Profile

• Above 11 years of Experience in IT and ITES industry
• Commanding knowledge in working for US based Health Insurance, Banking and Supply Chain companies
• Expertise in working on both Agile, RUP and regular SDLC projects
• Experience in consulting, development, implementation which includes Reporting, ETL, Configuration, Interfaces, Integration and satellite developments , maintenance, re-engineering and reverse engineering projects
• Expertise in Business Process Modeling for both Business Process Reengineering and Business Process Improvement projects with use of BPMN tools like
• IBM WebSphere BPM
• TIBCO
• Enterprise Architect
• MS Visio etc.,
• Expertise in identifying hidden opportunities and upselling solutions
• Expertise in writing business proposals for all types of business opportunities for existing and prospective customers.
• Commanding knowledge on EDI transactions for different industries like
• US Health Care
• Banking
• Supply Chain Management
• Expertise in Estimation, Project Planning and Project Management activities.
• Commanding knowledge on Business Analysis concepts like:
• Requirements Elicitation,
• Requirements Analysis,
• Requirements Planning and Management,
• Requirements Communication and
• Requirements Validation
• Expertise in Training on Business Analysis, US Healthcare, Supply Chain Management.
• Expertise in Requirement management tools like:
• Rational Requisite Pro,
• Caliber RM, and
• Visual Architect etc.,
• Commanding knowledge on methodologies like SDLC, RUP Workflow, Unified Modeling Language, Ontology etc.,
• Good knowledge in using defect tracking tools for QA like:
• JIRA
• HP Quality Center
• EDGE
• Macess etc.,
• Coordinate with technical team, designers, and architects, to translate business requirements into product/application features and functions. And help the technical team in decision making for the best possible solution for the business need
• Facilitate meetings/Capture meeting notes, and create project artifacts like:
• Business Requirement Documents,
• Use Case Documents,
• Wire Frames,
• Functional Specifications,
• UAT Plans/Cases and
• Functional Test Plans/Cases etc.
• Work with Data Conversion, Data Warehouse and Reporting team for Data conversion, Data Analysis and Data base mapping requirements and provide help in building data dictionary for the product/solution.
• Help PMO by providing support for defining project plans, WBS, estimation, strategic planning, contingency planning and risk mitigation planning etc.,

Skills

• Languages : PL/SQL Basics
• Operating systems : Windows
• Version Tools : Visual Source Safe, e-room, SharePoint
• Tools : MS VISIO, Rational Rose, IBM WebSphere Business
• Process Modeler, Visual Paradigm UML, Visual Architect, Enterprise Architect, BizAgi BPM.
• Documentation Tools : Caliber RM, Rational Requisite Pro
• Methodologies : SDLC, RUP, UML, AGILE, Ontology, BPM.
• Applications : MMIS, Facets, QNXT, MetaVance.
• Work flow tools : Macess, JIRA, e-room
• Defect tracking tools : JIRA, Lotus notes, Quality Center by HP.

Professional Experience 1

Confidential

ROLE: Functional Lead

Responsibilities:

• Leading a team of 7 business analysts working in customers' locations for coordination of work and implementation of eCAMS
• Define requirements management strategies for the following functional areas: Claims, Membership, Case Management, Care Management, Prior Authorization, Program Integrity and Managed Care.
• Update/maintain Requirements Specification and Detailed System Design documents
• Working as Business Lead and Subject Matter Expert SME by providing business expertise and direction for the Managed Care Enrollment functional team and Enrollee Medicaid Portal and Plan management.
• Manage assigned MITA Business Area scope and risks accountable for scope/risk management and ensuring change control management
• Lead a team of business analysts to validate requirements and conduct design to transfer a base system to meeting requirements of the customer.
• Identify gaps in business processes and potential opportunities to upsell solutions or create new products.
• Conduct cost vs benefit analysis for requirements which are not met by CNSI's product lines.
• Resolve issues within and between business areas
• Prepare WBS for the project and estimate the work effort and help the work plan manager for preparing project plan
• Participate in collaborative sessions to document Medicaid business processes
• Identify gaps and provide opportunities for product improvement and enhancements for CNSI's product lines.
• Help the technical team for Data Conversion, Data Mapping, User Interface screening, Report designing and planning etc.,
• Review ongoing MITA assessments and assist in the development of processes to achieve higher MITA levels.
• Also perform leadership activities for subordinates like hire resources based on project needs, train resources if needed or facilitate training needs based on project requirement, analyze and improve resource efficiency by nurturing them with new skillsets, mentoring subordinates, conduct appraisals, prepare, manage and track Performance Improvement Plans, manage budgets, prepare risk mitigation plans, prepare corrective action plans etc., for the project management activities.

Additional Initiatives:

• Preparing proof of concept for enhancing CNSI's existing eCAMS Electronic Claims Administration and Management System application for enhancing to venture into Commercial markets by making eCAMS which is presently customized for Medicaid business as a competition to commercial products like Facets, QNXT, MetaVance etc., and also serve Medicaid customers.
• Working on Proposals for State of Vermont and State of Missouri.

Prior Experience 1

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Conduct requirement workshops in customers' locations and understand their existing application, processes, supporting systems and its dependencies.
• Perform a current state assessment of the customer's business, and prepare BPMN Diagrams for future state.
• Prepare the initial Business Cases for Implementation.
• Help the leadership team for estimation, project planning, resource planning etc.
• Identify existing deficiencies and prepare plan for upgrading to cover all gaps and deficiencies, by creating requirements for satellite application developments and business process changes.
• Create deliverables like, use cases, business designs, test plans, user manuals etc.
• Maintenance of Requirement Traceability Matrices for the all project implementations.
• Help the development team to address business needs, gaps and deficiencies, and help data conversion team for data conversion, mapping and reporting activities.
• Prepare and execute test plans, test cases for UAT and conduct UAT.

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Leading a team of 3 business analysts and 7 programmers working in customers' locations for reengineering their existing system
• Conduct requirement workshops in customers' locations and understand the processes and systems and its dependencies.
• Perform a current state assessment of the customer's business and prepare current state and future state BPMN diagrams.
• Run simulation using BPMN simulation tools.
• Prepare estimates of work efforts.
• Prepare the initial Business Cases for transition.
• Conduct Cost Vs Benefit analysis for the change
• Identify existing deficiencies and prepare plan for upgrading to cover all gaps and deficiencies
• Mentor the associates for preparation of their deliverables like, use cases, business designs, test plans, user manuals etc.
• Maintenance of Requirement Traceability Matrices for the all project implementations.
• Help the development team to address business needs, gaps and deficiencies, and help data conversion team for data conversion, mapping and reporting activities.
• Provide demos for end users for using the new application.

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Leading a team of 9 business analysts working in customers' locations for coordination of work and implementation of MAPIR
• Conduct requirement workshops in customers' locations and understand the processes and systems and its dependencies.
• Perform a current state assessment of the customers.
• Prepare estimates of work efforts.
• Define project backlogs and sprints for the customers for implementation of MAPIR application according to their needs and deadlines according to the MITA and MMIS framework.
• Prepare the initial Business requirement documentations and business cases for each of the customers.
• Define Interface and Reporting requirements for the customers
• Mentor the associates for preparation of their deliverables like, use cases, business designs, test plans, user manuals etc.
• Maintenance of Requirement Traceability Matrices for the all project implementations.
• Maintenance of Best practices of MAPIR implementation
• Provide demos for customers' and end users for using MAPIR

Confidential

ROLE: Business Analyst Lead/Scrum Master

Responsibilities:

• Leading a team of 16 for development of MAPIR
• Prepare and maintain project plan and traceability matrix for MAPIR development
• Define high level use cases for estimation and work decomposition
• Define project backlogs and sprints for MAPIR development
• Prepare the initial Business requirement documentations and business cases for all compatible versions of MAPIR.
• Define basic Interface and Reporting requirements for MAPIR
• Mentoring the associates for preparation of use cases, business designs, test plans, user manuals etc.
• Maintenance of Requirement Traceability Matrices for the project development.
• Provide demos for customers' about MAPIR product

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Leading a team of 7 for development of Intelli Mapper
• Prepare and maintain project plan and traceability matrix for Intelli Mapper development
• Define functional decomposition of work
• Prepare the Business requirement documentations and business cases for Intelli Mapper.
• Mentoring the associates for preparation of use cases, business designs, test plans, user manuals etc.
• Maintenance of Requirement Traceability Matrices for the project development.
• Provide demos for customers

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Leading a team of 6 for development of Intelli Tester Suite
• Defined individual scope and test framework for impacted business areas line of business such as Claims, Membership, Medical Management, Product Benefits Management, Network Management, Contract Management, Provider Management, Profiling Management, Reporting Management, etc.
• Defined framework for testing EDI transactions inputs only which are impacted with shift to ICD-10
• Created common test plans for UAT, Functional Testing with the help of the BA team, and helped the testing team for preparing Integration, system, regression test plans and guided the technical team for preparation of unit testing.
• Defined business and technical scenarios for testing end to end
• Defined framework for testing for trading partners like providers and billing agents prospective, concurrent and retrospective
• Created reviewed test data for all possible types of business and technical scenarios, these can be tailored according to the needs of the customers.
• Helped the technical team for developing test environment.
• Provide demos for customers

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Leading a team of 6 Business Analysts for development of requirements for HPS claims area
• Prepare and maintain project plan and traceability matrix for claims area
• Define high level business design for claims area which was further used for estimation and work decomposition
• Conduct JAD sessions with other business areas to understand the dependencies and limitations in claims area
• Help the process team to define process documents for HPS project
• Prepare the initial Business requirement documentations and business cases for claims area.
• Prepare and review business process specification documents created by me and my team before presenting to the customers and other business areas
• Mentoring the associates for preparation of business process specification documents, use cases, business designs etc.
• Maintenance of Requirement Traceability Matrices for the project deliverables.

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Help the technical team to understand the process of migration from RTMS Real Time Membership System, product owned by HP to Facets Membership system
• Prepare and review mapping and interface requirements for the migration
• Prepare Gap analysis documents for migration
• Define scope for migration and prepare framework for ETL process
• Prepare Configuration documents for migration of base plans and customized group plans to Facets

Other initiatives include:

• Work with the sales team for hidden or new opportunities with current and prospective customers.
• Prepare proposals for new opportunities

Confidential

ROLE: Business Analyst Lead

Responsibilities:

• Recruit and groom resources on Business Analysis and US health care.
• Delegate and assign work efforts for the resources under me.
• Understand the customers present business processes and its systems.
• Prepare estimates of work efforts.
• Conduct requirement workshops from offshore through video conferencing.
• Prepare the initial Business requirement documentations.
• Mentor the associates for preparation of their deliverables like, use cases, business designs, wire frames etc.
• Maintenance of Requirement Traceability Matrices for the whole project.

Other initiatives include:

• Take up training at Organizational level for Business Analysis and US Healthcare
• Work with the sales team for hidden or new opportunities with current and prospective customers.
• Prepare proposals for new opportunities.
• Working on definition of Enterprise Business Architecture framework for Mpahsis Payer vertical .

Confidential

ROLE: Business Analyst

Responsibilities:

• Gather requirements from users and help desk logs to enhance the existing product.
• Prepare Functional requirements, Use cases, and review test cases prepared by the testing team for the enhancements.
• Conduct stake holders' analysis and Brainstorming sessions with the subject matter experts.
• Prepare Configuration scenarios for Alert Management
• Perform User Acceptance Testing

Confidential

ROLE: Business Analyst

• To define a framework for entire revenue cycle management, this includes ERA Electronic Remittance Advice , Reconciliation of Payments, Accounts Payables, and Accounts Receivables
• Responsibility in this project included was to prepare Use Case Documents, functional specification describing the business flow, and explain the specifications to the technical team for development and implementation of RCM solution.