SUMMARY

• Business Analyst over 15 years of experience in various Healthcare industries.
• Hands - on in gathering and converting User Requirements into high level and low-level documents (HLD/LLD) like Business Requirements (BRD), Functional Requirement Documents (FRD) and Functional Requirement Specifications (FRS).
• Proficient in preparing different requirement artifacts like workflow/process flow, algorithms, business rules, use cases, Software requirement specification (SRS), Change request (CR) and Requirement Traceability Matrix (RTM).
• Conducted Reviews and Audits for external and internal activities.
• Accurately estimate work efforts time (Use Case Point Analysis (UCP)) and complete assignments on schedule.
• Re-engineered the process design/activity using MS Visio.
• Organized many Joint Application Developments (JAD) sessions and Joint Requirement Planning sessions (JRP), walkthrough, Interviews, Workshops and Rapid Application Development (RAD) sessions with end-user/clients/stake holders and the IT group.
• Prepare presentation slides in MS Power Point, which was extensively used in different JAD sessions and to track progress.
• Assisted in preparing project proposals, risk register, project charter, timeframes, schedules and budgets. Liaise with key stakeholders to identify and define project requirements, budgeting, forecasting, estimation and scope of the project. Co-ordinated with teams to help understand the business process flows and Health Information Exchange (HIE).
• Worked on Data Integration, Data Migration, Claim Adjudication Process and Implementation of HIPAA 5010 and ICD-10 Interacted with healthcare providers, Insurance Policy Holders and other insurances.
• Experience working with Managed Care Plans like Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Point of Service (POS) plans. Possess knowledge of Patient Protection and Affordable Care Act (PPACA) or Obamacare, HIPPA and Consolidated Omnibus Budget Reconciliation act (COBRA).
• Excellent understanding of Healthcare Jargons like HIX (Health Insurance Exchange), Medicare (Part A, B, C, D)/ Medicaid systems, and Health Care Reform.
• Conducted Business Reviews, User Interviews, weekly/ Monthly meetings with Business Users, SME’s.
• Competent in Unified Modelling Language (UML) for developing use cases diagram, activity diagrams, sequence diagrams and class diagram for system design using Magic Draw and MS Visio.
• Excellent analytical skills in understanding the business process (AS-IS and TO-BE). Exceptional Problem Solving and Sound Decision-Making capabilities, along with ability to manage and resolve increasingly complex situations through Root Cause Analysis.
• Assist with the development and execution of detailed system and user acceptance test plans, test cases and test scripts for manual and automated testing.
• Experienced and good understanding of three tier, Mainframe and client server technologies.
• Adept at building a strong team environment and have the ability to acclimatize to new technologies and situations with ease.
• Experience in the documentation of system and business requirements and specifications, design and development of use and test-case scenarios and root-cause analysis, GAP analysis, developing test plans, test scripts using SQL, conducting System Integration testing (SIT), user acceptance testing (UAT).

TECHNICAL SKILLS

Requirements Management Tools: Jira, Confluence MS Excel, Microsoft Word, Microsoft PowerPoint, Visio

Analysis /Methodologies: Agile methodology, Waterfall methodology, Cost/Benefit Analysis, Gap Analysis, Feasibility Analysis

Programming Languages and Web Technologies: Oracle, Pega, SQL, C#

Microsoft Tools: MS office Suite, Adobe Acrobat Reader

Reporting: MS Excel, TrackWise

Database: Oracle, MsSQL

Testing: Manual Testing, HP Quality Centre, Quick Test Pro, Load Runner

Browsers: Internet Explorer, Google Chrome, Firefox Mozilla, Opera

Operating Systems: 2000/XP/7/2010

PROFESSIONAL EXPERIENCE

Business Analyst

Confidential, Minneapolis, MN

Responsibilities:

• Participating in Feasibility and Estimation meetings along with business owners and architects to add the annuity product and assisting in creating Project Plan and Road Map.
• Designed Legal Compliance Workflow using Sitecore Workflow to implement Content Document approval process
• Capturing As - Is Process, analyzed TO-BE Process and performed Gap Analysis by conducting several sessions with users and technical team
• Assisting project manager with various additional activities like documentation, presentations and team metrics and project status.
• Used JIRA to gather the information from User stories and managing the requirements.
• Collaborated with Scrum master and scrum teams for creating Scrum artifacts like Burn-down charts, Task boards, Velocity planning and Sprint grooming prioritizing backlogs.
• Preferred Feasibility Study, Cost Benefits Analysis, Return on Investment (ROI) and Risk Identification to reduce certain risk within the project.
• Conducted JAD Sessions, interviews and Brainstorming sessions with key stakeholders and SME s to gather requirement.
• Maintained Scrum artefacts like sprint burn down chart, Product burn down chart and Impediment List.
• Supervised and Maintained the Requirement Traceability Matrix (RTM).
• Effectively managed change by deploying change management techniques such as Change Assessment and Impact Analysis.
• Expert in writing detail system use cases, developing business use cases, and working with QA teams during testing phase thereby facilitating acceptance testing with stakeholders and business users.
• Analyzed business workflow and system needs.
• Created dashboard reports and ad-hoc reports on weekly and monthly bases.

Business Analyst

Confidential, Texas

Responsibilities:

• Created user stories with the help of Product Owner.
• I identified and documented process flows/mock - ups for my respective teams.
• Coordinated with end-users for data cleaning and variables selection to ensure the clinical data is meaningful and analysable.
• Assisted Product Owner in grooming the product backlog.
• Assisted product owner and scrum team to identify dependencies.
• Performed pharmacy clinical testing by running test claims.
• Hands on Formulary and Utilization Management testing.
• Worked with SIT and business teams for welcome season testing.
• Triaged and managed bug/defect life cycle.
• Used tools like VSTS and SFDC to log and track the defect.
• Participated in requirements review sessions.
• Documented test cases and assisted test lead in managing test plan.
• Performed clinics testing for commercial line of business.
• Reviewed the test results with business team.
• Participated and assisted Scrum Master conducting ceremonies like Sprint Planning/Daily Stand-up/Backlog Refinement/Sprint Review/Sprint Demo.
• Followed Kanban framework to deliver the work.
• Experience working within PBM workstreams like: Hierarchy and Eligibility, Benefits, Claims, Clinical, and Member Experience.
• Hands on experience in capturing requirements for Retail, Mail and Direct pharmacy claims.
• Captured requirements for Member Portal that is used to manage Mail Order Pharmacy.
• Attended several Program Increments (PI) to identify the cross-functional dependencies.
• Hands on experience in running NCPDP 5.0 pharmacy claims
• Using SQL, I ve manipulated files and their associated data for rapid delivery to clients or loading onto internal databases.
• Identified data issues using SQL and provided recommendations for resolution to ensure optimal performance.
• Designed and Populated specific tables, databases for collection, tracking and reporting of data using SQL
• Experience working within Agile Release Train (ART)
• Thorough understanding of Scrum of Scrums and Product Owner Sync.
• Used JIRA tool to create user stories and manage the product backlog as well as to generate Burn-up and Burn-down charts.
• Responsible for managing the documented System Requirements and Requirements Traceability.

Business Analyst/ Project Manager

Confidential

Responsibilities:

• Delivered business analysis and project management services for various clients
• Worked with Solution architecture (end - client & internal teams) for technical designs
• Built prototype solutions/Screen Mock-ups for clients to confirm solution requirements
• Built test cases/test scripts for a variety of custom developed applications for our clients
• Participated in and enabled early discussions and work planning for cloud migrations (Azure)
• Interviewed End-users and super users to write up business requirements for custom application development based on Microsoft Platforms - SharePoint, .NET custom development etc.)
• Established and owned customer satisfaction surveys, scoring and actions (toward delivery improvement)
• Interviewed End-users and super users to enable delivery of business requirements for custom application development based on Microsoft Platforms - SharePoint, .NET custom development for the company)
• Part of the core team working with HR to build career tracks for new hire employees