SUMMARY:

• Over 7+ years of extensive experience working as a Business/ Data Analyst
• Experienced in SQL queries to extract data from various databases for data analysis.
• Working knowledge of analytics and reporting using SAS
• Experience in interacting with stakeholders, business team, project sponsors, to understand the system requirements and delivery of project.
• Experience in the complete life cycle of project development (SDLC) and using Agile, Rational Unified Process (RUP) and Waterfall methodologies.
• Significant expertise in creating business requirements documents and functional requirement documents, developing business process flows and conducting cost benefit analysis
• Strong knowledge of Project Management skills such as time and cost estimation, task identification and WBS, and scope management.
• Organized many Joint Application Development sessions (JAD), process flow work sessions and User stories board meetings.
• Conducted interviews, workshops and requirement elicitation sessions with end - users, clients, stakeholders, development groups and Subject Matter Experts (SMEs).
• Performed GAP analysis documenting variances and suggesting steps to overcome the gaps
• Conversant in designing and defining user interface requirements prototypes, screen mockups, story boards and defining elements and business rules around the same.
• Proficient in developing and executing test cases performing functional, usability and stress testing to ensure that the product meets the system requirements.
• Experienced in users and developing manuals
• Strong team building, conflict management and time management skills.
• Excellent communication and interpersonal skills.
• Well versed at managing multiple projects simultaneously.

TECHNICAL SKILLS:

SDLC Methodologies: Waterfall, Agile, RUP

Tools: BluePrint, Share Point, MS Visio, MS Project, MS Office, Rational Requisite Pro, Rational Rose, MS BI Visual Studio, JIRA

Testing Tools: Quality Center (QC), Quick Test Pro (QTP), LoadRunner

Databases: MS SQL Server, Oracle

Operating Systems: Windows 7/.Net/XP/2000 UNIX

PROFESSIONAL EXPERIENCE:

Confidential

Business/ Data Analyst

Responsibilities:

• Executed Cost Benefit Analysis by coordinating with different work groups for estimating different operational and capital project costs and presented to finance committee for approvals.
• Performed descriptive statistical analysis employing SAS. Worked closely with ClientOperations team to determine the savings on postage from providing electronic retrieval of EOBs and bills and the possible target audience to build a strong business case.
• Created reports using SQL to assist business in better understanding of business requirements. Worked extensively with Market Analytics and Provider Contracting to provide the figures on attributed members from other states living in RI to get a better insight of possible revenues from participating in Value Based programs and building a brand new CBF functionality (Blue Cross ITS format for Interplan Financial transactions).
• Liaised with multiple business stakeholders, Subject Matter Experts, cross functional teams, design & development teams to elicit comprehensive business requirements by conducting interviews & facilitating consensus through JAD sessions
• Reported, documented & managed Business Requirements at Blueprint and Share Point
• Led work sessions to perform GAP analysis of As-Is and To-Be business processes and designed/revised business processes and operational workflows using MS Visio.
• Worked extensively with EDI, Account Implementation,, Underwriting and Broker Relations teams to define and accommodate processes on Group onboarding on exchanges, group set up, group renewals, group removals from exchanges and termination from BCBSRI coverage, maintenance and support, billing discrepancies, 834 file and XML group set up and support process, new product set up, sales and presales process, broker access and operations, Daily operational activities, User and group re, Rate loading process and audit control points on rates loading.
• Worked on analyzing the GAP and accommodating the changes in the existing BCBSRI provider network maintenance flows and facilitating discussions to design flow to accommodate CharterCare out-of-network authorizations by vendors doing authorizations for high-end radiology and Behavioral health.
• Facilitated discussions with heads of various departments including Provider contracting, EIM, Market Analytics, Finance, Legal, Market Implementation, FACETS configuration etc. to decide on claims/ CBF (Blue Cross ITS format) path to bill other plans and designing the work flow for Interplan financial settlements between sister blues for Value Based programs like ACO and PCMH.
• Analyzed BCBS Association and Healthcare mandate documents for defining future state business processes and business requirements to be followed as mandate
• Facilitated project manager on BCBS Association’s on-site visit to address open questions on CBF capabilities under Payment Innovations - Interplan Financial settlement project. Coordinated among business stakeholders and owners to define all concerning questions.
• Worked extensively with outside vendors on different projects to understand their systems capacities and managing BCBSRI business requirements and process flows accordingly.
• Conducted project kick-off meetings, process flow review presentations, requirements walkthrough meetings, Business analysis weekly team huddles etc.
• Worked closely with Business analysis team to make team processes continuously more efficient.

Environment: Waterfall Methodology, Agile, MS Visio, MS Office, MS Share Point, BluePrint, SAS, MS SQL

Confidential, Providence, RI

Business/ Data Analyst

Responsibilities:

• Facilitated sessions with senior agency staff to identify the business flows and determined whether any current or proposed systems are impacted by the EDI X12 Transaction Code Sets and Identifier aspects of HIPAA.
• Produced reports through Impact Analysis on system, data, technology, providers and clearing houses, enabling recommendations and best practices for becoming HIPAA compliant.
• Involved in developing Project Plan, detailing the tasks and effort required to achieve HIPAA compliance.
• Elicited, documented and managed Business and System requirements for HIPAA 5010 version 837, 834, 835, 270, 271, 276, 277 transactions through requirements gathering sessions with stakeholders.
• Performed Gap Analysis between HIPAA 4010 and 5010 and involved in evaluating benefits of new system with the Management team to strategize solutions to the process of HIPAA compliance.
• Deployed reportsin MS SQL Server and SAS
• Worked withSharePoint Server 2007while deploying SSRS reports.
• Created Vision, Scope, and Use Case documents, Business Process Models, System Models depicting software architecture and interaction of system components.
• Involved in developing Business Requirement Document, System Requirement Specification document for application development.
• Maintained Requirement Traceability Matrix, Change Requests.
• Coordinated work plans between project manager and stakeholders using MS Project.
• Utilized Waterfall methodology to configure and develop process, standards, and procedures.
• Coordinated Joint Application Development (JAD), Interview sessions with stakeholders throughout SDLC to resolve open issues.
• Worked with QA managers, developers to get sign offs after internal, external and system testing.
• Reviewed Privacy regulations of HIPAA and documented changes for developing PHI privacy policies for member, group employer and agents.

Environment: Waterfall Methodology, Rational Requisite Pro, Visio, SQL 2005, SAS, MS Project, MS Office, MS Project, Win Runner, Share Point 3.0, UML, Rational Clear Quest

Confidential, Long Beach, CA

Sr. Business Analyst

Responsibilities:

• Accumulated customer requirements from various end users through surveys, interviews and JAD sessions and analyzed the requirements..
• Developed User Business Requirement Document (BRD), Technical Requirement Specification andFunctional Requirement Specification (FRS) using Requisite Pro, Rational Rose and MS Visio.
• Designed and developedUse Cases, Class Diagrams, Activity Diagrams, Sequence Diagrams and End to End Scenarios using UML.
• Prepared Work Breakdown Structures (WBS) to comply with the triple constraint: time, cost and scope
• Prepared a roadmap for a product that can exceed market and user expectations
• Responsible for meetings with users and stakeholders to identify problems, resolve issues and improve the process to ensure a stable and accurate solution.
• Created and implemented a Test Plan, UAT Plan and UAT Test Cases and thereby assisted Quality Analysts to test the product in a timely manner
• Coordinated and tracked project communications and also maintained project schedules and milestones.
• Interfaced with top management to ensure that IT initiatives and involvement are clearly communicated and understood
• Mitigated risks all the time; motivated all the team members to meet the deadlines since time was very limited

Environment: Rational Requisite Pro, MS Visio, MS Office, Java, MS SQL Server, QTP

Confidential, Madison, NJ

Business Analyst

Responsibilities:

• Conducted interviews, live meetings and JAD sessionswith business users and Subject Matter Experts (SME’s) to understand the As-Is system and gather requirements for the To-Be system.
• Analyzed the pre-existing documents to have a better understanding of the present system.
• Developed Functional Requirement Specifications (FRS) from BRD and communicated it to the developers
• Met with variousHMO, PPO, Medicaid/Medicare Representatives discussing benefitsof contracts on behalf of facilities or appeals from denials and compliance issues.
• Presented to Stakeholders explaining the gaps in the system and how the changes would affect different modules with respect to Medicare.
• PerformedGap analysisto understand the best way of incorporating the changes in the system with respect toPOS.
• Developed a use case and UML diagrams using ERD; depicted clear relations associated between the entities.
• Worked on changes regarding newCMS directivesandproposed changes to be made in the current system.
• Worked with Source systemSubject Matter Experts (SMEs)to ensure that the extracts are properly mapped.
• Developed detailedTest plans, Test Cases, Test scripts for testing the functionality, GUI and security testing.
• IntegratedRequisite Pro with Rational Roseto provide all teams’ visibility and maintained tracks among requirements, use cases and change requests.
• Assisted in writing test case scenarios for regression testing andend-to-end testing.
• Assisted with user testing of systems and maintainedquality proceduresand ensured appropriate documentation is in place.
• Assisted end users and IT staff in the use of data to satisfy informational and reporting requirements and in implementation and usage of SQL and DBMS.

Environment: MS SQL Server, Rational Rose, Rational Requisite Pro, Rational Clear Case,MS Visio, MS Project.

Confidential, Richmond, VA

Business Analyst

Responsibilities:

• Interacted with the stakeholders by interviewing them, by preparing questionnaire and getting feedback.
• Communicated Project Requirements, Business Issues, Solution and made recommendation.
• Responsible for defining the scope of the project, gathering business requirements, doing gap analysis and documenting them textually or within models
• Analyzed and documented Business requirements and detail design of the software for full understanding of the business
• Supported the assigned project manager with creating detailed project plans and assisting in developing, scheduling and tracking project timelines.
• Identified KPI aligning with business rules.
• Create Use Case using UML tools and Process Analysis tool such as Fishbone Diagram, and business process flow chart using MS Visio.
• Created use case scenarios and documented workflow and business process.
• Prepared the UML Use Cases using Rational Rose
• Used MS Visio for flow-charting, process model and architectural design of the application.
• Documented business workflows textually as well as in UML diagrams according to RUP for the stakeholder review.
• Produced requested reports and ran analytics using SAS.
• Conducted JAD sessions to allow different stakeholders to communicate their perspectives with each other, resolve any issues and come to an agreement quickly.

Environment: RUP, Rational Requisite Pro, Rational Rose, Visio, SQL 2008, SAS, UML Diagrams, Quality Control, Test Director.

Confidential, Columbia, MO

Business Analyst

Responsibilities:

• Acted as a primary liaison between business lines, operations, and technical areas throughout the project cycle.
• Conducted JAD sessions and meetings with developers, QA team, and users for communicating primary requirements, also discuss different versions of requirements, queries, and clarify the issues.
• Participated in writing data mapping documents and performing gap analysis to verify the compatibility of existing system with new business requirements.
• Created Requirements Traceability Matrix.
• Reviewed Business Requirements Documents and the Technical Specification.
• Design UML diagrams like Use Case Diagram, Class Diagram, Sequence Diagram, and State - Diagram for project documentation using MS Visio.
• Coordinated UAT and executed environment build plans.
• Wrote SQL Queries to perform Data Validation.
• Organized and Performed GUI Testing, Functional Testing, Regression, and support for User Acceptance Testing (UAT).
• Involved in defect tracking and bug management using Rational Clear Quest.
• Planned, scheduled, and controlled projects based on plans and requirements outlined by the business.
• Interacted with developers to report data related bugs and re-tested the fixed issues.
• Involved in providing input for Modification and Enhancement Requests.
• Involved in meetings, walkthroughs and creating minutes of the meeting.
• Created and submitted weekly status report to the project manager.

Environment: J2EE, Java Script, HTML, Oracle, MS Visio, Rational Requisite Pro, MS Office