SUMMARY

• 8 years of experience as aBusiness Analystin Software Development utilizing both iterative software development life cycle principles and classic SDLC methodologies.
• Dynamic professional that utilizes creativity, leadership, collaboration, and teamwork to identify, design, create, implement, and execute solutions that create customer value.
• Techno-functional person having a good hold of both technical and business aspects of healthcare domain which are helpful during application enhancements. Also with Bachelors in Computer Science and MBA, have the ability to ask the right question during requirements gathering and differentiate between Business and System requirements.
• Experienced in interacting and coordinating between end-users, expert teams, development and QA teams and drawing key changes to the business architecture.
• Worked as a Scrum Master and managed onsite and offshore team members, facilitated daily scrums, retrospective and resolved impediments
• 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.
• Actively used Joint Application Development JAD and Joint Application Requirements JAR sessions with Business users and Stake holders alike in gathering requirements, collating and analyzing them to identify the real business need and facilitating the development of a customized solution which delivers maximum cost and usability benefit to the client and company.
• Recognized as a change agent who has worked on multi-million dollar enterprise projects, with documented ability to take initiative and provide positive program results using best practices and project management disciplines.
• Thorough Knowledge of various SDLC methodologies like Waterfall, Agile Scrum .
• Hands on experience in analyzing and documenting Business Requirements BRD and System Functional Specifications including Use cases, Use cases narratives.
• Excellent analytical skills in understanding the business process AS-IS and TO-BE , understanding the functional requirements and translating them to system requirement specifications.
• Extensive experience in using UML Unified Model language tools to create Activity, Sequence, Use Case, Class, and collaboration diagrams.
• Excellent communication, inter-personal, leadership and presentation skills.

AREA OF EXPERTISE

IT Software Development

• IVR Interactive Voice Response Customer Relationship Management CRM
• Salesforce.com
• Health Care Reform, HIPAA Health Insurance Portability and Accountability Act
• Care Management Case Management, Utilization Management Disease Management
• Rating and Quoting of Health Plans
• Claims Processing, Member Enrollment and Billing
• Web Portal
• Medicare Medicaid
• ICD International Classification of Diseases
• JAD/JAR Joint Application Design/ Joint Application Requirements
• Gap Analysis
• Test Plans and Test Cases
• SDLC Methodologies: Waterfall, Agile Scrum

TECHNICAL SKILLS TOOLS EXPERIENCE

• TriZetto Care Advance Enterprise CAE
• FACETS
• MKS Integrity
• IBM Rational Requisite Pro, Rational Team Concert RTC , Rational Requirements Composer RRC , Clear Case, Clear Quest
• SQL, Java
• Siebel
• HP Quality Center
• IBM SPSS
• SAP FICO

Microsoft Office Word, Excel, Access, PowerPoint, SharePoint, Project, Visio

PROFESSIONAL EXPERIENCE

Senior Business Analyst/Scrum Master

• The Quoting and Rating business process is the first point of entry for prospective group insurance customers across the Small Group and Select Market Segments into Aetna.
• The Quoting and Rating domain deals with validating the needs of the prospective customer, providing the customers with product options and the corresponding cost, helping the customer choose the product that best supports their need and budget, determining product cost for the customer by employing rating algorithmsand interacting with plan sponsor, billing and fulfilment processes to set the customer up as an Aetna Plan Sponsor
• As a senior business analyst and scrum master in Quoting and Rating domain, monitored scrum team which included onsite and offshore members and ensured successful completion of sprints. Worked on ACA Health Care Reform and Coventry Integration projects. Currently working on a new initiative to integrate Quoting, Rating and Sales application Small Group with Salesforce.com and I'm part of the project team to gather requirements and provide my ideas for strategic solution.

Responsibilities:

• Eliciting requirements by interacting with the end users of the system through JAD sessions, questionnaires, interviews and shadowing.
• Fine-tuning and documenting requirements in the form of functional requirements , non-functional requirements , use case diagrams , use case narratives and user stories
• Establishing traceability and connectivity between the business needs, requirements, design artefacts, code artefacts and testing artefacts.
• Managing changes to requirements due to constant interaction with business stakeholders and technology partners.
• Understanding the desired business functionality , existing business functionality and the critical paths in the business processes to help determine system changes
• Providing functional support for the developers and clarifying questions on business processes and domain information.
• Providing functional support to testers by providing them with guidance on the business processes and scenarios and answer queries on test coverage.
• Providing expert know how and troubleshooting support for the team during final code deployment.
• Creating and detailing user stories from epics and business needs.
• Grooming the user story created to document changes needed to systems / processes
• Moderating the effort sizing session and helping the team / pod determine the effort that should be associated with a user story in terms of story points.
• Helping the product owner prioritize and rank the product backlog based on business needs and systems constraint.
• Planning the sequence of changes to be implemented along with work assignment to the team through sprint planning sessions.
• Tracking the development, QA and UAT sign-offs on the user stories through RTC and daily check point meetings.
• Providing a demo of the system increment / changes to the product owner and obtaining customer sign-off through sprint demo sessions.
• Tracking best practices, bottle necks and scope for improvement in team operations through the sprint retrospective sessions.
• Managing the day to day interactions amongst the various stakeholders and the scrum teams to discuss updates, issues, changes and dependencies through the scrum and scrum of scrum sessions.
• Troubleshooting integration issues and dependency issues through triage calls and managing risks , scope creeps and defect triages

Senior Business Analyst

• Confidential and Confidential have jointly created a new company to handle their administrative work, as of January 1, 2012. Topaz will handle billing, enrollment and claims processing operations for both Blues plans' small group policies.
• As a senior business analyst in Care Domain, gathered business requirements and created process flows for Member Onboarding Experience, Care Management Case Management CM , Disease Management DM Utilization Management UM and also involved in FACETS integration strategy.

Responsibilities:

• Created Business Workflow Diagrams, Activity diagrams using MS Visio, translated high-level business requirements into specifications for TriZetto team and followed change control process. Designed use-cases and use-case models to further refine the requirements and understand the business processes.
• Worked with cross functional teams to support the implementation and integration of the complete stack of theTriZetto suite of applications
• Liaised with constituents to understand business problems in order to assess and propose process and technology solutions
• Applied relevant tools and techniques to assess impact based on changes to the enabling technologies that support business processes. Lead development of future state process and drive changes across business and operations
• Influenced solutions to effectively use systems and applications without customization Work to promote process change as an alternative to customization
• Created Business Requirements Document BRD and Use cases for CareAdvance enhancements.
• Involved in the creation and documentation of Business Requirements Documents BRD , Requirements, Traceability Matrix RTM , process models, use cases, and all applicable artifacts using the Integrity 10 MKS requirements Management tool to meet complex business needs
• Prepared detailed business specifications from which applications are designed, developed, coded, and tested
• Created appropriate business deliverable documentation that drives downstream deliverables such as detailed designs, program code, and technical documentation
• Identified issues, recommended document changes and implemented same

Confidential

Business Systems Analyst

Worked on projects involving Siebel UI User Interface enhancements and gathered requirements for integration of Siebel with the new clinical portal system for Medical Review. Also, gather requirements and developed use cases for projects related to Enrollment and Billing Systems EM B- Enrollment, Maintenance Billing which required creating Exceptions in Siebel and enhancing UI for displaying new data.

Responsibilities:

• Analyzed, evaluated and developed existing and proposed systems enhancements.
• As a member of an Applications Development team, provided application software development services or technical support for projects about how the system should perform or the business rules the system supports.
• Developed requirements for new BCBSF Blue Cross Blue Shield of Florida applications and analyzed and modified logic in existing applications.
• Coordinated activities with other IT Information Technology organizations e.g., database, telecommunications, operations, technical support, etc. to ensure that system improvements are successfully implemented.
• Analyzed requirements and communicated those to development and testing teams.
• Effectively worked with the business and facilitated the definition of functional system requirements JAR/JAD Sessions .
• Worked with the technology team to translate business requirements into detailed design documents and Serve as liaison between the business and technology groups
• Coordinated user involvement throughout the project lifecycle and played a key role in managing system requirement changes and estimating system/development impact.
• Effectively and proactively reported status to IT and business management

Confidential

Business Analyst

• Worked on easy to resolve navigation project which provided service advocates with a single interface that displays accurate, consistent and timely 'source of truth' data and information that are used or needed for member problem resolution. IVR project was built in order to provide a centralized control system that directs calls to various other human and automated systems, such as Interactive voice Response Units VRU , and Automatic Call Distribution ACD systems.
• Gathered Business Requirements from the Subject Matter Experts SMEs and documented the requirements in the BRD Business Requirements Document .
• Planned and defined system requirements to create Use Cases, Data Flow Diagrams using MS Visio and wireframes for User Interface UI design using the UML Unified Modeling Language methodologies.
• Utilized data flow diagrams, use case diagrams and process flow diagrams to represent information provided by the Business Owners. Also, worked towards getting sign offs from business
• Mapped process flows assess as-is process through user interviews, data collection and analysis, design and evaluation of to-be process solutions.
• Maintained the Traceability Matrix table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.
• Assisted the QA Quality Assurance team in designing the Test Plan and Test Cases for User Acceptance testing.
• Designed and developed Use Cases using UML and Business Process Modeling.
• Identified gaps in the business process and proposed new solutions which minimized the data flow and steps for quick resolution

Confidential

Systems Analyst

Worked as a Systems analyst for multiple web development projects and involved the in the SDLC process for web designing and web enhancements.

Responsibilities:

• Organized and documented use cases, business rules and functional requirements for the system functionalities and ensured that critical requirements are not missed
• Established a tightly coupled change control system
• Developed a schedule and identified project milestones.
• Designed extensive work flows and process flows for AS IS as well as TO BE vision of the application
• Provided guidance and established vision and direction for the application.
• Documented the requirements and approach and circulated to the Business Tech teams for Signoff
• Mentored the team who work as System Administrators on requirement collection and documentation
• Reported project progress to the team, senior management and all stakeholders periodically
• Acted as liaison between functional business units and application team managers to assist in defining objectives, requirements, functions, and priorities of applicable business system related projects
• Identified/handled project risks/issues/changes and helped establish and enhance Business Continuity
• 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
• Identified the Critical Path of the project and monitored the risk.
• Reviewed various Re-engineering techniques with Technical Experts to finalize the Approach.
• Schedule weekly meetings with Business tech group to discuss issues / concerns / status
• Worked closely with the Business Development team to understand and document the current process and identify pain points and business risks.