SUMMARY

• Sr. Business Analyst professional with 8 years of expertise in the Healthcare and Financial domains. Within most of the previous roles was responsible for enhancements to various systems and web portal upgrades to increase efficiency. Highly experienced in working with the development as well as the business side to create complete technical and functional specifications.
• In - depth knowledge of financial instruments including Stocks, Bonds, Forwards, Futures, Options, Swaps, Asset Backed Securities, Mortgage Backed Securities, Hedge Funds, Exchange Traded Funds, and Money Market Instruments.
• Extensive experience in Electronic Health Records, Medicare, Medicaid, Health Care Reform, and Patient Protection and Affordable Care Act (PPACA).
• Well-versed with Six Sigma (DMAIC/DMADV) Methodologies, CMMI Principles and Sarbanes Oxley (SOX) Compliance.
• Experience working with federal agencies on 508 compliance documentation guidelines and checklists for CMS.
• Expertise with HIPAA EDI Transactions such as 835, 837 (P, D, I) 276, 277, 278, etc.
• Proficiency in Data Requirements, identifying Data Sources, determining content of Data Fields, and creating Data Mapping Documents.
• Performed Data Extraction and Data Compilation using SQL queries.
• Experienced in User Acceptance Testing including creating and reviewing UAT Scripts and performing Use Case based testing using Mercury Quality Center tool.
• Skilled in Financial Analysis, Metrics Reporting and creating standardized, highly adaptable Market Reports.
• Highly qualified in changing the needs of business users and stakeholders to the functional/technical requirements.
• Served as a critical resource and liaised between subject matter experts and technologists throughout the project life cycle.
• Excellent conceptual and technical skills to create Business Requirements Document, Functional Specifications Document, Process Flow Diagram, and Detailed Design Document.
• Proficiency in conducting JAD (Joint Application Development) sessions with Stakeholders and Business Partners to resolve issues.
• Conducted Scope Analysis, Stakeholder Analysis, Gap Analysis, and Traceability Matrix and used Visio for Business Process Modeling adopting UML standards.
• Worked with the project team to determine appropriate Test/Deployment Plans, and supported the product launch.
• Coordinated with Analysts, Managers, Developers and Testers for complex projects during the SDLC.

TECHNICAL SKILLS

• RUP
• UML
• Agile
• Waterfall
• MS Visio
• MS Office (Word
• Excel
• PowerPoint
• Project
• Outlook
• Access)
• Rational Requisite Pro
• Rational Clear Quest
• Clear Case
• HP Quality Center
• Rational Rose
• Test Director
• Quick Test Pro
• Mercury Quality Center
• Borland
• Caliber
• TOAD
• OOAD
• Object Modeling
• XML
• Metadata
• Sharepoint

PROFESSIONAL EXPERIENCE

Sr. Business Analyst

Confidential, Minneapolis, MN

Responsibilities:

• Worked with the Business Unit to define business requirements and analyze the possible technical solutions. Responsibilities included requirement gathering, business process flow, business process modeling and business analysis.
• Designed, tested, and inspected data communications system.
• Responsible for planning, coordination, implementation, and execution of policies, programs and activities related to the Data centers and infrastructure deployed in them.
• Served as the Data center technical business analyst and assisted with infrastructure deployment and retirement.
• Facilitated and managed meeting sessions with committee of SMEs from various business areas including Mortgage Servicing, Loan Monitoring and Asset Management.
• Designed and developed project document templates based on Agile/Scrum Methodology.
• Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, and Collaboration Diagrams.
• Assisted Project Managers with the development of project schedules.
• Conducted Workflow, Process Diagram, Gap Analysis and Data Analysis to derive requirements for the automation process.
• Conducted Estimation and Feasibility Analysis to wrap up project in the specified time period.
• Organized cross training of team members and users to become more responsive.
• Designed and implemented basic SQL queries for QA testing and report/data validation.
• Assisted Data Analyst in mapping task.
• Led the identification and documentation of business metrics.
• Interacted with data architect for Data Mapping, Data Modeling and Entity Relationship Diagram.
• Collaborated with development architect and the business to develop both high-level and detailed application architecture to meet the business needs.
• Participated in the Logical/Physical Design Sessions and developed design documents.
• Identified internal and external system requirements, design and configuration set-up. Created User Documentation and conducted training classes.
• Helped the testing team in documenting system requirements and testing system development.
• Designed screen mockups for changes in system functionality using iRise and MS Visio.

Environment: MS Visio, Agile/Scrum, MS SharePoint, SQL Navigator 5.1.1, SQL Server 2003/2005, ASP.NET, iRise, MS Office Suite

Business Systems Analyst

Confidential, Lincoln, NE

Responsibilities:

• Collaborated with Business Stakeholders to gather correct requirements to enhance Salesplace functionality.
• Responsible for resolution of various issues from Business Stakeholders as a liaison between Business and IT department.
• Responsible for architecting integrated HIPAA, Medicare Solutions, and Facets.
• Facilitated the organization and reviewed deliverables process related to the HIX/IES project by EOHHS staff to PMO resulting in decrease of the turnaround time of documents by 5 days each review cycle.
• Managed sub-projects of the HIX/IES project in relation to supporting EOHHS efforts on the project.
• Responsible for verifying the plan's pricing and illegibility of policy holders in regards to ACA (Affordable Care Act).
• Led JAD sessions to identify the business flows and determined whether any current or proposed systems were impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA.
• Validated the following Transaction Processing: 837 (Health Care Claims or Encounters), 834, 835 (Health Care Claims Payment/Remittance), 270/271 (Eligibility Request/Response), 834 (Enrollment/Dis-enrollment to a health plan.)
• Ensured deliverables met SSA's general policy/standard such as Security Standard, 508 Compliance Standard, etc.
• Lead collection and organization of hospital production materials for metadata sourcing.
• Understand Cúram Case Management functionality and Used Cúram for Income Support for Medical Assistance, Life Event Management, Social Program Management Platform, Universal Access and Verification Engine.
• Designed and developed Building Infrastructure Service, Business Layer, and Data Access Layer components, and performed Unit Testing Framework for the WCF web service using Visual Studio 2010, .Net framework 3.5 and C#.
• Used Informatica to extract and transform data from various DB2 database to the data warehouse.
• Used Test Director and Mercury Quality Center for updating the status of all the Test Cases, Test Plan & Test Scripts that were executed during testing process.
• Assisted project teams in preparing Functional Specification Documents (FSD), Business Specification Documents (BSD), User Interface Design Documents (UI) and Supplementary Specification Documents (SS).
• Conducted various Joint Application and Design Sessions with participants (including Business, Deployment and Support personnel) from across the globe.

Environment: MS Project, MS Excel, MS Access, MS Visio, UML, SDLC, JAD, SQL, XML, Clarity, Visual Basic, TOAD.

Business/Systems Analyst

Confidential, Austin, TX

Responsibilities:

• Responsible for handling various issues from Business and acted as a liaison between Business Stakeholders and IT Development.
• Collaborated with key Stakeholders and Business Users to understand and analyze the business needs and data to model the target business processes.
• Reviewed deliverables on behalf of EOHHS and reported issues to HIX/IES project lead/team prior to JAD and review sessions.
• Supported the Centers for Medicare and Medicaid (CMS) and primary vendor (CSC) in the development of 508 compliant.
• Implemented Junit test case in curam framework.
• Reviewed and provided comments to upper management on functional and technical designs for CURAM extensions and configurations such as workflow and/or rules.
• Worked on Curam Workflow API for the Enactment of task.
• Created QA test strategy documentation for use with 508 Compliancy for client.
• Responsible for developing and implementing business requirements for compliance with the Affordable Care Act.
• Responsible for all activities happening on the IES activities of the HIX/IES project, including changes to mahealthconnector.org website and working with Project Teams.
• Analyzed Business Requirements and segregated them into high-level and low-level Use Cases, Activity Diagrams/State Chart Diagrams (UML).
• Responsible for analysis of AS-IS system and developed the TO-BE system concept and prepared the System Process Maps.
• Responsible for HIPAA EDI transactions such as 834, 835, 837 (P, D, I) 276, 277, 278.
• Converted Business Requirements to the Functional Specification and Conducted JAD Sessions to develop an architectural solution that the application met the business requirements, resolved open issues, and change requests.
• Performed GAP Analysis of claims and enrollment business process for changes from SSN identifier to USI (Unique Subscriber Identifier) affecting for HIPAA EDI X12 transactions 837, U277, 276/277, 270/271, 278,835 and 820.
• Updated and maintained the project plan, budget spreadsheet, and quality process assurance documentation.
• Responsible for writing Functional Requirement Specifications (FRS) and point of contact for System Requirement Specification (SRS).
• Produced detailed description of User Stories, Business Rules, Flows, and Data Elements required in developing new and modifying existing products.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models.
• Mapped data elements to capture transactions coming from Trade Order Management Systems.
• Resolved issues related to requirements during system testing and UAT plan preparation.
• Created Activity diagrams and Use Case Diagrams (UML Diagrams) using Rational Rose.
• Performed GAP analysis between current system and the requirements.

Environment: J2EE, MS Project, MS Access, MS Visio, UML, Borland Caliber/RM, SQL, FIXML, MS SQL, MS Office.

Business/Systems Analyst

Confidential, NYC, NY

Responsibilities:

• Gathered legacy business requirements through interviews Customer Service Representatives (CSRs), Customer Relationship Representatives (CRRs), prepared questionnaires, and identified limitations in the current system and GAPS in the proposed system.
• Performed extensive data modelling to differentiate between the OLTP and Data Warehouse data models.
• Used Rational Rose for creating the Use Cases Diagrams, Activity Diagrams, Class Diagrams, and Sequence Diagrams, etc.
• Performed System Testing of the Claims Processing Systems (Pricing Rules, Duplicate/Limits validation, Member Eligibility, Provider Enrollment).
• Responsible for understanding the Business Process and the Functional Specifications of the entire web sales process that included Underwriting, Evaluation, Enrollment, Membership and Billing, and the Vendors Business Processes.
• Reviewed documents/templates to create BRD and implemented the RUP process, identified Gap Analysis and the AS-IS and TO-BE model.
• Met with various HMO, PPO, Medicaid/Medicare, and Tricare/Campus Representatives discussing benefits of contracts on behalf of facilities or appeals from denials and compliance issues.
• Created Mapping Documents, Report Mockups and modified existing report mockups and finalized for development.
• Created Use Cases, Activity Report, Logical Components to extract Business Process Flows and workflows involved in the project using Rational Rose, UML and Flow Chart Tools such as MS Visio.
• Collaborated with Project Manager to analyze change requests from business side to determine the change of scope and distribution of tasks between mainframe and Business Process Models (BPM) development teams.
• Prepared Business Process Models (BPM) that included modeling of all the activities of business from conceptual to procedural level.
• Presented the requirements to the Development Team and Management in the form of Mathematical Business Rules, Scenarios and User Stories.
• Created and maintained data model/architecture standards including master data management (MDM).
• Created documents such as Business Glossary to facilitate the other teams in understanding client business in Requisite Pro.

Environment: UNIX, .NET Framework, UML, Rational Rose, MS Project, MS Access, MS Visio, OOAD, Sybase, SQL, Oracle, MS Office Suite.