business Process Model and Design BPM and BPD , system definition model SDM , use cases, functional specifications as well as requirements management, defect tracking, testing, traceability and status reporting.
- Proficient with the various phases of the System Development Life Cycle SDLC with immense experience in the Waterfall Agile models.
- Functional and non functional Requirements Gathering.
- Experienced in Business analysis, Risk analysis, GAP analysis, Traceability Matrix and Project Planning.
- Experience in requirement gathering viz. business requirements, functional requirements technical requirements, with a penchant for detail ability to deliver work on time.
- Creating 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.
- Strong Knowledge of HIPAA standards Title I Title II , Medical Loss Ratio ACA , NCPDP 5.1/D.0, ICD 9/10, EDI transactions 4010/5010 versions.
- Broad knowledge of Medicare, Medicaid, PPO, HMO, POS, diagnostic codes and claims process.
- Experienced in facilitating Joint Application Development JAD , Rapid Application Development RAD , interviews, workshops, and requirement elicitation sessions with end-users, clients, stakeholders and development team.
- Extensive experience in using, UAT User Acceptance Testing , UML Unified Model language tools to create Activity, Sequence, Use Case, Class, and collaboration diagrams and testing.
- Conduct interview sessions, process - analysis walkthroughs, requirement review sessions, questionnaires, brainstorming sessions etc.
- Worked in healthcare insurance domain including Medicare, Medicaid and commercial Insurance.
- Experience with HIPPA ANSI X12 EDI transaction codes such as 270/271, 276/277, 810, 834, 835, 837I and 837P, 997
- Experience in creating UML based Use Case Diagrams Data Flow Diagrams using MS Visio.
- Ability to analyze complex business systems and understand current processes in order to derive requirements for proposed systems.
- Solid Object - Oriented Analysis design skills in creating Class Diagrams, Sequence Diagrams, and Activity Diagrams Collaboration Diagrams.
- Define Business Process identify the risk, methods, baseline acceptance criteria, and deliverables.
- Experience in creating Test Cases using Mercury Quality Center / Quick Test Pro / Load Runner.
- Vast experience in Business Analysis, Business Modeling, Data Modeling.
- Performed GAP Analysis Impact Analysis for each requirement.
- Proficiency in MS Office applications Word, Excel, Access, PowerPoint and Visio , SQL Queries and GUI Mockups.
- Strong ability to analyze all options to mitigate risk provide the best solution for the business.
- Good knowledge of SQL Oracle9i.
- Excellent communication skills - written and verbal.
- Ability to work equally well as a member of a team or independently proficient at establishing business relationships.
- Ability to comfortably converse with all facets in the client organization.
Business Modeling Tools:
Rational Suite, MS-Visio, MS-Project,
MS-Word, MS-Excel, MS-PowerPoint
Mercury Quality Center, Quick Test Pro,
SQL, UML, C, C , C
Oracle 9i, MS-SQL Server, MS-Access
Sr. Business Analyst
Confidential provides medical benefits plans, dental coverage, behavioral health coverage, pharmacy benefits and products and services to consumers through health plans offered by large Confidential employers.The goal of the project was to integrate Cigna Behavioral Health products with other new products brought in the company.
- Worked closely with developers and stakeholders to identify business, data and functional requirements.
- Collect, understand and communicate business requirements and manage the requirements in the business life cycle.
- Involved in the Subject Matter Expert SME sessions for better understanding of the business and IT processes with Subject Matter Experts of various departments.
- Developed business Use Case using UML for new product functionality after conducting requirements elaboration sessions with client teams. Worked with internal product management teams. Ensure that the product, client and 3rd party teams were in agreement with the requirements.
- Involved in providing analytical services to clients to assist them in downsizing their applications focusing on business analysis and custom application development.
- Validation of Use Cases.
- Upload Share point for the Use Case.
- Update the Use Case Library.
- Documented and coordinated changes and enhancements of products and services.
- Served as a primary liaison between business unit and systems department providing leadership and defining, business systems requirements, with the intent of automating and increasing business unit effectiveness and efficiency.
- Develop, derive and clarify specifications for system related projects to ensure business unit needs are identified and communicated and to ensure technical programmers understand the functional requirements of the business unit.
- Refined and realized Use Case models and created UML diagrams to reflect use case text narratives.
- Coordinated the development, design and execution of user acceptance testing programs.
- Confer periodically with both business unit and technical programmers throughout the lifecycle of the project to track progress, identify changes and to ensure changes are communicated to both the business unit and technical staff.
- Provide analysis support and recommendations to management regarding major system conversions and enhancements.
- Converted Business Requirement Documents to Functional Requirements.
- Involved in Production Support / Design and Development / Future initiatives.
Environment: RUP, Visio, UML, MS Office Word, Excel, Access, PowerPoint, Outlook and SQL
Sr. Business Analyst
Confidential offers quality health care products and services designed exclusively to meet the changing health care needs of customers. They provide kidney dialysis services and renal care products, including treatment options for later stage CKD Chronic Kidney Disease to Medicare patient with ESDR End Stage Renal Disease . This project was about integrating the RCG Renal Care Group clinics and bringing their patient data in the Fresenius Integration Hub.The project included integrating 400 RCG clinics which were serving around 35,000 patients. It included upgrading the RCG ADT Admission, Discharge and Transfer HL7 messaging system to Fresenius ADT HL7 messaging system. As a part of the huge scope of the project, I have worked on various ADT messages like A01 Admit a patient , A04 Register a patient , A05 Pre admit patient and A08 Update patient information .
- Responsible for writing Functional Requirement Specifications FRS .
- Worked with business representatives to understand requirements and priorities and ensure that software development work is appropriately aligned
- Involved in the meeting with Business Process Owners, SME Subject Matter Experts and Health Center users for Requirement gathering in Definition Stage using Rational Requisite Pro.
- Facilitated Joint Application Development JAD Sessions, as well as weekly client team meetings
- Interacted with the Subject Matter Experts SME and stakeholders to get a better understanding of client business processes and gather business requirements.
- Performed Gap Analysis to identify the deficiencies of the current system and to identify the requirements for the change in the proposed system.
- Involved in creating sample mappings for the conversion of ADT HL7 Transaction code sets A01,A04,A05 and A08
- Organized impacted systems into high, medium and low impact to help business analyze the level of effort for remediation activities and ease resource allocation work.
- Managed list of vendors and trading partners that were impacted by HL7 Version 2.3 Messaging system and required remediation work to be compliant.
- Participated in user meetings, gathered Business requirements for the Data- warehouse design.
- Created various Use Cases and workflow diagrams, sequence diagrams, and Class diagrams using MS Visio and used UML methodology to define the Data Flow Diagrams DFD and UAT.
- Developed user stories, project backlog, and prioritization for timely smooth execution of the project.
- Maintained Traceability Matrix in Excel.
Environment: Windows XP, Chairside, Meditech, cloverleaf, open Link, Oracle, Rational Requisite Pro, UML, UAT.
The Confidential Program provides health services to low income individuals, has an annual budget of 7.2 billion dollars and provides services to more than 1 million recipients annually. MMIS processes 51 million Medical claims annually for more than 30,000 Medicaid providers. The focus of the project was the replacement of 22 year old Medicaid Management information System MMIS . It included technical and professional services related to analysis and assessment of the current MMIS and EDI claims, documentation of business and technical requirements, preparation of cost analysis and implementation of new MMIS automation system.
- Coordinated with the stakeholders and project key personnel to gather functional and non-functional requirements during JAD sessions.
- Studied the existing business process and created AS-IS workflow to illustrate the existing system.
- Responsible for the full HIPAA compliance lifecycle from gap analysis, mapping, implementation and testing for Medicaid Claims.
- Responsible for gap analysis in changing old MMIS and Involved in testing new MMIS.
- Responsible for Medicaid Claims Resolution/Reimbursement for peach state health plan using MMIS.
- Recorded requirements in the Requirement Traceability Matrix RTM defining each technical requirement in detail from areas like: main hardware, application software, networks, servers, internet and desktop configuration.
- Assisting the project manager in creating the business case and project plan.
- Served as a liaison between the internal and external business community Claims, Billing, Membership, Capitation, Customer service, membership management, provider management, advanced Healthcare management, provider agreement management and the project team.
- Actively analyzed current business processes Claims, Recipient eligibility and enrollment etc. and worked with management to improve and implement enterprise solutions to ensure compliance.
- Work with business representatives to understand data marts requirements and priorities and ensure that IT works is appropriately aligned.
- Responsible for creating business work flows and processes and creating management reports based on the analysis.
- Followed the UML based methods using Rational rose to create use cases, activity diagram, sequence diagram, collaboration diagram that include functional and non-functional specifications to hand off to development teams.
- Actively involved in updating internal processes submit claims, check eligibility , updating data collection and data reporting.
- Defects and bug testing by using Rational Clear-Quest, Configuration management and Version control with Clear-Case.
- Propose strategies to implement HIPAA 4010 in the new MMIS system eventually move to HIPAA 5010.
Environment: MS Office suite 2010, SQL Server, Agile, MS Project, MS FrontPage 2003, MS Access, EDI, Documentum 2.0., Lotus Notes, Microsoft Excel, Microsoft Word, Microsoft Power Point, Visio
Confidential is a neuroscience-based biotechnology company that is focused on discovering, developing, manufacturing and marketing advanced therapies in neurology, autoimmune diseases, and severe pain. The purpose of the new online time card system is to replace their paper time card. The new system was built to reduce paper work and increase accuracy.
- Worked as an interface between the users and the different teams involved in the application development for the better understanding of the business and IT processes.
- Facilitated the project manager to prepare Joint Application Development JAD sessions to identify business rules and requirements and then documented them in a format for inter and intra departmental review.
- Reviewed the Software Requirements Specifications SRS document with the Quality Assurance QA team and coordinate their efforts in the QA process.
- Prepared and involved in overall project plan, incorporated costs and tasks from the various components, ensured a successful and timely project implementation.
- Developed Use Case diagrams, Activity Diagrams and Sequence Diagrams based on Unified Modeling Language UML methodologies.
- Documented Business processes in terms of customer service and feedback.
- Documented functional, non-functional requirements and Use Cases.
- Ensured methodology compliance, document problem areas and coordinate resolutions, reporting to management as necessary.
- Developed, tested and implemented application.
- Provided weekly status updates and generated follow up tasks.
Environment: RUP, UML, Windows XP, MS Visio, Word, Excel, PowerPoint, Rational Rose, Rational Requisite Pro
Confidential is a technology company that has been inventing solutions for the broadcasting industry for almost 30 years. As innovations, our products and services are used at more than 9,000 radio stations, TV music channels, cable companies, satellite radio networks and Internet stations worldwide.
- On-site software installation, establishing client server setup, setting up the database according to client needs, general maintenance of the database.
- Providing comprehensive training to the client on the software.
- 24/7 support to clients over the cell phone / email / messenger.
- Build maintain client relationships, hold individual meetings with the clients.
- Trouble-shooting the database back end our software front end .
- Technologies involved: MS-Access, Microsoft SQL Server and MSDE.
- Promoted from Aircheck India Pvt. Ltd. to Radio Computing Services India Pvt. Ltd.
Environment: MS Access, MS Word, MS PowerPoint, Adobe Acrobat Pro, Airwaves Traffic, Airwaves Online, Airwaves Mail, MS Visio.