Professional Summary

• Business analyst with 6 years of hands on experience in requirements definition and functional design - for a variety of solutions in Medicare Medicaid, Commercial Healthcare Payer, Pharmacy Benefit Management PBM , Education Management
• Worked as Business Analyst with key customers like WellPoint, CVS Caremark, XEROX, Association of American Medical Colleges at onsite and offshore
• Expertise in business process definition and experience in working with cross-functional teams throughout the software development life cycle requirements discovery analysis, functional design use cases wireframes, development, testing and go-live training for software solutions.
• Experience in working on Agile / SCRUM projects and using agile techniques for requirements management
• Quick learner with excellent communication and interpersonal skills with the ability to communicate effectively with business stakeholders as well as the technical team.
• Possess good experience in team coordination, motivation as well as the ability to communicate effectively across cultural barriers.

Skill Profile:

Confidential

Role: Business Analyst

• Working as Business Analyst for implementation of ACS Xerox Health Enterprise system, an MMIS product for states that want to move away from existing non-compliant systems. Health Enterprise is, Medicaid Management Information System MMIS , claims processing system for a state's Medicaid Program. In addition to processing claims, the MMIS supports coordination of benefits, surveillance and utilization review, federal and management reporting, and case management. Several states have partnered with Xerox/Cognizant to implement Medicaid Information Technology Architecture MITA aligned Health Enterprise system that meets the CMS required Medicaid Enterprise Certification Toolkit MECT .
• Worked on understanding As Is requirements of the existing base product of Health Enterprise by going through use cases, user interface documents available.
• Completed MMIS based training.
• Performed gap analysis of the current system use cases to find for the missing functionality as demanded by the states during the RFP/RFI stage.
• Worked on aligning MITA business process to third party liability member management for Health Enterprise use cases.
• Performed the MITA BP mapping to MECT requirements to the system use cases.
• Worked on reviewing of UIS document for claims front-end module for Montana MMIS.

Role: Business Analyst

Confidential

• Worked as Business Analyst at Resolution Health Inc. RHI a WellPoint for mobile messaging campaign to deliver clinical and non-clinical care gap messages to WellPoint members. Project aims at increasing member engagement by delivering messages through a mobile platform, which also helps in capturing analytical data like member interaction, response time, response type etc.
• Conducted requirements workshop with customer SME and architect to get overview of the scope of the requirements and overall project.
• Understand and document AS-IS process before defining the To-Be state of the system.
• Interact with WellPoint and RHI business teams to understand the requirements. Understand business requirements and ensure all the expected functionalities are documented.
• Conduct JAD sessions with development and testing teams for common understanding on requirements.
• Create and maintain requirements in the form of use cases to cover all functionalities.
• Provide requirements walkthrough and updates to the development team at offshore.
• Discuss the questions clarifications required by the development team with business users and provide feedback to the development team.
• Create use cases, workflow diagrams to define the requirements.
• Create requirements traceability matrix business requirements to account for change in requirements.
• Review functional test cases and provide feedback to the testing teams
• Create User Manual/ User Guide for end user training.

Role: Business Analyst PBM, Healthcare

Confidential

• Digital Webservices development project- New webservices development projects for CVS Caremark PBM :
• iPad integration initiative- An initiative to build a common IOS application for CVS retail pharmacy and Caremark PBM to provide them with seamless user experience.
• Worked as Business Analyst at CVS Caremark for the following projects:
• Enterprise wide Login Service
• Member Authentication Service
• 3. Member Registration Service

Responsibilities:

• Interact with the Caremark teams to gather requirements for retail and PBM IPad integration project.
• Requirements elicitation with the CVS Caremark PBM and CVS Retail teams for the iPad and webservices projects.
• Interaction with various stakeholders in different departments of the organization to get a consensus on the requirements.
• Interact and understand the process requirements from the subject matter experts SME .
• Identify, track, prioritize and maintain an inventory of business requirements / feature requests raise by different business units within CVS Caremark.
• Develop business cases including business requirements for mobile application development for IOS and android-based platforms.
• Analyze business requirements and perform current, target and gap impact analyses
• Define, validate and deliver solutions that meet business needs, goals and budget.
• Interact with different Caremark clients to understand their requirements and interact with them on a regular basis to find gaps if any.
• Created test plan and test cases to be used for the User acceptance testing UAT for the webservices project.
• Performed User Acceptance Testing UAT for the webservices development project.

Role: Business Analyst

Confidential

MedAps Curriculum Inventory is an online platform that allows US Canadian Medical Schools to submit/review Curriculum Data to AAMC in Medbiquitous XML standard and AAMC Curriculum Administrator to process verify the submission though its intuitive web interface. Curriculum data collected through this platform prepopulates ASSET Accreditation standards Self evaluation tool to facilitate schools to go through the accreditation process. It also enables AAMC and the Medical Schools to generate comprehensive reports based on data submitted and compare against nationalized standards. Project involved creation of a web service exposed to US Medical Schools for submitting Curriculum Data in XML format. Web service is responsible for validating if the data submitted is in XML format, complies with the web service specs created based on Medbiquitous standard, and validating business rules. In return service provides success / failure acknowledgments, invokes business rule errors notifications.

Responsibilities:

• Interface with Medical Schools AAMC Partner organizations to understand user pain points and shortcomings in the existing products through user surveys, interviews and focus group sessions.
• Conduct JAD sessions with business users product owner to identify high level requirements
• Define prioritize epics user stories, write acceptance criteria, create storyboards/wireframes, capture business rules.
• Build and groom product backlog s . Create short, medium and long-term product roadmaps and get internal agreement with key stakeholders.
• Worked on the requirements gathering for Web-services, needed for validating submissions from the school in the Medbiquitous format and meeting the AAMC business rules.
• Provide requirements walkthrough to offshore development team and provide clarifications to build a good understanding of requirements before team starts working on the project. Interface between development team and business users to obtain timely clarifications.
• Create sample XML , with all business rules, for testing.
• Assist Project Manager to run successful Release Planning and Sprint Planning sessions, as well as Sprint Reviews and Retrospectives.
• Review the functional quality of the work being delivered by offshore through functional reviews
• Involved in Functional testing and validation of XML against medbiquitous schema, involved in the end-to-end agile development cycle.

Role: Process Analyst

Confidential

Responsibilities:

• Worked as Process Analyst at CVS Caremark Silver Script-Pharmacy Benefit Manager for Medicare Part-D
• Help team as Subject Matter Expert for resolving retail and mail order claims and eligibility issues that got escalated. Provide assistance to plan members about their benefits included in the Medicare Part D Med-D . Update the members about the Med-D enrollment dates and explain them the different plans that are available.
• Responsible for accepting prescription orders from members for Mail Order Pharmacy and addressing any payment concerns.
• Resolve any queries about the coverage from participating pharmacies.
• Led a team of 5 process associates.

Role: Incident Manager

Confidential

Responsibilities:

• Managing the lifecycle of all applications related Problems with an objective to prevent Incidents from happening, and to minimize the impact of Incidents that cannot be prevented.
• Maintaining information about Known Errors and Workarounds.
• Responsible for managing IT major incidents and service impacting events per process.
• Coordinate amongst Tier 2 and 3 level IT resources and drive remediation calls forward to restore service
• Ability to effectively communicate to IT teams, IT Leadership, and Business owners during production impacting events
• P1 assigned P2 post resolution activities including, RCA, Executive Summary, etc.
• Assist in reporting of production impacting incidents and provide monthly metric reports to leadership levels of IT and Operations/Infrastructure

Role: Business Analyst

Confidential

Responsibilities:

• Engage with the clients across various sectors to identify requirements for online learning management system.
• Understand and analyze clients learning management needs and competing learning management products available in the market.
• Work with Product Manager to define high-level product requirements. Perform the requirement analysis and documented the requirements in the Product Requirement Document PRD .
• Create use-case documents and wire frames / mockups in Visio and work flow diagrams
• Conduct client meetings, one on one interviews, conducted requirements gathering, created analysis/functional specifications.
• Train and help end-users in adapting to new solution through product demos and workshops.