SUMMARY

• Solution oriented Business Systems Analyst with 8 years of experience in Business System Analysis, Software Validation and Business Process Re-Engineering with proven ability to articulate Business values.
• Experience involving Business Process Re-Engineering, Software Re-Engineering using Agile/Scrum, Waterfall methodologies and ERP Systems Implementation and Continuous Improvement techniques.
• Successful and Progressive record of hands-on experience in Managing, Evaluating and Defining Requirements.
• Experienced in Financial and Health Care domain.
• Played a major role in successful implementations of Patient Protection and Affordable Care Act Obama care for FFM-AT Federally Facilitated Marketplace/ Exchange Account Transfer , Idaho's ownSBM State Based Marketplace/ Exchange, i.e. YHI-Your Health Idaho andHIPAA 5010.
• Strong Analytical Skills including in depth knowledge of Software Development Life Cycle SDLC , having thorough understanding of various phases like Gap/Discovery Analysis, Requirement Gathering, Design, Development, System Testing and Production Support.
• Expertise include transforming Business Rules into Business Requirements, System Requirements, Functional Requirements Software Requirements Specifications SRS and designing business models using UML Diagrams such as Use Case Model, Class Diagrams, Activity Diagrams, Sequence Diagrams and Collaboration Diagrams in Rational Rose and MS Visio.
• Performed thorough analysisand evaluated information gathered from CMS materials like BSD's, Data Element Payload Mapping doc's, Navigable samples, WSDL XSD's for understanding, transforming and implementing CMS requirements.
• Analyzed and performed formal and informal testing for generatingXML PayloadRequests and receiving Responses between State to Hub, Hub to TDS, TDS to Hub and Hub to Statelike H1 RIDP , H15 FFM Account Transfer , H14 Verify ESI MEC , H31 Verify Non-ESI MEC , H8T Verify Current Household Income , H9T Verify Annual Household Income and Family size , H19T APTC Computation and H79 RRV Composite .
• Experience in creating Use Cases, User Stories, Process Flow Diagrams, Flowcharts and Screen mockups / Wireframes.
• Experience in Designing, Developing and Reviewing of Software Requirement Specifications SRS , Business and System Requirements Design BSRD , Functional Specification Documents FSD , Systems Design Specification SDS , Requirement Traceability Matrix RTM and Testing Plan Management Documents.
• Worked on Integration and writing SQL queries to Extract, Transform and Load data for data analysis, reporting and testing.
• Worked on identifying work for upcoming PSI i.e. 'PSI Readiness' forPSI Planning, creating EPICS, writing User Stories, creating Back Log Items, facilitating Grooming Sessions and Sprint Retrospective's.
• Performed planning and development of Test Plans, Test Cases, Test Scripts and Test Scenarios to make sure the Business Rules, System, Functional and Technical requirement are met.
• Involved in various kinds of Testing such as Business Integration Testing, Functional Testing, Regression Testing and User Acceptance Testing.
• Proficient in facilitating and performing User Acceptance Test UAT by working with internal and external Users / Customers and obtaining delivery approval for the project.
• Excellent interpersonal and communication skills with ability to build professional relationships with peers and superiors, and work comfortably with both Business and Technical Professionals.
• Demonstrated high capacity to learn new technologies rapidly with no formal training.

Software/Environment:

Jira v6.2.3, Scrum WorksPro, SoapUI 3.6, Bugzilla, Rational RequisitePro, Rational Clear Case, Rational Clear quest ClearQuest, Test Director, TOAD, UltraEdit, Fileviewer, Macro enabled Excel Spreadsheets, Windows XP/2000/98, Windows Vista, Windows 7, MS-DOS, Adobe Photoshop, Flash, Oxygen XML Editor15.1, WSDL, XSD, UML, HTML, C , Java, UNIX, Mainframes, DB2, PL/SQL, Business Objects, Data Modeling, Data Warehousing, Notepad , MS Visio, MS Access, MS Project, MS-Office, Microsoft Outlook 2010, Lotus Notes.

Work Summary

Confidential

Sr Business Process Analyst

Responsibilities:

• Support and facilitate technical integration between the state Medicaid Enrollment Eligibility E E system and the Federal Data Services Hub FDSH .
• Analyze CMS materials like BSD's, Data Element sample XML Payloads and distill important/ relevant information and communicate it to MRI Project.
• Perform complex program analysis - evaluate, recommend and plan actions to create processes to integrate the business analyst role into the welfare automated systems Agile Scrum development process.
• Coordinate the gathering and reconciliation of detailed business requirements and systems requirements for system development within an agile development model.
• Work with PO's Product Owners , Scrum Master's and leadership to develop processes for capturing Business Requirements, BusinessIntegration Testing and User Acceptance Test that incorporate best practices and are integrated with the Agile Scrum development process.
• Collaborate with Information Technology staff and developers to ensure best practices, available technologies, and system improvements are understood and considered in automated solutions.
• Participate in a team of individuals in the Automation Bureau functioning, supporting development of several large automated systems within the Division of Welfare to ensure business coordination, alignment, and priorities drive automation development.
• Develop and test process enhancements to ensure standards for customer experience remain high.
• Ensure documentation, testing, and communications of automation initiatives are completed.
• Provide recommendations on viable improvements in automation development strategies and methods.
• Conduct Data Analysis to interpret, map and transform the data received on XML Payload'sfrom FFM AT's Federally Facilitated Marketplace - Account Transfers and Idalink Online Web Application .
• Create BSRD Business and System Requirements Design document's that demonstrate the 'as-is' and 'to-be' business design and changes to the current Legacy system.
• Conduct analysis on FPL Budget limitations to determine eligibilities for Administers Self Reliance Programs serving low-income individuals and families and calculate APTC Advance Premium Payment Tax Credits and CSR Cost Share Reductions for people who are not eligible for state and federal programs including Medicaid, Child Support, Food Stamps, Child Care, TAFI, and AABD.

Environment:Agile/ Scrum, Jira v6.2.3, ScrumWorksPro, Business Objects, Bugzilla, Outlook 2010, MS Visio, MS Access, Microsoft Word, Power Point, Excel, Notepad , JAVA, Selenium, Adobe Live Cycle, Oracle 11g, Mockito, JMock, Apache CXF, JAXWS, JBoss Web services, Spring 3.0, Watij, Selenium Automation Framework, JBoss 5.1, SiteMinder, LDAP, Windows 7, MS-DOS, Oxygen XML Editor 15.1,SoapUI-3.6, UML, HTML, PL/SQL.

Confidential

Sr. IT Business Systems Analyst

Responsibilities:

• Gaining full and complete understanding of reference material reference materials gives insights and provide valuable information for Gap Analysis identified as useful for transitioning from ICD-9 to ICD10.
• Studying the existing business processes and creating an AS-IS workflow to illustrate the current and proposed process.
• Conduct impact analysis to identify and assess the impacts of transitioning to ICD-10 and documenting the impacted changes between ICD-9 and ICD-10.
• Organizing and managing meetings between MLTC Users Medicaid Long-term Care and MMIS Legacy staff.
• Conducted JAD sessions involving Subject Matter Expert's SMEs , End-User's, development and legacy teams.
• Working on Database structure and Data analysis to identify areas of ICD-10 impact.
• Gathering High level Deliverables for ICD-10 Remediation of Configuration rules to comply with ICD mandate, to regroup with Sequential ICD-10 Codes.
• Gathering business requirements for ICD-10 Groupings/ classes pertaining to maintenance process, ICD-10 Business rules remediation process, Medical Claims Processing System MCPS .
• Analyzing and understanding ICD-9-CM, ICD-9-PCS to and from ICD-10-CM and ICD-10-PCS GEM'S tool.
• Establishing cross functional teams across to remediate the identified areas of impact within MMIS and its business partners.
• Documenting organizational policies and procedures in the context of system requirements.
• Facilitating Scrum meetings with Technical Analyst to understand and convert the Technical Requirements to Functional and Business Requirements.
• Maintaining Requirements Traceability Matrix RTM throughout the project.
• Created Test Scripts, Test Cases and Test Scenarios for testing the Diagnosis and Surgical Procedure Codes received on 837D, I P transaction are in compliance with ICD-10 mandate.
• Developing User Documentation for Companion Guides, Implementation Guides, NE Medicaid Directives for Trading Partners and Providers.
• Extensive use of MS Office tools like MS Access, MS Word, MS Excel, MS PowerPoint and MS Project for data migration.

Environment: Windows Vista, Windows7, MS Visio, MS Access, MS Project, Microsoft Word, Power Point, Excel, Outlook 2010, Lotus Notes, UltraEdit, Fileviewer, Macro enabled Excel Spreadsheets, PL/SQL, DB2, Sybase, XML, UML, HTML, UNIX, Mainframes, Word Perfect.

Confidential

Sr. IT Business Systems Analyst

Responsibilities:

• Analyzed 4010A1 and 5010 TR3 Implementation guides to identify and document the changes for HIPAA EDI Transactions such as 270/271, 276/277, 837 D, I P , 820, 834 and 835.
• Documented Gap Analysis Document GAD based on the gaps identified for the 270/271, 276/277, 837 D, I P , 820, 834 and 835 ASC X12 EDI Transactions.
• Responsible for Analyzing, Documenting, Gathering Requirements and Process Design for the new HIPAA 5010 Transaction 277Claim Acknowledgement.
• Responsible for Analyzing, Documenting and Gathering Requirements for the Electronic Claim Activity Reports Daily and Weekly .
• Created General System Design GSD document's that demonstrate current and proposed business design and changes to the current Legacy system.
• Documented General System Design GSD for NE Medicaid Online Claims Processing Screens such as Claim Resolution, Adjustment, Information and COB Screens.
• Interviewed Subject Matter Expert's SME's to understand the system and gather requirements.
• Analyzed and tested Trading Partner EDI Proprietary flat files enrolled with NE MEDICID MMIS for EDI transactions 270/271 and 837 D, I P and sending the Feedback form.
• Maintain Requirements Traceability Matrix RTM throughout the project.
• Work with technical staff and business users to problem-solve and identify workable solutions.
• Create and execute test cases, test scenarios, test script, data sets and user procedures.
• Performed Unit Testing and User Acceptance testing and documented detailed results.
• Developed User Documentation for Companion Guides, Implementation Guides, NE Medicaid Directives for Trading Partners and Providers.
• Answer questions and inquires about the system functionality, provide user support, and include training, help and instructions.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Tested HIPAA Gateway Application Interface for all inbound and outbound messages Healthcare Eligibility 270 and 271, Healthcare Claim Status request and Response 276/277, electronic notification 997/999 and 277CA Transactions .
• Worked on EDI transaction 835 to identify key data set elements for designated record set. Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Extensively worked on testing tools like TEST DIRECTOR, TOAD and ULTRA EDIT for validating EOB's and 835 test scripts against output files, EOB PDF's.

Environment: Agile/ Scrum, Windows Vista, Windows7, MS Visio, MS Access, MS Project, Microsoft Word, Power Point, Excel, Outlook 2010, Lotus Notes, UltraEdit, Fileviewer, Macro enabled Excel Spreadsheets, PL/SQL, DB2, Sybase, XML, UML, HTML, UNIX, Mainframes, Word Perfect.

Confidential

Business Systems Analyst/Quality Analyst

Responsibilities:

• Interacted with Technical team in understanding Operational and Technical functions of the existing Payment Engine.
• Interaction with operational staff at all levels in gathering requirements relating to application design.
• Created high quality functional requirement specifications and supporting documents for business.
• Under general direction, gathered, defined and documented highly complex business requirements.
• Created Requirement Specification Documents after conducting interviews with End-Users, JAD Sessions and analyzed their current systems.
• Extensive use of MS Office tools like MS Access, MS Word, MS Excel, MS PowerPoint MS Project for data migration in to the CI System Knowledge Data Base in Microsoft SharePoint Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams using EA Tool.
• Experience in EDI automated first-pass claim adjudication, requiring thorough understanding of claim processing, both front and backend operations.
• Tested HIPAA Gateway Application Interface for all inbound and outbound messages HealthCare Eligibility 270 and 271, HealthCare Claim Status Request 276/277, HealthCare Claim 837 and 835 .
• Worked on Functional System Testing, Integration Testing, Regression Testing, and User Acceptance Test using the test cases given by the client before releasing the application.
• Extensively worked on testing tools like TEST DIRECTOR, TOAD and ULTRA EDIT for validating EOB's and 835 test scripts against output files, EOB PDF's and Velocedi HTML files.
• Participated in the bug review meetings, updated requirement document as per business user feedback and changes in the functionality of the application.
• Involved in QA team issues and reviewed test plans and test scripts developed by QA team to make sure that all requirements will be covered in scripts and tested properly.

Environment:Waterfall,Windows Vista, Windows7, MS Visio, MS Access, MS Project, Microsoft Word, Power Point, Excel, Outlook 2010, Lotus Notes, Clear Quest, UltraEdit, Fileviewer, Macro enabled Excel Spreadsheets, Rational RequisitePro, Rational Clear Case, Rational Clear quest, Business Objects, PL/SQL, DB2, Sybase, XML, UML, HTML, UNIX, Data Modeling, Data Warehousing.

Confidential

IT Business Systems Analyst/QA Analyst

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Conducted user interviews and documented business and functional requirements.
• Performed Requirement Analysis and developed UML Use Cases, Activity Diagrams using Rational Rose to understand the requirements.
• Created use case scenarios and documented work flow and business process.
• Documented requirements associated change requests with requirements and connected requirements with Use cases.
• Incorporated Rational Unified Process RUP to create Requirement Document Specifications using Visible Analyst.
• Involved with all the phases of Software Development Life Cycle SDLC methodologies throughout the project life cycle.
• Served as conduit for managing system requirements between the business and the software development team.
• Worked directly with users of the Multi-Channel Desktop to gather and document their business requirements. Followed up with the users to test the implementation, achieved sign-off and continued to move the system toward go-live.
• Worked hands on with the Multi-Channel Desktop to test it to ensure it meets the business requirements.

Environment: Windows XP Professional, Oracle9i, MS Access, MS Excel, RUP, UML, Rational Rose, Requisite Pro, Clear Case 2002, Rational Clear Quest, MS Office suite, MS Visio

Confidential

IT Systems Analyst/QA Analyst

Responsibilities:

• Effectively interacted with Stakeholders, SME's and business users for requirements gathering.
• Understanding functional specifications and documenting technical design documents.
• Developed business case, objectives, cost analysis and budget for implementation financial business systems.
• Involved in creating business processes and modeling diagrams using Rational Unified Process RUP .
• Work closely with Business Owners and Stakeholders to outline Business Requirements.
• Work with System analyst and IS teams to understand the flow of data.
• Assisted the PM in developing Use Cases and project plans and also managed changes to the scope of the project.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and OOD using UML.
• Assumed ownership of Use Case Diagrams, Use Case narratives and other various artifacts.
• Involved in setting up different configuration environment for compatibility testing and manual testing.
• Upgraded the existing Test Scripts and created new scripts for client application to be able to work for new versions and patches, which improved product quality.
• Evaluated testing results for each potential release build using Test Director, Quality Center and Bugzilla reports, listing summarized bug information in priority sequence, recommended viability of release for production.
• Created MS Access database s and forms to capture training evaluations and attendance.
• Developed customized SQL reports and queries for management decision-making and operational management.
• Wrote PL/SQL statement and stored procedures in Oracle for extracting as well as writing data.

Environment: RUP, Rational RequisitePro, Rational Clear Case, Rational Clear quest, Java, DB2, MS Word, MS Excel, MS Access, MS Visio, Power Point, Oracle 9, SQL, Sybase, UNIX, Windows XP.