SUMMARY

• 8 years of cumulative experience as a Business Analyst, with expertise in Healthcare Industries with a solid understanding of Business Process Flows, Case Tools, Business Analysis and skills.
• Experience in working with QA testing teams, while interacting with business users and gathering user requirements to develop necessary Test Plans, Test Cases and Test Scripts.
• Extensive experience in gathering Business and Functional Requirements, developing Use Cases, conducting Gap Analysis and preparing Training manuals
• Experience in developing UML use case diagrams, Work Flow Diagrams using tools like Rational Rose and MS Visio
• Excellent Business writing skills in creating Business Requirements Document BRD , Use Case Specifications, Functional Specifications, and Systems Requirements Specification SRS .
• Expertise in Rational Unified Process RUP methodology, Use Cases, Software Development Life Cycle SDLC processes and rational tools used during all four phases of RUP: Inception, Elaboration, Construction and Transition.
• Through understanding and hands on experience with BABOK Business Analysis Body of Knowledge and PMBOK Project Management Body of Knowledge concepts, tools, techniques and competencies
• Proficient in developing and executing Test Plans, performing functional, usability testing and ensuring that the software meets the system requirements
• Excellent Team player work in conjunction with testing, development and other teams in validation and testing complex scenarios and projects and in the maintenance of Quality Standards in Projects.
• Experienced with industrial standards/compliances such as HL7, EHR, GMP, HIPAA, ICD-10, HIPAA 4010, 5010, and NCPDP.
• Knowledgeable about preparing RTM documents.
• Experience in Commercial Off-the-Shelf COTS software system implementation in evaluating andselecting COTS solution
• Proficient in soliciting client requirements through interviews, workshops, existing system documentation and organizing JAD sessions.
• Writing and Reading data objects i.e. stored procedures, tables, and views, etc. in SQL Server

Skill Sets:

Rational Requisite Pro, Doors, EnClarity ,Enterprise Architect, Smart Draw, MS Visio, System Architect, Rational Rose ,Business Process Models BPM , Unified Modeling Language UML PLSQL, SQL, JAVA, .Net, C, C , UNIX, COBOL ,Oracle, MS SQL Server, MS Access ,Windows, Linux, Unix, RedHat Linux, Solaris,HL7, HER, GMP, HIPAA, ICD-10-CM, ICD-10-PCS, HIPPA 4010, 5010, NCPDP, PBM, MEDICAID, MITA

Business Skills:

• Requirements Gathering, Business Requirements Definition, Business Processes Research, Analysis and Documentation, Functional Requirements gathering, JAD JRP Sessions, GAP and SWOT analysis, Team building, Conflict Management and Time Management.

Professional Experience:

Confidential

Data Analyst

Responsibilities

• Weekly MS Product Coverage Reporting for Biogen new product Plegridy
• Providing key data insights from existing data sets
• Solely responsible for creating Coverage Templates for Biogen Idec new product Plegridy
• Development of formulary coverage tools, templates and reporting using their data sources both internal and third party.
• This position will have responsibility developing appropriate analytics and reporting to track shipment and inventory trends which will act as leading indicators for product performance commercial and free goods . This individual will work with the CIM team to integrate distribution data with broader data strategy and automate reporting to scale for additional products and requests.
• Responsible for developing business plan templates and providing data/analytical support for the Trade Acct Mgmt. Team. This individual will also coordinate with Trade Account Mgmt. Team on preparation for Distribution and SPP QBR meetings
• Act as primary point of contact and conduct ad hoc analytics to support Distribution team, Acct Management Team.
• Develops report to track operational readiness to identify gaps
• Produces analyses based on operational data to support process reengineering initiative
• Designs conclusions gained from analyzing data using statistical tools such as Microsoft Excel and others
• Writes business requirements and specifications to create intuitive standard reports with data representation in charts, graphs, and tables for ease of use.
• Coordinates release with Business Intelligence for promotion to production.
• Leads and manage stakeholders understanding of reporting features to production
• Provides executive level summary to the report presentation layers
• Serves as a data expert for the department

Environment: MS Office Word/Excel/PowerPoint, MS Project, MS Visio, , Web Services, Fingertip Formulary, SharePoint , Symphony data .

Confidential

Sr. Business Analyst

Responsibilities

• Modeled the 'AS-IS' process flow and the 'TO-BE' process flow and did a thorough gap analysis and proposed action plan to fill the gap
• Conducted user interviews, gathered requirements, and analyzed the requirements
• Ensured all stakeholders and impacted groups are kept informed
• Worked with BPC to assist in the application support process when required
• Supported The Stores Development Teamand Stores Application Team to create an application support process for POC and Pilot
• Application Support for POC and Pilot
• Participated in the daily captain calls facilitated by the store ops team during release pilot.
• High Frequency Apps were validated along with Low Frequency Apps
• BPC S and me were at the store to perform In-Store Validation.
• Test scenarios will be used to create the In-Store Validation Plan.
• Was working with BPC Business process consultant to create the In-Store Validation Plan. Key test scenarios from the UAT
• In-Store Validation performed for POC
• Identified the stakeholders, developed a stakeholder list and created stakeholder assessment matrix to prioritize them
• Evaluated opportunities for improvement / consolidation
• Responsible for performing UAT in the SWIFT POS QA environment.
• Responsible for reviewing the UAT Plan with the project team to get signoff.
• Created benefits documentation required to obtain project funding
• Prepared for and conducted project tollgates
• Created and maintained Control Plan
• Ensured that requirements are reviewed or inspected according to the PM Plan
• Created and maintained requirements traceability from objectives through testing
• Participated in risk and issue management, estimating, and other activities as requested by the PM
• Coordinated and participated in User Acceptance Testing
• Ensured that project knowledge is appropriately transitioned to support

Environment:MS Office Word/Excel/PowerPoint, MS Project, MS Visio, Windows NT/XP/Win 7, Web Services, SQL Server 2008, SharePoint

Confidential

Sr. Business Analyst

Responsibilities:

• Conducted brainstorming sessions to analyze provider contracts, provider reimbursement, benefit rules, medical policies and medical management rules to see the impact of ICD 10 diagnosis codes.
• Assisted BCBSLA in determining the right approach to carry out ICD 10 operations by assessing their business and IT operations.
• Helped BCBSLA with building ICD 9 to ICD 10-crosswalk map by grouping thousands of codes and ranges in Clinical, Benefits, Financial, and Medical policy waves.
• Conducted working sessions to gather and document high level business requirements and detailed level business requirements for different business units impacted by ICD 10 such as EDI Claims Intake, FACETS- Claims Adjudication, Medical Management- Utilization Management, Case management and Provider Reimbursement- Provider Payment.
• 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.
• Prepared use cases and data flow diagrams to analyze the impact of ICD 10 diagnosis codes embedded in different systems and applications
• Prepared and maintained requirements traceability matrix RTM throughout the project lifecycle.
• Gathered and validated inventory of applications, interfaces, and reports that will need to be modified to comply with ICD-10 requirements.
• Created and maintained IT ICD 10 project plan using Microsoft Project and reported status for different IT work threads each week.
• Managed list of vendors and trading partners that were impacted by ICD 10 and required remediation work to be compliant.
• Worked with the compliance and audit team to make sure we were following correct HIPAA guidelines/protocols throughout the project lifecycle.
• Worked with Trizetto, Ingenix/Optum Health and other vendors for their release of ICD 10 compliant tools and worked on integration of these tools with the existing systems
• Included in selection committee for the selection of a code-mapping tool.
• Participated in provider outreach program for ICD 10 program
• Participated in monthly calls with BCBSA on ICD 10 impacts for home and host plans.
• Worked with different teams such as HIPAA 5010 to identify any project dependencies or initiatives competing against ICD 10 schedules.
• Created a comprehensive Test Plan to test existing and new features in the IVR system.
• Worked with the preferred vendor NACR to design the call flow tree with all the positive and negative menu items documented.

Environment:MS Office Word/Excel/PowerPoint, MS Project, MS Visio, Rational Rose, Windows NT/XP/Win 7, Web Services, FACETS Customer Service Module, SQL Server 2008, SharePoint, XML , XSLT

Confidential

Business Analyst/Data Analyst

Responsibilities:

• Identification of data elements deemed to PHI Protected Health Information as HIPAA Regulation, Created Meta data for encryption engine.
• Data analysis to support UB92, HCFA, 4010 to 5010, NCPDP 5.1 to D.0 conversion.
• Trends break analysis and History data conversion to new layout.
• Knowledge of834 transactions for benefit enrollment.
• Data Analysis related to ICD9 to ICD 10 qualifiers.
• Reviewed existing system manuals, design documents and user guides and created As-Is Business Process flows
• Facilitated JAD sessions to confirm understanding of the As-Is Business Process
• Interviewed business users, SMEs, end users and gathered requirements for To-Be Systems
• Defined Project Scope and created Business Requirements Document BRD
• Facilitated Requirements walkthrough with Business and IT stakeholders and prioritized requirements across releases.
• Assisted the Project Manager in building the product release roadmap
• Created Detailed Functional Specifications based on the high level requirements
• Used UML tools - Use Case Specifications, and Activity Diagrams to describe functionality/features in Functional Specifications
• Traced Business Requirements BRD to Functional Requirements using Requirements Traceability Matrix
• Coordinated with the offshore development teams and acted as a primary point of contact for Requirements/Business Rule clarification
• Assisted Quality Assurance Testers in preparing System Test Cases and clarified Requirements
• Prepared User Acceptance Test Cases and ensured that all Business and Functional Requirements are adequately covered by the UAT Test Cases
• Performed Business Requirements, Functional Specifications, UAT walkthroughs with the team members and incorporated modifications and obtained Sign-off
• Produced clear user manuals training guides for User Acceptance Testing UAT and deployment with step-by-step instructions and created appropriate GUI screenshots.
• Interacted with the Data Modelers and Data Warehouse teams to understand the designing of the new data warehouse
• Used SQL to query the existing data warehouse. Required data was exported to an excel sheet which was then provided to the Business Intelligence team for their analysis purposes.
• Created Data Mapping documents to support migration of data from Legacy to New systems

Environment: HCFA, UB92, NCPDP 5.1/D.0, 4010/5010 I P, Oracle 10g, Mainframe, Windows, JAVA, C

Confidential

ROLE: Business Analyst

Responsibilities:

• Elicited and gathered user and business requirements through open ended discussions and brainstorming.
• Conducted JAD sessions with stakeholders.
• Responsible for assisting the testing team to develop the test plans and test cases for the system.
• Act as a key facilitator within an organization, acting as a bridge between the client, stakeholders, Business, IT and the solution team.
• Collecting metrics for the scalability measurements for each application from the business and responsible for preparing the Requirement Specification Document.
• Analyzing the Program Requirements Document PRD with the help of Value-Function and Quality.
• Developed a positive working environment where all team members were encouraged to communicate in an open manner and make active contribution to help resolve conflicts, problems and business challenges.
• Developed strong relations with existing and prospective customers and external vendors.
• Responsible for analyzing and evaluating the criticality of issues and making decisions as to the appropriate level of escalation.
• Involved in preparing the change request form, mitigation and risk assessment plan to handle changing requirements.
• Collecting Input layouts for the scalability measurements for each application from the business and responsible for preparing the Requirement Specification Document.
• Analyzing the Program Requirements Document PRD with the help of Value-Function and Quality.
• Developed strong relations with existing and prospective customers and external vendors.
• Responsible for analyzing and evaluating the criticality of issues and making decisions as to the appropriate level of escalation.

Environment: MS Word, MS Excel, MS Visio, MS Project, RTM, Oracle 11g, Mercury Quality Center, Informatica 8.1, Micro strategy

Confidential

Business Analyst

Responsibilities:

• Acted as a bridge between business teams, technical teams and user representatives Gathered business and system requirements, both functional and non-functional after conducting extensive user interviews with stakeholders and end users.
• Assigned to use MOSS 2007 as a content management and records management tool throughout the project.
• Conducted GAP Analysis of current state As-Is and proposed state TO-Be situations and represented them on MS Visio.
• Worked in an AGILE/SCRUM environment that posed initiating several JAD Sessions and active interaction with business and technical teams. Activity, State and Class.
• Created detailed Product Backlog Documents containing User Stories ,
• Documented the AS-IS and TO-BE processes.
• Conducted Sprint planning meetings before the initiation of every sprint to select the user stories for the new sprint backlog and Sprint Review meetings to show what has been accomplished during each sprint.
• Created Test Plan and Test Cases and reported defects usingQuality Center.
• Conducted and participated in daily stand-up meetings or Daily Scrum.
• Worked with WYSIWYG tools such as Dreamweaver, Adobe Photoshop.
• Closely interacted with designers and software developers to help them understand application functionality and navigational flow, by creating MS PowerPoint presentations and Wireframes.
• Participated in testing by conducting User Acceptance Testing UAT .

Environment: MS PowerPoint, Requisite Pro, MS Visio, Quality Center, Load Runner, Adobe Photoshop, MS Excel, MS Access, Oracle, UML, Java

Confidential

Business Analyst

Responsibilities:

• Responsible for defining the scope of the project, gathering business requirements, doing gap analysis and documents them textually or within models.
• Created use case scenarios and documents work flow and business process.
• Prepared the UML Use Cases using Rational Rose.
• Supported IT unit by creating functional specification documents for the design, development and implementation of strategic projects.
• Gathered requirements for generating account balance and transactions reports for a full year.
• Analyzed the requirements for linking the card payment system to the centralized payment system.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly.
• Involved in maintaining and managing different versions of Documents using Rational Clear Case.
• Performed feasibility, adaptability study and risk analysis to identify the business critical areas from the user perspective.

Environment:Java J2SE 5.0 , Oracle, UNIX, Rational Suite.