SUMMARY

• Over seven years of diverse experience in the field of Information Systems with emphasis on Business Analysis, Healthcare Processes, Strategic Planning and Banking projects focused on Banking, Healthcare Medicare, Medicaid and Pharmaceutical based industries.
• Extensive experience in gathering User and Business Requirements and creating Business Requirement documents (BRD), Functional Requirements, (FRD), Use Cases, Scope document, Contingency Plan
• Experience working with Medicare and Medicaid insurance data, Medicare parts A, B, C & D, and Insurance Claims.
• Expert with HIPAA 4010/ transactions such as 837, 835, 834, 278, 270 and 271.
• Expertise on EDI 837 transactions, ICD - 9/ICD-10 codes.
• Worked on various Line of business PPO, HMO, POS, Medicare and Medicaid claims.
• Worked onFacets - a product for Healthcare Insurance sector.
• Knowledge of Object Oriented Analytical Design (OOAD), Data Modeling and Mapping Design and implementation of RACI charts
• Knowledge of project management tools, approaches, methodologies and processes that help implement the Change Management, Content Management and Configuration Management effectively.
• Experience in Conducting Joint Application Development (JAD) sessions, requirement elicitation sessions, workshops, interviews sessions with Subject Matter Experts (SMEs)/ end users/development group/Client, asking detailed functionality aspects of business process and carefully updating the information to the requirements in an easily understandable format.
• Extensive experience in analyzing and creating Use Case Diagrams, Activity Diagram, Data Flow Diagrams, Workflow Diagram, Wireframes, Class Diagram and Sequence Diagrams using MS Visio, IBM Rational Software Tools.
• Expert in tracing requirements throughout the development process and verifying adherence Requirement Traceability Matrix (RTM).
• Expert in conducting GAP Analysis, SWOT Analysis, Cost Benefit Analysis, Impact Analysis and Data Analysis.

TECHNICAL SKILLS

Methodologies: Waterfall, RUP, Agile (Scrum and XP), OOAD

Requirement Management Tools: UML, IBM Rational Requisite Pro, Power Designer

Project Management Tool: Microsoft Project 2008 and MS SharePoint

Database: Oracle, SQL Server, MS Access

Testing tools / QA: Win Runner, Load Runner, Quality Center (Test Director), QTP

Business Modeling Tools: Power Designer, Rational Rose, Microsoft Visio, Smart draw, Concept Draw Pro, Justinmind Prototyper pro edition, Snipping tool, Serena change management dimensions.

Operating System: Windows 95/98/2000/ XP, OS X, UNIX

Change Management Tools: Rational Clear Quest, Rational Clear case

PROFESSIONAL EXPERIENCE

Confidential, Orange NJ

Sr. Business Analyst

Responsibilities:

• Involved in business analysis and project management, coordinating between the team members, SME’s and creating test plans according to the business requirements
• Created Business Requirements and converted them into System Requirement Specifications
• Worked on SCRUM Project Management and Agile Methodologies for Software Development Life Cycle
• Performed Feasibility, Adaptability & Risk Analysis to identify critical and high risk areas of the application
• Worked on HIPAA 5010 compliance and EDI 837transactions, ICD - 10 Codes
• Studied and analyzed requirements to be achieved and brainstormed to gather effective requirements for a quality product.
• Worked extensively as a key contributor on project involving updating, automating and enhancing claims edits and audit as per the MMIS claims processing system.
• Identified and documented deficiencies in existing healthcare administration business processes and information systems as per MITA
• Prepared business process models; used Visio to create use case diagrams.
• Created Use case scenarios according to business needs and specifications and Implemented UML methodologies to design Use Case Diagrams, Data Flow Diagrams, Activity Diagrams, Sequence Diagram and ER diagrams
• Generated various SQL queries whenever required.
• Participated in Design walk-through with end users to baseline the business architecture.
• Performed GAP analysis on the existing solution and its transition into the new HIPAA 5010.
• Managed the requirements change requests with ITIL framework.
• Managed Change Requests by capturing them in the available organization templates and thoroughly analyzing them for the impact on existing requirements.
• Responsible for managing the documented requirements by Requirement traceability Matrix
• Created data flow and sequence diagrams to describe how EDI Healthcare Transaction set (837) was used to submit health care billing information.
• Supported User Acceptance Testing with UAT cases and resolved any issues with the users
• Involved in preparing a simple and detailed User manual for the application, for an intended user.

Environment: RUP, UAT, GAD (Gap Analysis Document), Microsoft Office 2003 Professional (Outlook, Word, Excel, Visio, Access), Test director, HTML, SQL.

Confidential, Newyork, NY

Business Analyst

Responsibilities:

• Involved in business analysis and project management, coordinating between the team members, and creating test plans according to the business requirements.
• Held interactive sessions with various groups about patient care, including business owners, subject matter experts (SME’s)and marketing team, for effectively gathering requirements assuring that business objectives and priorities are aligned.
• Expertise in HIPPA, Phases of Clinical trials, Clinical trial designs, safety reports, adverse event management and reporting, Protocol designing and regulatory requirements.
• Effectively understand the clinical trial operations and business problems of the pharmaceutical, biotechnology, device and Clinical Research organizations and effectively gather requirements. Developed Process Model and detailed Business Policies ensuring HIPAA guidelines.
• Used Bizagi business process management (BPM) solutions make modeling, executing, and improving business processes easy
• Created the logical models and generated the physical models in the databases.
• Followed the RUP methodology for the entire SDLC.Created full life-cycle documentation from product requirements in the developmental stage to functional specifications. Experience in developing BRD’s.
• Created Use case scenarios according to business needs and specifications and Implemented UML methodologies to design Use Case Diagrams, Data Flow Diagrams, Activity Diagrams, Sequence Diagram and ER diagrams.
• Assure the Traceability of application functional, performance, and security requirements to the business process steps
• Performed Gap analysis designed new process flow, documented the business process, various business scenarios and activities of the business from the conceptual to procedural level.
• Performed Defect Tracking and Change Control Procedures using Rational Clear Quest, and Configuration Management and Version Control using Rational Clear Case.
• Reviewed and evaluated all the modules of the software before delivery to users to confirm meeting the standard criteria. Performed basic UAT with the different customers and different business modules. Interacted with developers and various members of my team to discuss and resolve defects and their priorities.

Environment: Rational Clear Quest, MS-Visio, Test Director, UNIX, BizAgi BPM, MECT, Windows NT, Java, HTML, Oracle.

Confidential, Buffalo, NY

Business Analyst

Responsibilities:

• Interaction with the business user and IT team for understanding the requirements. Work with business representatives and SME’s to understand data requirements and priorities and ensure that IT work is appropriately aligned
• Created Business Requirements and converted them into System Requirement Specifications.
• Worked on SCRUM Project Management and Agile Methodologies for Software Development Life Cycle
• Worked on HIPAA 5010 compliance and EDI 837transactions, ICD - 10 Codes
• Studied and analyzed requirements to be achieved and brainstormed to gather effective requirements for a quality product.
• Played an active and lead role in gathering, analyzing and documenting the Business Requirements, the business rules and Technical Requirements from the Business Group and the Technological Group.
• Worked with production staff to identify and map detailed current processes, identify gaps and failure points, perform root cause analysis and develop functional requirements that supported overall strategy, goals and objectives. Conducted JAD sessions with business users, stakeholders to understand the requirements in more detail
• Generated various SQL queries as and whenever required.
• Drafted the Physical Data Mapping document for the data flow from Facets to the data warehouse.
• Participated in Design walk-through with end users to baseline the business architecture.
• Performed GAP analysis on the existing solution and its transition into the new HIPAA 5010.
• Used Rational Rose to carry out the business modeling and object modeling effort.
• Managed the requirements change requests with ITIL framework.
• Created data flow and sequence diagrams to describe how EDI Healthcare Transaction set (837) was used to submit health care billing information.
• Involved in preparing a simple and detailed User manual for the application, for an intended user.

Environment: Oracle, PL/SQL, MS Word, MS PowerPoint, MS Access, MS Visio, MS Project, XML files, UML

Confidential, Columbia, South Carolina

Business Analyst

Responsibilities:

• Worked closely with the project managers in defining the scope and schedule of the project.
• Established a business analysis methodology around the Agile development process
• Researched the various steps of the life cycle
• Studied and assessed the client systems and the business process
• Designed and developed Use case, Activity diagrams, Sequence Diagrams using UML tools with MS Visio
• Provided key inputs in defining the projects and system requirements
• Assisted the team members in writing the test cases and executed the test plans for the User Acceptance Testing
• Assisted the team members with documentations like Business Requirement documents and Use case specification documents
• Conducted individual and JAD sessions with the stakeholders and the technical units
• Assisted the project manager in developing the project plan, scope plan and business process plan
• Assisted the team member during implementation, testing and maintenance
• Involved with the project managers in feasibility analysis-schedule, technical, economical and operational feasibility
• Assisted the technical team in defining the candidate system matrix and feasibility matrix
• Assisted the team in writing the user manuals

Environment: MS Visio, MS Office Suite, Java, Test Director, Client Server, UML, RUP, Windows XP, Test Director, MS Project, MS Access

Confidential

Business Analyst

Responsibilities:

• Played a key role in the planning, testing, and implementing system enhancements and conversions.
• Provided key project inputs by working with users in defining the project and system requirements.
• Reviewed business process, and functional requirements.
• Worked on Pharmaceutical data processing for improving database for storing user files.
• Analyzed business needs, created and developed new functionality to meet real time data integration that facilitated decision.
• Worked on functions such as Change Control and Request, and managed complaints to ensure customer satisfaction.
• Experience of managing multiple stakeholders across the organization, and in QA integration of systems.
• Involved in detailing project mission, data process flow diagrams, and timelines.
• Worked with SQL queries for data manipulations.
• Assisted in building a business analysis process model using Rational Rose, Requisite Pro and Visio.
• Designed and developed Use Cases, Activity Diagrams and Sequence Diagrams.
• Assisted in process modeling; conducted and participated in JAD sessions with system users; helped with design walkthroughs with stakeholders for base lining architecture.
• Developed strategic partnerships with the business unit to develop a solid knowledge base of the business line, including the business plan, products and processes.
• Research operational procedures and methods and recommended procedures for improvement - with an emphasis on automation and efficiency.
• Assisted Test Lead, Testers understanding business process and help them successful completion of Unit Testing, Integration Testing

Environment: Oracle 9i, XML, Rational Rose, Requisite Pro, QTP,, MS Visio, RUP, MS Project, SQL, MS Access, MS Excel and MS Word.