Skills

Experience writing executive summary documents,5 Years,2012 Experience developing technical design documents,5 Years,2012 Work with healthcare coding schemes,5 Years,2012 Work with healthcare payment models,5 Years,2012 Work with common epidemiologic analytic tools,5 Years,2012Experience in establishing standards based electronic exchange of ELR,2 Years,2012

Employment History

Confidential, Manistee, MI March 2011 – Present 
Business Analyst 
Confidential is a 25-bed acute-care critical access hospital in Manistee, Michigan. They provide a full range of emergency, diagnostic, treatment, and rehabilitation services. A Physician Support System was built to capture the out patients clinical data using an Electronic Medical Record Management System. The purpose of this system was to have a Paperless Medical Record and instant retrieval of data and laboratory records by the doctors. The patient’s medical record contained information such as physical examination and information specific to the medical discipline. The system could also capture information about the patient’s appointments with the doctors; the patient’s medical summary and also track the flow of patients throughout the clinic.

• Gathering business requirements through interviews and sessions with end users.
• Conducted JAD sessions with users to gather and document the requirements.
• Served as Communication Bridge between non-technical users and technical solution developers.
• Conducted Business and Technical Analysis for Electronic Laboratory Systems (ELR)
• Collaborating with project stakeholders throughout all SDLC phases to ensure timely delivery of specified business solutions.
• Implemented the Rational Unified Process (RUP) methodology of iterative software development with its various workflows, artifacts and activities.
• As part of a team, involved in Project planning, gathering requirements, modifying, and executing GUI.
• Extensive experience in integrating the Statistical Tools such as SAS, Microsoft Office & SPSS to create Forecasting Models for purpose of Forecasting and Time Series Analysis
• Have done complex quantitative analysis using sigmastat, SPSS and SAS.
• Participates in the development of project plans, assessing business processes, working with business users and IT to develop system solutions, and implementing solutions.
• Recognize scope limitations and raise potential scope issues while designing the best system approach.
• Provided support to the business during the User Acceptance Testing (UAT).
• Development of business rules and testing for HIPAA compliance certification of healthcare standard
• Worked with standard interface requirements for HL7 2.3.1 and HL7 2.5.1
• Recommended tactic to implement HIPAA 4010 (EDI X12 837, 834, 278, 270) in the new system.
• Held review meetings to monitor progress of the project as per schedule, and ensured timely completion and delivery of the project to the client
• Prepared Training manuals and Knowledge Transfer manuals for the project users.
• Reviewed the UAT Results to identify defects and enhancement request from the Users.
• Documented the workflow of the application with various Screenshots of the application.

Environment: Windows, Microsoft Office Suite, MS Visio, UML, SQL, Activity diagrams, Test Director, HL7, CMS, and, Agile.

Confidential, Fort Mills, SC January 2010 – March 2011 
Business Analyst 
Confidential is a major Health Care provider providing the highest-quality pharmaceutical and health care products. The project was centered at the Sales Department for creating Drug Distribution application (DDA). This is a workflow application used by Sales Representatives. The focus of the project was to help representatives find if the products they wanted are available with any other Reps. Also helps in publishing excess stock of products available with them. System keeps track of the transfer of available and wanted products and notifies the product manager. If the transaction is completed, the Reps report to Accounts department for Credits and Debits with proper approval cycle. The integration project used an extensive repository of drug information. It provided means for efficient dispensing and pricing of drugs in all pharmacies.

• Involved in requirement gathering and created user requirements, managing change control process, updating existing documentation
• Created Data Flow Diagram for the Drug Distribution Application
• Extensive interactions with the client and the management teams to understand the business needs.
• Involved in designing Use Case Diagram, Class Diagram, Sequence Diagram for project documentation
• Analyzed user statement of requirements to develop new reports
• Wrote standard and complex SQL Queries to perform Data Validation to make sure test results matched back to expected results based on the user needs.
• Participated in User Acceptance Testing (UAT)
• HL7/HIPAA compliance.
• Conducted Business and Technical Analysis for Electronic Laboratory Systems (ELR)
• Have done complex quantitative analysis using sigmastat, SPSS and SAS.
• Analyzed user requirements, attended Change Request meetings to document changes and implemented procedures to test changes using Rational Clear Quest.
• Performed GAP Analysis to derive requirements for existing systems enhancements.
• Performed Impact Analysis for readiness of ICD-10 conversion
• Functioned as the primary liaison between the business line, operations and the technical areas throughout the project cycle

Environment: Rational Clear Quest, UML, MS-Office, , MS-Visio, MS-SQL Server 2000,SQL, HL7,Windows NT. 

Confidential. NY, NY February 2008 – December 2009 
Business Analyst 
Confidential. is the largest health benefits company in terms of commercial membership in the United States. Through its networks nationwide, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. The project involved the up gradation of the existing health insurance system whereby web-based application and a direct portal was setup to register Insurance Policies for prospective clients.

• Managed the project as Business Analyst to implement Automation Underwriting.
• Launched the business requirement collection approach based on the project scope and SDLC Methodology.
• Worked on Electronic health record system as a web based application.
• Analyzed and synthesized results from Joint Application Development (JAD) session.
• Well versed with ICD9, CPT, HIPPA, claim adjustments, claim processing claim review, identifying claims processing problems, their source and providing alternative solutions.
• Clarified client requirements, business needs and project objectives, via feedback sessions and client meetings, in collaboration with all stakeholders.
• Conducted business analysis, project assessment and feasibility determination.
• Understand and articulated business requirements from user interviews, and workshops and then convert requirements into technical specifications.
• Assigned work to team based on the client requirements.
• Functioned as the primary liaison between the business line, operations and the technical areas throughout the project cycle
• Monitored the development of system based on RUP.

Environment: Microsoft Office Suite, Rational Rose, UML, SQL Server, Windows, Load Runner. 

Confidential, NY, New York June 2006 – December 2007
Business Analyst
Confidential Corporation and its subsidiaries serve millions of people worldwide. It is known as a health and related benefits company. Application was an Electronics Claims Processing (ECP) system designed to accept the electronic claims coming from the various providers (doctors and hospitals) and process them. The project was also to make the service providers acquired by CIGNA, HIPAA compliant and to integrate all of them into one system.

• Performed SWOT and Gap analysis for the new functionality requirements
• Worked with HIPPA rules and regulations to draft business rules and claim processes.
• Interacted with the client and the Technical Team for requirement gathering and translation of Business Requirements to Technical specifications.
• Conducted JAD sessions.
• HL7/HIPAA compliance.
• Identified and documented the dependencies between the business processes.
• Documented the Use Cases and prepared the Use Case, Activity, Sequence diagrams and Logical views using MS Visio, MS Office and Rational Rose for a clear understanding of the requirements by the development team.
• Data modeling using UML.
• Extensive experience in integrating the Statistical Tools such as SAS, Microsoft Office & SPSS to create Forecasting Models for purpose of Forecasting and Time Series Analysis
• Have done complex quantitative analysis using sigmastat, SPSS and SAS.
• Create and maintain Use Cases, visual models, including activity diagrams, logical Business process models, and sequence diagrams using UML.
• Well versed with HIPAA, claim adjustments, claim processing from point of entry tofinalizing, claim review, identifying claims processing problems, their source and providing alternative solutions using best practice model and principles.
• Involved in preparing project plans and identifying major milestones for each stage as per the SDLC model (RUP Methodology).
• Implemented the HIPAA privacy and security regulations to enhance the capabilities of the systems to process new products.
• Used MS Project for various planning and budgeting activities.

Environment: Rational Unified Process (RUP), UML, Dreamweaver, Rational Test Manager, Win Runner, Rational Clear Quest, Windows, MS Office, HTML, T-SQL, ASP.NET, VB.NET, HL7,Windows 2003.

Confidential, January 2005 – May 2006 
Business Analyst 
The Confidential is the premier health care facility in Ghana. It is the only tertiary hospital in the southern part of Ghana and it is also a teaching hospital affiliated with the medical school of the University of Ghana. Three centres of excellence, the National Cardiothoracic Centre, the National Plastic and Reconstructive Surgery and the Radiotherapy Centre are all located within it. The project with the medical center was in relation to the Medicare population base. This included gathering and documentation of user requirements, analyzing the existing system and performing gap analysis to relate to the target system.

• Gathered Business Requirements, interacted with the Users, Designers, Developers, and Project Manager to get a better understanding of the Business Processes, and analyzed and optimized the process.
• Accepted inbound transactions from multiple sources using FACETS.
• Researched/Analyzed the various steps in the claims processing lifecycle and then wrote the Business Requirement Document and Functional Requirement Document in such a way that the developers could construct the system.
• Extensive experience in integrating the Statistical Tools such as SAS, Microsoft Office & SPSS to create Forecasting Models for purpose of Forecasting and Time Series Analysis
• Have done complex quantitative analysis using sigmastat, SPSS and SAS
• Management of patient profile transfer (PPT) reports created by data team by verifying the associated data.
• Analyzed corporate healthcare business processes to develop customized solutions.
• Wrote queries and developed reports for various levels of management by using SQL and Excel.
• Provided reporting to management via Excel reports of workload and work completion on daily, weekly, and monthly bases.

Environment: Windows, MS Excel, SQL, Oracle, UML, Rational Unified Process.