SUMMARY

• Over 7 years of IT experience in Healthcare/Insurance industry with strong understanding of Business Requirements Gathering, Process Flow, Business Process Modeling, and Business Process Re - engineering.
• Extensive experience in Agile and Waterfall methodology to elicit, analyze, specify and verify Business and Functional Requirements.
• Expertise in Creating Unified Modeling Language (UML) diagrams such as Use Case diagrams, Activity Diagrams, Class diagrams, Sequence diagrams and Domain Models using MS Visio.
• Facilitate Joint Application Development (JAD) and Joint Resource Planning (JRP) sessionswith management, SMEs, vendors, users and other stakeholders.
• Experience working with the business users as well as the senior management for web-based and desktop based applications.
• Expertise in data mapping process, and gathering requirements using various Brainstorming techniques and focus group interviews.
• Excellent technical documentation skills in preparing Business Requirements Document (BRD), Use Case Document, Functional Requirement Document (FRD), Software Requirements Specification (SRS), Workflows.
• Sound understanding of Object Oriented Analysis & Design (OOAD) and documentation of AS-IS and TO-BE business processes. Adept at using Gap Analysis techniques to gain a clear understanding of the AS-IS process of the system and additionally derive new user scenarios to understand the potential TO-BE process.
• Experience in creating and managing project templates, use case templates, test case templates and Requirement Traceability Matrix (RTM)
• Closely liaison with the QA team to conduct User Acceptance Testing (UAT), SWOT analysis and document Test Cases.
• Experience in creating User Manuals for training internal customers and End Users.
• Strong communicator and problem-solver skilled at analyzing/eliciting business needs.
• Excellent communication skills (written and verbal), ability to proactively build relationships with other team members and interact with Business Units and all levels of Management within the organization

PROFESSIONAL EXPERIENCE

Confidential, Minnetonka, MN

Lead Business Analyst

Responsibilities:

• Lead a team of business analysts both onsite and offshore for requirements gathering for correspondence and report generation within the Correspondence Report Competency Center at Medica for the Phoenix program.
• Coordinate with Minnesota Health Exchange (HX) program staff and other stakeholders to define and develop requirements for correspondence generation across various business lines.
• Follow a tight agile methodology, lead sprints and prioritize line items based on key business initiatives with respect to the ACA mandate and Health Care Reform Act
• Lead JAD sessions for requirements gathering with subject matter experts from each work stream/business unit for particular correspondence lifecycles, process flows, triggering conditions etc. for development within the HPExstream environment, translate business requirements into a functional document and solution design.
• Create data mapping documentation including standardizing and validating data tags, creating data dictionaries for new and existing correspondences and reports for the purposes of data analysis. Work closely with HPExstream, Click 4 Care and Health Rules developers to understand system specifications and formulate requirements to align with these specifications.
• Help develop integration solutions that create interoperability between Health Rules, Click 4 Care and HP Exstream.
• Track user stories, burndown hours and project progress in Version 1 for correspondence and reports efforts across various work streams, participate in daily scrum calls, provide status reports, impediments and milestones to scrum masters to meet tight project deadlines. Raise issues and escalations in IRAAD as possible threats to project deadlines.
• Lead Member Experience Review Boards to gather a user experience perspective on content, usability and readability of correspondences. Liaison closely with content writers to align the content to specific and unique business needs.
• Devise workarounds, make recommendations and modify procedures to solve intricate problems considering system capacity and limitations, operating time, and desired business results.
• Work with Quality Assurance team to validate system acceptance and user acceptance test plan and test scripts.

Confidential, NY

Sr. Business Analyst

Responsibilities:

• Worked with theSME's,Stakeholders,Project ManagerandseniorBusiness managersin defining, documentingand diagramming the business needs andBusiness Process flow.
• Producedfunctional specificationsandledweeklymeetingswithdevelopersandbusiness unitsto discussoutstanding technical issuesandupcoming deadlines.
• PerformedChange Request Processto handle the changes in the requirements of theapplication.
• Used the guidelines and artifacts of SCRUM to strategize the implementation of SCRUM process effort in different iterations and sprints Definition, Development and Deployment of the SDLC methodology.
• Involved in analyzing and new modules CPOE, Patient Portal, Documentation management System and enhancements in existing module Administration, Physician of the application.
• Acted as a liaison between subject matter experts, system users and managers to gather requirements, worked with technical architects to provide assistance in understanding requirements.
• Conducted JAD sessions to refine prototypes, prioritize and time-box use cases with management, SMEs (Subject Matter Experts), users and other business managers.
• Involved in reviewing existing documentation for current systems to create AS-IS and TO-BE processes for Gap analysis.
• Involved in performing Risk Analysis on CPOE, internal messaging, administrative and reporting module of the application and came up with contingency plans.
• Created Business Requirements Document (BRD), Screen Mockups, Use Case Document, Use Case diagrams, Activity Diagrams and Flow Charts. Generated initial use-case diagrams using UML in MS Visio.
• Involved in creatingprototypesfor the differentmodulesof theapplicationto helpStakeholdersandBusiness Users Visualizetheapplication.
• Worked extensively asTest Leadwith theQA(Quality Assurance) team for designing andevaluating Test Plan,Test System,Test DataandTestCasesfor the application
• Conductedfunctional walkthrough,User Acceptance Testing(UAT)sessions, andsupervisedthe development of the usermanualsfor thecustomers.
• Involved in usingQuality Centerformanaging the defect. Performed manualBack-End testingby writingSQL Queries for validatinguserinformationin the tables.
• Coordinated with thedevelopment team,data warehousingteam andQA teamthroughout all phases of theSCRUM methodology.

Confidential, Tampa, FL

Business System Analyst

Responsibilities:

• Gathered requirements and prepared business requirement documents (BRD).
• Responsible for translating BRD into functional specifications and test plans. Closely coordinated with both business users and developers for arriving at a mutually acceptable solution.
• Conducted JAD sessions to define the project and to reduce the time frame required to complete deliverables.
• Used Rational Rose/MS Office Suite for creating use cases, workflows and sequence diagrams according to UML methodology thus defining the Data Process Models.
• Defined Use cases from requirements and helped convert them into software specifications.
• Involved in HIPAA/EDI Medical Claims Analysis, Design, Implementation and Documentation.
• Involved in preparing the Test Scenarios for Health Care Claim Payment/Advice.
• Written multiple Use Cases for multiple transactions include 837I, 837P, 835, 276, 277, 270, 271,852,867(both inbound and outbound) transactions.
• Maintained Requirement Traceability Matrix (RTM).
• Use Case development and UML modeling using modeling tools like Rational Rose/MS Visio.
• Presented the nursing outcomes to C-Level executives in Gentiva Nursing and Data Management group using Crystal Reports XI.
• Analyzed business needs, created and developed new functionality to meet real time data integration that facilitated decision-making.
• Created product documentation, printed user manual and training materials.
• Developed queries using SQL to automate the weekly and monthly “Meds Update Reports” and FCO reports.
• Coordinated Regression Testing and created test scenarios for User Acceptance Testing (UAT).
• Maintained documents for change request and implemented procedures for testing changes.