Business Analyst Resume Profile, NY - Hire IT People

Summary:

Around 7 Years as Business Analyst with multiple full lifecycle implementation experience on various Health Care Systems. Accomplished and fluent communicator with strong investigation, problem-solving and decision-making skills, combined with a pragmatic approach and sound business acumen. Highly experienced in analysis and requirement gathering, business process mapping and the development of interactive prototypes.
Gathered and documented requirements, defined scope and handled stakeholder communication.
Prepared flow charts and system diagrams to assist in problem analysis.
Prepared test data scenarios for unit, string and parallel testing, and resolved customer issues with software solutions, responding to suggestions for improvements and enhancements to products as necessary.
Designed, evaluated, configured, tested and documented applications based on system and user requirements.
Worked in multiple projects in current organization and was responsible for engaging with various stakeholders, requirement engineering, solution assessment and validation, implementation, handing over deployed solution to business-as-usual ongoing maintenance.
Analyzed business requirements, processes and system integration considerations to determine appropriate solutions.
Worked in projects that involved coordination with various vendors including BlueCross Partner Plans, HealthCare provider institutions, Pharmacy Benefit Manager - Caremark, Catamaran, Truven Health, Eyemed, MedSol, Mckesson, Connecture, BCBS Association, State of Vermont, TwoBolt.
Experience in leading multiple projects involving DataStage, Business Objects, Java CAPS, Mainframe, WTX, Sterling, CA7, vendor products from requirements to implementation.
Experience in Problem resolution and defect tracking by applying ITIL practices for defect management.
Studied the different systems that exist in Health-care insurance and their functional impact and the work flow in the insurance system.
Experience in creating solutions for client in different Business applications used in Healthcare like CCMS Care management , BCBSA proprietary ITS, PBM Pharmacy Benefit Manager , CALLIDUS Broker Commissioning System , Facets LRSP Claims adjudication system, Group Rating System.
Assisted users to solve operating problems.
Conducted peer reviews of program specifications and program codes against coding standards and user requirements.
Extensive work experience of databases like Netezza, Oracle, SQL Server, DB2, MS-Access.
Mentored and guided peers across different geographical locations.
Responsible for designing, developing, and implementing system testing of the various requirements as requested by clients.
Conducted efforts estimations and implemented work products.

Technical Skills

Business Area	Benefit Analysis, Claims, ITS, HIPAA 837 transactions, Healthcare, Care management, PBM, Membership Enrollment, Medicare, HIPAA 5010, ICD10, HealthCare Reform, X12s, EDI transactions.
Data Base	Oracle, Netezza, MS-Access, DB2, SQL Server
Business Applications	Microsoft Office Suite- MS Word, Excel, Outlook, PowerPoint, Access, Visio, Lotus Notes.

Certifications

Dell internal CBAP course.
IBM certification for DB2.
ITIL V-3 Certification.

Professional Experience

Confidential

Business Analyst

Brief description of Job duties

Assisting with Business case and requirement analysis.
Define and document business and functional requirements.
Acts as a liaison between all stakeholders in developing or ehancing system and ensure optimal operational performance.
Planning and Monitoring Business requirements.
Elicitation of requirements, documentation, requirements management and communication.
Solution scoping and requirement/ design reviews.
Analyzing user requirements and providing software solutions.
Creating Estimates and Implementation plans.
Overseeing software design and customization for client use with the aim of optimizing operational efficiency.
Creation of Test Scenarios for approved business requirements and assisting tester on queries.
Assisting user to solve operating problems.
Analyzing system defects and providing resolutions.

Confidential

Business Analyst

Populate the member's primary diagnosis within the CCMS single source transaction as well as retro correct members.
Enhance Care Coordination Management system CCMS for ICD10. Objective is to achieve ICD10 compliance for CCMS applications. This ICD10 sub-project deals with CCMS upgrade including the interfaces to/from Customer Data Systems claims processing .
Implement Mckesson Clear coverage genetic Testing Preauth Software. Membership information to be sent and auths to be received.

Confidential

system Enhancements

Return, display Provider Addresses and details for termed providers.
Pega Bluelyncs 2J security - Restricted access to select staff for Work items, Cases for 2J protected members.
Automation of all letters which were created manually in Pega GAU Application. Update Medicare GAU letters in compliance with CMS regulations.
Automate and Update Medicare Customer Service letters per CMS mandate in BlueLyncs

We provide IT Staff Augmentation Services!

Business Analyst Resume Profile

NY

We'd love your feedback!

Resume Categories

Client Services

Job Seekers

Visa Sponsorship