SUMMARY:

• Over 8 years of professional experience as a Business Analyst working on gathering business and application requirements, Business Processes, identifying risks, impact analysis, UML modeling, and Sequence and Activity Diagrams using Microsoft Visio in Clinical, Pharmaceutical and Health Information Management (HIM) processes.
• Extensively worked on analysis & compliance of ICD 9 to ICD 10 and HIPAA (Health Insurance Portability and Accountability Act) 4010 and 5010 EDI transactions.
• Experience with Medicare, Medicaid and commercial insurances in HIPAA ANSI X12 formats including 270/271, 276/277, 278, 820, 834, 835, and 837.
• Proficient in authoring Business Requirement Document, Narrative Use Cases, creating Use Case diagrams, Sequence Diagrams, Activity Diagrams and other UML based diagrams using MS Visio.
• SAS Certified Clinical Trials programmer and Certified Base SAS programmer using SAS 9 with strong knowledge on the clinical trials process, accessing, managing, and transforming clinical trials data, statistical procedures and macro programming, reporting and validating clinical trials data.
• Sound knowledge of Patient Protection and Affordable Care Act (PPACA).
• Extensive knowledge about the various types of health insurance programs such as: Medicaid, Medicare (Part A, B, C and D), PPO (Preferred provider organization), and HMO (Health maintenance organization).
• Extensive Experience in all the phases of Software Development Life Cycle including: Requirements Gathering, Feasibility study, Analysis, Design, Development, Testing, Deployment and Maintenance. Also worked using various methodologies such as Agile Software Development, Rapid Application Development (RAD), Joint Application Design (JAD) and Prototyping.

TECHNICAL SKILLS:

Knowledge of 6: Sigma, Lean, process analysis and improvement tools

Good knowledge of statistical tools: SAS and SPSS

Methodologies: UML, RUP, Agile/Scrum, Waterfall, SDLC, RAD, JAD and Prototyping

Project tools: MS Project, MS Visio and Rational Rose

Documentation: MS Excel, MS Word, MS PowerPoint, and MS Outlook

Database: MS SQL Server and MS Access

Operating systems: Windows XP/7/8/8.1/10, Mac OS

Statistical software: SAS and SPSS

PROFESSIONAL EXPERIENCE:

Confidential, CA

Senior Business Analyst

Responsibilities:

• Assisted in the collection, analyzing and documentation of the requirements and the experiment hypothesis.
• Supported activities around business use case development, test execution, and summarization of results.
• Participated in weekly calls for strategy, design and roadmap discussions.
• Developed a streamlined process to relay the requirements from the business team to the technical team.
• Designed workflows, created SOP’s, and documented business, functional, privacy (HIPAA, 21 CFR part 11, Safe Harbor) and security requirements for a cloud based data sharing platform for Data Scientists.

Confidential, Waukegan, IL

Business Analyst

Responsibilities:

• Identified improvements & implemented systems which achieved a 70% lead time reduction in master data approval process
• Coordinated with GDSN vendors to integrate internal systems to GDSN pool for GS1 master data export
• Deployed GDSN data synchronization solutions to export GS1 data related to US & European markets
• Elicited, presented and documented requirements related to Gxp serialization Track and Trace (TnT) enterprise systems
• Re - designed business process to accommodate serialization TnT regulations
• Lead system analysis for Packaging, Distribution & Enterprise level Gxp serialization TnT systems
• Performed GAP analysis on existing systems to prepare a roadmap to make the systems 21CFRPart11 compliant
• Coordinated with Turkey and China affiliates for TnT regulatory reporting right from the initial phase to go live and production support
• Mapped the current and future state process
• Interacted with cross-functional teams to gather / document business and user requirements, translate high level requirements into detailed functional requirements
• On average managed requirements on 3 medium-high impact projects simultaneously, assisted project manager in project scope definition and time line estimation
• Designed user experience and prototyped user interfaces to ensure optimal usability
• Provided subject matter expertise and managed day to day relationships with 5 internal and external application vendors
• Prepared test scripts and coordinated UAT with end users, trained and supported end users during and after system deployment
• Worked with external partners to develop processes to exchange serialized data
• Identified & presented opportunities for future process improvement to all stakeholders
• Interacted with cross-functional teams, gathered and documented business & functional requirements
• Created knowledge base about GxP serialization TnT systems for ITSM level 1 support

Confidential (Springfield, IL)

Business Analyst

Responsibilities:

• Primary role was to collect requirements from the business user and facilitate developers in understanding the NCPDP -D.0 and 270/271 programming changes needed for real time and Batch process.
• Prepared initial ICD-10 impact analysis document for various Bureau and sister agency of HFS.
• Performed UAT testing for Bureau of Technical Support user for NCPDP D.0 and 270/271 project.
• Extensively used REV transaction in internal mainframe program to see we are returning correct service type code for each recipient with specific REV BLOCK CODE assigned.
• Performed Medical Electronic Data Interchange (MEDI) testing for NCPDP claim and status inquiry screen
• Performed MEDI testing for Eligibility Screen (270/271).
• Prepared the Gap analysis document for various transaction types of D.0 version and X12-270/271.
• Prepared the Business Requirement Documents for various transaction types of D.0 version and X12-270/271.
• Prepared the Functional Requirement Documents for various transaction types of D.0 version and X12-270/271.
• Prepared the Business Requirement Documents for ICD-10 changes impacting various bureaus.
• Provided analysis, understanding and business perspectives on many operational issues.
• Prepared comprehensive test strategy, testing plan, test cases, execution plan and migration plan for each of the component.
• Performed UAT testing for NCPDP-D.0, and 270/271 project.
• Developed and documented Test plan and Test cases for the given requirement and executed Test cases for defects finding.
• Reported the providers and vendor transition report to higher management on progress of 5010 and D.0 transactions.
• Worked on multiple Projects related to Pharmacy system along with core project,
• Pharmacy Pricing changes
• Narcotic Prior Approval Requirement
• Brand Name and Generic Name determination
• ECP IRDB sequence change
• Illinois Cares Rx Copay and Co-Insurance increases
• 90-day supply of certain drugs
• DRUG Prior Approval system

Confidential, MI

Business Analyst

Responsibilities:

• Worked as a BA for an email alert system project which checks outbound warehouse order transactions and reports the missing data via email to the EDI administrator.
• Developed the Business and System Requirements documents.
• Participated in meetings with different middleware vendors.
• Documented the technical requirements for middleware programmers.
• Worked with the development team in creating partner profiles of different trading partners.
• Prepared XML containing email addresses of the recipients.
• Prepared user manuals used to train in-house staff on basic middleware.
• Partnered with leads to obtain clear, concise and accurate project status in a timely fashion.
• Lead the team meetings on status updates, issue resolution, track bug report, and postfix analysis.
• Communicated the project plan tasks, s and status to Project/Program Management on a weekly basis.

Confidential

IT Analyst

Responsibilities:

• Reviewed business process, URS, and functional requirements.
• Assisted in process modeling; conducted and participated in JAD sessions with system users; helped with design walkthroughs with stakeholders for base lining architecture.
• Involved in detailing project mission, data process flow diagrams, and timelines.
• Worked with SQL queries for data manipulations.
• Developed a streamlined process to relay the requirements from the business team to the technical team.