Objective:

To become a potential asset for companyin order to contribute the best traits in field of business analysis as mediator, connector and ambassador with, in-depth knowledge and profound experience towards ultimate outcome.

Professional Summary:

• A resourceful and dynamic Business/projectAnalyst and scrum master with nearly 7 years of diverse IT experience in Health Insurance, Pharmaceutical and Hospital domains.
• Worked closely with various stakeholders, SMEs and staff to understand and document Business, Functional and Software requirements.
• Possess excellent Analytical skills and Technical skills in gathering business requirements from business stakeholders and converting them into Functional requirements, Use case document, Test case document and User manuals.
• Adept enhanced knowledge of industries'standard SDLC methodologies and having extensive experience working on all the phases of Waterfall, Agile, RADand RUPincludingJoint application development JAD , Joint requirement planning JRP .
• Hands on experience with HL7 and FacetsTrizetto.
• Expertise in interviewing stakeholders by learning organizational culture and stakeholder psychology.Skilled at performing SWOT Analysis, Gapanalysis, Root Cause analysis, Impact analysis and Cost benefit analysis.
• Functional experience inClaim life Cycle and Health Care Payer/Provider domain along with various line of health insurance system like PPO, HMO, POS and CHIP.
• Expertise in Process modeling, Data mapping, Data mining, Regression Test, UAT.
• In-depth knowledge of Medicaidand Medicareclaims processing along with extensive knowledge onCMSO,MITA, MMIS, Electronic Medical Health Record EMR/EHR and Pharmacy Benefit Management PBM .
• Worked on healthcare standards such as HIPAA 4010, 5010, ICD-9 and ICD-10,HIX and EDI Transactions 270,271,277,820,834,835,837 .

Technical Summary:

Professional Experience:

Confidential

Business Analyst

State of Missouri had legacy system FAMIS for more than 20 years foreligibility determination process towards foodstamping, child careand disability incentives solutions. State of Missouri Eligibility determinationand Enrollment for Medicaid incentive program was done with legacy system. Engage point updated state-of-the-artautomated human services eligibility, enrollment, and case management system for the Family Support Division FSD and DSS offices located throughout the State of Missouri.

Web portal where FAMIS was substituted by MEDES.

Unique job Responsibilities:

• Performed role of liaison between the business units, technology teams and support teams.
• Worked on Agile methodology, with excellent use of product backlog review meetings, sprint backlog meetings, sprint review meetings.
• Performed GAP analysisand Impact analysis for SOA implementation and rule engineering system. Elicited the current system to create the user story with As is process followed To be document from FAMIS to MEDES.
• Gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true needs.
• Utilized JIRA tool towards software development process and for connecting people, system and respective tools which made process of gathering content more fluent.
• Heavily utilized837,270 and 271.Elicited requirements using JAD sessions, requirements workshops, surveys, site visits, traceability matrix and workflow analysis
• Collaborated with developers and SMEs subject matter experts to establish the technical vision, and analyze tradeoffs between usability and performance needs.
• Prepared the test case scenarios with all details for Main path, data to be tested and exceptions to ensure that Testing team can test the requirements in documented scenarios.

Environment:RUP, UML, Microsoft Office Word, PowerPoint, JIRA, SharePoint,MS-Project

Confidential

Business Analyst

Confidential offers wellbeing assessment tool to various insurance companies, where the patients holding Medicare services perform various evaluation tests towards five elemental factors of wellbeing. System provides online evaluation assessment test results. After determination of patient eligibility, risk factors are evaluated at the back end, which are further counted to check whether patient qualifies for discount programs or not. My team developedone stop shop system for new and existing customers. Fusion Middleware Control and the WebLogic Scripting Tool WLST were utilized during the process. More than 11 million senior citizens are benefited so far with this facility.

• Adopted agile and waterfall methodologies where first part was Agile methodology while in subsections where existing customer's information was updated, waterfall methodology was implemented.
• Interacted with the Business Users to get a better understanding of client business processes and Business Requirements.
• Wrote and maintained Business Requirements Documents BRD and Functional Requirements Documents FRD defining new systems operations for the project using Rational Requisite Pro.
• Created Use cases, Use Case Diagram, Business flow diagram, Work and Navigation flow diagram using Unified modeling language UML .
• Worked as business liaison with developers, business users and QA team to ensure that all the business goals are met.
• Created Use Cases, and developed detailed Use Case Diagrams and Sequence diagrams describing how actions are to be carried out using MS Visio.
• Conducted User Acceptance Testing UAT and verified performance, reliability.
• Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Organized many Joint Application developments JAD and Joint Requirement Planning sessions JRP , Interviews, workshops and requirement Elicitation sessions, Rapid Application Development RAD sessions and JAM session with end-user/clients/stake holders and the development group.

Environment: Waterfall, Windows 2000, MS Visio, MS Word, MS Power point

Confidential

Project Analyst

Confidential Cancer Center is one of the original three comprehensive cancer centers in the United State. The theme of the project was improvement in new electronic medical Health records in compliance with current HIPAA regulations. Previously active legacy system had bugs and some issues. Hence the main purpose of this system was to update web portal which can instantly retrieve medical and laboratory records of patients and also can provide ICD-9 to ICD-10 transitions oriented issues which were unfixed for long time. My team updated the system with appropriate changes as per the requirement.

Unique Responsibilities:

• ICD 9 has alphanumeric categories rather ICD 10 has strictly numeric categories Hence some chapters been rearranged, titles been changed, conditions have regrouped on the web portal. ICD 10 has almost twice as many categories as ICD-9 Minor changes to the coding rules for mortality were performed.
• Worked extensively with GAP AnalysisforICD-9 to ICD-10 and gathered and validated inventory of applications that are needed for ICD-10 transition.
• Extensively involved in the implementation of New Electronic Medical Health Record EMHR systemand verified that new system is compliant with HIPAA. Verified newly added functionalities of EMR/EHR System like clinical data repository and drug database.
• Assessed new electronic medical record management system and performed GAP analysis. Tracked and maintained stakeholder's requests with excellent use of Requirement traceability matrix RTM
• Successfully created Business requirement documents and functional specification documentsfor the new system to be implemented.
• For doing this my team utilized the agile methodology of iterative software development. Conducted JAD sessions to gather key business requirements KBR and participated in the development of project plans and key business processes assessment.
• Established questionnaires for implementing ICD-10 and worked extensively on identifying needs, assessing risks and HIPPA concerns of the hospital in order to comply with ICD-10 transition.
• Handled the change managementrequests from technical team, documented project change request PCR and updated them accordingly. Utilized MS Visio to draw Use case diagrams and Process flow mapping to capture the requirements so that the development team and stake holders can understand the business process.
• Performed or supporteddata processing, data mining.

Environment:RUP, UML, MS Visio, MS Excel, MS word, JAD, GAP, PCR, JIRA, SQL

Confidential

Business Analyst

Confidential for-profit American health care company that markets and administers health insurance in the United States. One of the divisions of Humana is responsible to deliver services to EHS department, where company provides Health Hazard solution program in collaboration with EHS Department of Environmental Health and Safety .Being third party contractor my team learnt requirements of three emerging companies which are direct clients of Humana and provided them updated version of EHS rules and regulation form for their respective UI.

Unique Responsibilities:

• Participated in meetings with developers, Project managers and Quality analysts to discuss business requirements, test planning,
• Utilized Agile ad Rational unified process to createdBRD and FRD.
• Worked with cross functional business teams and stored project artifacts using MS SharePoint.
• Successfully handled Facet Trizetto tool.
• Developed business requirement and specification documents as well as high-level project plan and translated business requirements into Process models and Use cases using MS Visio.
• Conducted JAD sessions with stakeholders throughout SDLC to resolve open issues.

Environment: RUP, UML, MS Office, MS Project, Test Director, Facets.

Confidential

Project Analyst

Confidential Limited is an Indian multinational pharmaceutical and biotech company, headquartered in Mumbai.Cipla primarily develops therapeutics to treat cardiovascular disease, arthritis and depression. The application allowed researchers and scientists to store and retrieve data as and when required. The project involved development of a centralizedWeb-based database called EDR Electronic DataReserve to be used by various members for generating reports and data from different departments.

Unique Responsibilities:

• Conducted interviews and brainstorming sessions with the key stake holders during the process of requirement gathering.
• Analyzed business needs and played a key role in planning and implementing web based database for storing important pharmaceutical data and user files of the organization.
• Documented BRD and FRD using MS Word and stored project artifacts using MS SharePoint.
• Performed feasibility studies to check the compatibility of new system with various interfaces.
• Planned and documented procedures for data processing and prepared data flow diagrams for the new web based database.
• Designed and developed Usecasesand activity diagrams using MS Visio to analyze and translate business requirements into system specifications.
• Documented test cases, test scripts and user manuals for the new application.

Environment: Waterfall, Windows 2000, MS Visio, MS Word, MS Power point

Professional Organizational affiliation

Leadership traits:

• Healthcare Finance Management Association Director of Marketing/Business Development
• Community Relation Director Health care finance Association
• Committee coordinator and SGA representative Medical Group of Management Association.
• Healthcare Student Association Vice President of Finance, University of Houston

Honor and awards:

• Society of Business Analystvice president for Missouri chapter
• Executive officer Academic Honesty Panel
• Public Relation Director Student Government Association
• Student Ambassador and Mentor at SHOSTS
• Omicron Delta Kappa and Sigma Alpha Pi presidential level inductee
• Who's Who among Students in American Universities and College
• National Engaged Leader Award, Orientation leader awards.